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Published in: BMC Pregnancy and Childbirth 1/2015

Open Access 01-12-2015 | Research article

Biomarkers of nutrition and stress in pregnant women with a history of eating disorders in relation to head circumference and neurocognitive function of the offspring

Authors: Saloua Koubaa, Tore Hällström, Kerstin Brismar, Per M Hellström, Angelica Lindén Hirschberg

Published in: BMC Pregnancy and Childbirth | Issue 1/2015

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Abstract

Background

Eating disorders during pregnancy can affect fetal growth and the child’s early development, but the underlying mechanisms have not been elucidated. The aim of the present study was to investigate serum biomarkers of nutrition and stress in pregnant women with previous eating disorders compared to controls and in relation to head circumference and early neurocognitive development of the offspring.

Methods

In a longitudinal cohort study, pregnant nulliparous non-smoking women with a history of anorexia nervosa (n = 20), bulimia nervosa (n = 17) and controls (n = 59) were followed during pregnancy and their children’s growth and neurocognitive development were followed up to five years of age. We investigated maternal serum biomarkers of nutrition and stress (ferritin, cortisol, thyroid-stimulating hormone, free thyroxine, insulin, insulin-like growth factor I (IGF-I) and IGF binding protein 1) in blood samples collected during early pregnancy and compared between groups (ANOVA, LSD post-hoc test). The results were related to previous data on head circumference at birth and neurocognitive development at five years of age of the offspring (Spearman rank correlation or Pearson correlation test).

Results

Serum levels of ferritin in the women with previous anorexia nervosa, but not in those with a history of bulimia nervosa, were significantly lower than in the controls (p < 0.01), and correlated strongly to impaired memory function in their children (rs = −0.70, p < 0.001). Maternal serum levels of free thyroxine were similar between groups but correlated positively to reduced head circumference at birth of the children in the bulimia nervosa group (r = 0.48, p < 0.05), and with the same tendency in the anorexia nervosa group (r = 0.42, p = 0.07), but not in the controls (r = 0.006). There were no significant differences in cortisol or the other biomarkers between groups.

