Researchers from the University of Padua have found that the some complications around the time of birth (during delivery and immediately after birth) could play a major role in the development of certain eating disorders such as anorexia nervosa and bulimia nervosa.
Previous studies have already established that eating disorders are caused by a complex interplay of genetic and environmental factors. Results of some observational studies highlight the possibility of a definitive association between neurodevelopmental and eating disorders. Certain studies have indeed established a correlation between obstetric complications and anorexia nervosa.
"Obstetric complications might have more than one role in the etiopathogenesis of eating disorders; first, they may cause hypoxic-induced damage to the brain that impairs the neurodevelopment of the fetus, and second, the adequacy of nutrition during pregnancy and in the immediate postnatal period seems to influence the nutritional status of the adult and appetite programming throughout life," write the authors.
Researchers analyzed nearly than 187 women, diagnosed with anorexia nervosa (114) and bulimia nervosa (73). A control group consisting of 554 women, devoid of either of the conditions was also included. During the course of the study, few more patients referred to the outpatient clinic of the hospital were also included. The incidence of obstetric complications in this group of women was noted down and an analysis made.
Conditions such as anemia (reduced levels of hemoglobin in blood), diabetes mellitus and infarction of the placenta (lack of blood supply to a part of the placenta, resulting in death of the tissue) in the mother were found to be associated with an increased risk of anorexia nervosa in the child, later in life. The presence of cardiovascular problems, tremors, hypothermia (reduced body temperature) and hyporeactivity (reduced response to external stimuli) in the neonate were also linked to an increased incidence of anorexia development.
Furthermore, the age at which children developed anorexia nervosa was found to be dependent on the number of complications either during or soon after birth. Children with five or more complications had an average age of onset of 16.3, in comparison to 17.5 years for children with less than five complications. Those devoid of any complications developed the condition at 18.8 years of age.
"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. These findings seem to show some resemblance to what has been found in schizophrenia and, with less evidence, in other severe psychiatric disorders. 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 " said, one of the researchers.
It is hypothesized that oxygen deprivation to the fetus could play a major role in the development of neurodevelopmental disorders or it can aggravate an already existing neonatal brain damage.
More studies are clearly indicated to better understand the pathogenesis of eating disorders in relation to obstetric complications. This could probably pave way for the development of specific and effective treatment options for eating disorders.