February 14, 2005
CHAPEL HILL — Researchers at the University of North Carolina at Chapel Hill are collaborating with colleagues in Norway to study the effects that eating disorders among pregnant women have on these mothers’ newborns.The UNC and Norwegian researchers will conduct a population-based study of 100,000 babies born in Norway. The mothers are recruited for participation when they come to the clinic for their 17-week ultrasound.

The study focuses on how maternal nutrition, eating disorders, depression and anxiety influence pregnancy outcome and child development.

Norwegian researchers will collect blood samples and a wide variety of data from mothers, fathers and children, and store the blood and data for analysis. UNC researchers will play a key role in data analysis and publication of the results. They also will assist in designing questions for follow-up and will prepare additional grants to follow the children through the age of risk.

This study is believed to be the first to examine this cycle of risk in a single population-based group.

Some research suggests that women with eating disorders experience pregnancy complications more frequently than healthy women do, said Dr. Cynthia M. Bulik, the study’s principal investigator. Bulik is the William and Jeanne Jordan distinguished professor of eating disorders in the UNC School of Medicine’s department of psychiatry.

Individuals with eating disorders are more likely than healthy individuals to have a history of birth complications themselves, Bulik added.

“Weight gain during pregnancy can be very difficult for women with histories of eating disorders. Even subtle under-nutrition during pregnancy may increase the risk for birth complications, which may then be a setup for later eating disorders.”

The study’s design and size offer a unique opportunity to explore both environmental and genetic risk factors for serious disorders, said Dr. Ted Reichborn-Kjennerud, the study’s co-principal investigator at the Norwegian Institute of Public Health.

“We are delighted to be able to work with this distinguished group of researchers at UNC, who have already made important contributions to the field, and are looking forward to a fruitful, long-term collaboration.”

Women with eating disorders have a higher rate of complications during pregnancy, Caesarean deliveries and postpartum depression, Bulik said. Moreover, their babies tend to weigh less than the babies of women without eating disorders and to experience more problems with growth and development.

With respect to low birth weight, prospective epidemiological research suggests that individuals with anorexia nervosa are more likely to have been born prematurely and to have been small for gestational age, Bulik added.

Both bodies of research suggest that such events may be critical to the development of eating disorders and that the perinatal period may be of particular relevance in further understanding what causes eating disorders, she said. Also, women with eating disorder symptoms may increase their risk of adverse pregnancy outcomes by restricting food intake during pregnancy.

Together, these studies suggest that genetic and environmental factors may help create a multi-generational cycle of risk for eating disorders, Bulik said.

Assessments of the mothers, fathers and children in the study will include drawing blood samples for DNA analysis, psychosocial factors, infections, medication use, nutrition, life styles, occupational exposure, use of health services, substance abuse, socioeconomic factors and chemical and physical factors in the environment.

Health variables include fetal ultrasound, maternal and paternal history, and health outcomes for the mother and child detected during and after pregnancy. Eating disorders and related behaviors will be assessed in the 17th week of pregnancy and 18 months after birth.

In addition to Bulik, UNC researchers participating in the study are Dr. Patrick F. Sullivan, a professor in the department of genetics; Dr. Barry Popkin, a professor in the department of nutrition, and Dr. Anna Maria Siega-Riz, associate professor in the department of nutrition, which is jointly housed in the schools of medicine and public health; and Dr. Robert Hamer, a professor in the department of psychiatry.

The Norwegian researchers, all at the Norwegian Institute of Public Health, are led by Reichborn-Kjennerud. The other Norwegian researchers are Drs. Margaretha Haugen, Kari Kveim Lie, Per Magnus, Helle Meltzer, Camilla Stoltenberg and Kristian Tambs.

Bulik and Reichborn-Kjennerud have collaborated previously, when both were on the faculty of Virginia Commonwealth University. They have published several papers together about eating disorders among twins. The idea for the new study originated two years ago, Bulik said, while she and UNC’s Sullivan were working on analyses for the twin studies at the Norwegian Institute of Public Health.

The study is funded by a grant of $1.7 million from the National Institute of Child Health and Human Development, a component of the National Institutes of Health.

 

This release was researched and written by Tom Hughes of the UNC School of Medicine.

Note: Contact Bulik at (919) 843-1689 or cbulik@med.unc.edu.

UNC School of Medicine contact: Stephanie Crayton, (919) 966-2860 or scrayton@unch.unc.edu

For further information please contact Emily Smith by email at ejsmith@email.unc.edu

 

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