Conclusions

Low maternal serum ferritin in women with previous anorexia nervosa may be of importance for impaired memory capacity in the offspring at five years of age. Our results also indicate that thyroxin levels in pregnant women with previous eating disorders are positively associated with fetal head growth.
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Literature
1.
go back to reference Koubaa S, Hällstrom T, Lindholm C, Hirschberg AL. Pregnancy and neonatal outcomes in women with eating disorders. Obstet Gynecol. 2005;105:255–60.CrossRefPubMed Koubaa S, Hällstrom T, Lindholm C, Hirschberg AL. Pregnancy and neonatal outcomes in women with eating disorders. Obstet Gynecol. 2005;105:255–60.CrossRefPubMed
2.
go back to reference Ekeus C, Lindberg L, Lindblad F, Hjern A. Birth outcomes and pregnancy complications in women with a history of anorexia nervosa. BJOG. 2006;113:925–9.CrossRefPubMed Ekeus C, Lindberg L, Lindblad F, Hjern A. Birth outcomes and pregnancy complications in women with a history of anorexia nervosa. BJOG. 2006;113:925–9.CrossRefPubMed
3.
go back to reference Micali N, Treasure J. Biological effects of a maternal ED on pregnancy and foetal development: a review. Eur Eat Disorders Rev. 2009;17:448–54.CrossRef Micali N, Treasure J. Biological effects of a maternal ED on pregnancy and foetal development: a review. Eur Eat Disorders Rev. 2009;17:448–54.CrossRef
4.
go back to reference Wentz E, Gillberg IC, Anckarsater H, Gillberg C, Rastam M. Reproduction and offspring status 18 years after teenage-onset anorexia nervosa-a controlled community-based study. Int J Eat Disord. 2009;42:483–91.CrossRefPubMed Wentz E, Gillberg IC, Anckarsater H, Gillberg C, Rastam M. Reproduction and offspring status 18 years after teenage-onset anorexia nervosa-a controlled community-based study. Int J Eat Disord. 2009;42:483–91.CrossRefPubMed
5.
go back to reference Koubaa S, Hällstrom T, Hagenas L, Hirschberg AL. Retarded head growth and neurocognitive development in infants of mothers with a history of eating disorders: longitudinal cohort study. BJOG. 2013;120:1413–22.CrossRefPubMed Koubaa S, Hällstrom T, Hagenas L, Hirschberg AL. Retarded head growth and neurocognitive development in infants of mothers with a history of eating disorders: longitudinal cohort study. BJOG. 2013;120:1413–22.CrossRefPubMed
7.
go back to reference Sandman CA, Davis EP, Buss C, Glynn LM. Exposure to prenatal psychobiological stress exerts programming influences on the mother and her fetus. Neuroendocrinology. 2012;95:8–21.CrossRef Sandman CA, Davis EP, Buss C, Glynn LM. Exposure to prenatal psychobiological stress exerts programming influences on the mother and her fetus. Neuroendocrinology. 2012;95:8–21.CrossRef
8.
go back to reference Monteleone P, Luisi M, Colurcio B, Casarosa E, Monteleone P, Ioime R, et al. Plasma levels of neuroactive steroids are increased in untreated women with anorexia nervosa or bulimia nervosa. Psychosom Med. 2001;63:62–8.CrossRefPubMed Monteleone P, Luisi M, Colurcio B, Casarosa E, Monteleone P, Ioime R, et al. Plasma levels of neuroactive steroids are increased in untreated women with anorexia nervosa or bulimia nervosa. Psychosom Med. 2001;63:62–8.CrossRefPubMed
9.
go back to reference Spinillo A, Viazzo F, Colleoni R, Chiara A, Maria Cerbo R, Fazzi E. Two-year infant neurodevelopmental outcome after single or multiple antenatal courses of corticosteroids to prevent complications of prematurity. Am J Obstet Gynecol. 2004;191:217–24.CrossRefPubMed Spinillo A, Viazzo F, Colleoni R, Chiara A, Maria Cerbo R, Fazzi E. Two-year infant neurodevelopmental outcome after single or multiple antenatal courses of corticosteroids to prevent complications of prematurity. Am J Obstet Gynecol. 2004;191:217–24.CrossRefPubMed
10.
go back to reference Haddow JE, Palomaki GE, Allan WC, Williams JR, Knight GJ, Gagnon J, et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med. 1999;341:549–55.CrossRefPubMed Haddow JE, Palomaki GE, Allan WC, Williams JR, Knight GJ, Gagnon J, et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med. 1999;341:549–55.CrossRefPubMed
11.
go back to reference Setia S, Sridhar MG. Changes in GH/IGF-1 axis in intrauterine growth retardation: consequences of fetal programming? Horm Metab Res. 2009;41:791–8.CrossRefPubMed Setia S, Sridhar MG. Changes in GH/IGF-1 axis in intrauterine growth retardation: consequences of fetal programming? Horm Metab Res. 2009;41:791–8.CrossRefPubMed
12.
