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Perinatal complications linked to eating disorders

The JAMA Network Journals

Certain complications during and immediately after birth are associated with the development of the eating disorders anorexia nervosa and bulimia nervosa, according to a study in the January issue of Archives of General Psychiatry, one of the JAMA/Archives journals.



Several specific complications in the mother--including maternal anemia (low levels of hemoglobin in the blood), diabetes mellitus and placental infarction (death of part of the tissue of the placenta)--increased a child's risk of developing anorexia nervosa. Neonatal heart problems, hypothermia (low body temperature), tremors and hyporeactivity (a less than normal response to stimuli) also were associated with later development of anorexia. Placental infarction, neonatal hyporeactivity, early difficulties with eating, shorter than average birth length and low birth weight were associated with bulimia nervosa.

In addition, the number of complications affected the age at which the children developed anorexia nervosa. Those with more than five complications developed the disorder at an average age of 16.3, compared with 17.5 years for those with one to five complications and 18.8 years for those with no complications. "This type of relationship is considered evidence of a causal link and would indicate that an impairment in neurodevelopment could be implicated in the pathogenesis of anorexia nervosa," the authors write.

"These findings seem to show some resemblance to what has been found in schizophrenia and, with less evidence, in other severe psychiatric disorders," they report--that some obstetric complications may contribute to the development of psychiatric illnesses by robbing a fetus of the oxygen and nutrients needed for proper neurodevelopment or by causing neonatal brain damage. "However, this observation should lead to a search for other more specific risk factors that interact with perinatal factors and are able to predict the development of one particular psychiatric disorder rather than another."

In addition, they write, future research "should try to assess the prognostic impact of the presence of obstetric complications and whether this factor might help in the choice of appropriate and effective treatment."


(Arch Gen Psychiatry. 2006;63:82-88. Available pre-embargo to the media at

Editor's Note: This study was supported by the University of Padua, Padua, Italy.