go back to reference Ornoy A. Growth and neurodevelopmental outcome of children born to mothers with pregestational and gestational diabetes. Pediatr Endocrinol Rev. 2005;3:104–13.PubMed Ornoy A. Growth and neurodevelopmental outcome of children born to mothers with pregestational and gestational diabetes. Pediatr Endocrinol Rev. 2005;3:104–13.PubMed
13.
go back to reference American Psychiatric Association (APA). Diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV). Washington DC: American Psychiatric Association; 1994. American Psychiatric Association (APA). Diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV). Washington DC: American Psychiatric Association; 1994.
14.
go back to reference Kadesjö B, Janols LO, Korkman M, Mickelsson K, Strand G, Trillingsgaard A, et al. The FTF (Five to Fifteen): the development of a parent questionnaire for the assessment of ADHD and comorbid conditions. Eur Child Adolesc Psychiatry. 2004;13:3–13.CrossRefPubMed Kadesjö B, Janols LO, Korkman M, Mickelsson K, Strand G, Trillingsgaard A, et al. The FTF (Five to Fifteen): the development of a parent questionnaire for the assessment of ADHD and comorbid conditions. Eur Child Adolesc Psychiatry. 2004;13:3–13.CrossRefPubMed
15.
go back to reference Korkman M, Jaakola M, Ahlroth A, Personen A-E, Turunen M-M. Screening of developmental disorders in five-year-olds using the FTF (Five to Fifteen) questionnaire. A validation study. Eur Child Adolesc Psychiatry. 2004;13 Suppl 3:31–8.PubMed Korkman M, Jaakola M, Ahlroth A, Personen A-E, Turunen M-M. Screening of developmental disorders in five-year-olds using the FTF (Five to Fifteen) questionnaire. A validation study. Eur Child Adolesc Psychiatry. 2004;13 Suppl 3:31–8.PubMed
16.
go back to reference Trillingsgard A, Damm D, Sommer S, Jepsen JRM, Ostergaard O, Frydenberg M, et al. Developmental profiles on the basis of the FTF (Five to Fifteen) questionnaire. Eur Child Adolesc Psychiatry. 2004;13 Suppl 3:39–49. Trillingsgard A, Damm D, Sommer S, Jepsen JRM, Ostergaard O, Frydenberg M, et al. Developmental profiles on the basis of the FTF (Five to Fifteen) questionnaire. Eur Child Adolesc Psychiatry. 2004;13 Suppl 3:39–49.
17.
go back to reference Bohlin G, Janols L-O. Behavioural problems and psychiatric symptoms in 5–13 year-old Swedish children – a comparison of parent ratings on the FTF (Five to Fifteen) with the ratings on CBCL (Child Behavior Checklist). Eur Child Adolesc Psychiatry. 2004;13 Suppl 3:14–22.PubMed Bohlin G, Janols L-O. Behavioural problems and psychiatric symptoms in 5–13 year-old Swedish children – a comparison of parent ratings on the FTF (Five to Fifteen) with the ratings on CBCL (Child Behavior Checklist). Eur Child Adolesc Psychiatry. 2004;13 Suppl 3:14–22.PubMed
18.
go back to reference Naessén S, Carlström K, Glant R, Jacobsson H, Hirschberg AL. Bone mineral density in bulimic women-influence of endocrine factors and previous anorexia. Eur J Endocrinol. 2006;155:245–51.CrossRefPubMed Naessén S, Carlström K, Glant R, Jacobsson H, Hirschberg AL. Bone mineral density in bulimic women-influence of endocrine factors and previous anorexia. Eur J Endocrinol. 2006;155:245–51.CrossRefPubMed
19.
go back to reference Bang P, Eriksson U, Sara V, Wivall IL, Hall K. Comparison of acid ethanol extraction and acid gel filtration prior to IGF-I and IGF-II radioimmunoassays: improvement of determinations in acid ethanol extracts by the use of truncated IGF-I as radioligand. Acta Endocrinol. 1991;124:620–9.PubMed Bang P, Eriksson U, Sara V, Wivall IL, Hall K. Comparison of acid ethanol extraction and acid gel filtration prior to IGF-I and IGF-II radioimmunoassays: improvement of determinations in acid ethanol extracts by the use of truncated IGF-I as radioligand. Acta Endocrinol. 1991;124:620–9.PubMed
20.
go back to reference Povoa G, Roovete A, Hall K. Cross-reaction of serum somatomedin-binding protein in a radioimmunoassay developed for somatomedin-binding protein isolated from human amniotic fluid. Acta Endocrinol. 1984;107:563–70.PubMed Povoa G, Roovete A, Hall K. Cross-reaction of serum somatomedin-binding protein in a radioimmunoassay developed for somatomedin-binding protein isolated from human amniotic fluid. Acta Endocrinol. 1984;107:563–70.PubMed
21.
go back to reference Heinonen K, Raikkonen K, Pesonen AK, Kajantie E, Andersson S, Eriksson JG, et al. Prenatal and postnatal growth and cognitive abilities at 56 months of age: a longitudinal study of infants born at term. Pediatrics. 2008;121:e1325–33.CrossRefPubMed Heinonen K, Raikkonen K, Pesonen AK, Kajantie E, Andersson S, Eriksson JG, et al. Prenatal and postnatal growth and cognitive abilities at 56 months of age: a longitudinal study of infants born at term. Pediatrics. 2008;121:e1325–33.CrossRefPubMed
22.
go back to reference Tamura T, Goldenberg RL, Johnston KE, Cliver SP, Hickey CA. Serum ferritin: a predictor of early spontaneous preterm delivery. Obstet Gynecol. 1996;87:360–5.CrossRefPubMed Tamura T, Goldenberg RL, Johnston KE, Cliver SP, Hickey CA. Serum ferritin: a predictor of early spontaneous preterm delivery. Obstet Gynecol. 1996;87:360–5.CrossRefPubMed
23.
go back to reference Hou J, Cliver SP, Tamura T, Johnston KE, Goldenberg R. Maternal serum ferritin and fetal growth. Obstet Gynecol. 2000;95:447–52.PubMed Hou J, Cliver SP, Tamura T, Johnston KE, Goldenberg R. Maternal serum ferritin and fetal growth. Obstet Gynecol. 2000;95:447–52.PubMed
24.
go back to reference Allen LH. Biological mechanisms that might underlie iron’s effects on fetal growth and preterm birth. J Nutr. 2001;131:581–9. Allen LH. Biological mechanisms that might underlie iron’s effects on fetal growth and preterm birth. J Nutr. 2001;131:581–9.
25.
go back to reference Chatzi L, Koutra K, Vassilaki M, Vardiampasis A, Georgiou V, Koutis A, et al. Maternal personality traits and risk of preterm birth and fetal growth restriction. Eur Psychiatry. 2013;28:213–8.CrossRefPubMed Chatzi L, Koutra K, Vassilaki M, Vardiampasis A, Georgiou V, Koutis A, et al. Maternal personality traits and risk of preterm birth and fetal growth restriction. Eur Psychiatry. 2013;28:213–8.CrossRefPubMed
26.
go back to reference Laplante DP, Brunet A, Schmitz N, Ciampi A, King S. Project Ice Storm: prenatal maternal stress affects cognitive and linguistic functioning in 5 1/2-year-old children. J Am Acad Child Adolesc Psychiatry. 2008;47:1063–72.CrossRefPubMed Laplante DP, Brunet A, Schmitz N, Ciampi A, King S. Project Ice Storm: prenatal maternal stress affects cognitive and linguistic functioning in 5 1/2-year-old children. J Am Acad Child Adolesc Psychiatry. 2008;47:1063–72.CrossRefPubMed
27.
go back to reference Bolten M, Wurmser H, Buske-Kirschbaum A, Papousek M, Pirke KM, Hellhammer D. Cortisol levels in pregnancy as a psychobiological predictor for birth weight. Arch Womens Ment Health. 2011;14:33–41.CrossRefPubMed Bolten M, Wurmser H, Buske-Kirschbaum A, Papousek M, Pirke KM, Hellhammer D. Cortisol levels in pregnancy as a psychobiological predictor for birth weight. Arch Womens Ment Health. 2011;14:33–41.CrossRefPubMed
28.
go back to reference Li Y, Shan Z, Teng W, Yu X, Li Y, Fan C, et al. Abnormalities of maternal thyroid function during pregnancy affect neuropsychological development of their children at 25–30 months. Clin Endocrinol. 2010;72:825–9.CrossRef Li Y, Shan Z, Teng W, Yu X, Li Y, Fan C, et al. Abnormalities of maternal thyroid function during pregnancy affect neuropsychological development of their children at 25–30 months. Clin Endocrinol. 2010;72:825–9.CrossRef
29.
go back to reference Olausson H, Löf M, Brismar K, Lewitt M, Forsum E, Sohlström A. Longitudinal study of the maternal insulin-like growth factor system before, during and after pregnancy in relation to fetal and infant weight. Horm Res. 2008;69:99–106.CrossRefPubMed Olausson H, Löf M, Brismar K, Lewitt M, Forsum E, Sohlström A. Longitudinal study of the maternal insulin-like growth factor system before, during and after pregnancy in relation to fetal and infant weight. Horm Res. 2008;69:99–106.CrossRefPubMed
30.
go back to reference El-Masry SA, El-Ganzoury MM, El-Farrash RA, Anwar M, Abd Ellatife RZ. Size at birth and insulin-like growth factor-I and its binding protein-1 among infants of diabetic mothers. J Matern Fetal Neonatal Med. 2013;26:5–9.CrossRefPubMed El-Masry SA, El-Ganzoury MM, El-Farrash RA, Anwar M, Abd Ellatife RZ. Size at birth and insulin-like growth factor-I and its binding protein-1 among infants of diabetic mothers. J Matern Fetal Neonatal Med. 2013;26:5–9.CrossRefPubMed
31.
go back to reference Fraser A, Nelson SM, Macdonald-Wallis C, Lawlor DA. Associations of existing diabetes, gestational diabetes, and glycosuria with offspring IQ and educational attainment: the Avon Longitudinal Study of Parents and Children. Exp Diabetes Res. 2012;2012:963735.CrossRefPubMedPubMedCentral Fraser A, Nelson SM, Macdonald-Wallis C, Lawlor DA. Associations of existing diabetes, gestational diabetes, and glycosuria with offspring IQ and educational attainment: the Avon Longitudinal Study of Parents and Children. Exp Diabetes Res. 2012;2012:963735.CrossRefPubMedPubMedCentral
Metadata
Title
Biomarkers of nutrition and stress in pregnant women with a history of eating disorders in relation to head circumference and neurocognitive function of the offspring
Authors
Saloua Koubaa
Tore Hällström
Kerstin Brismar
Per M Hellström
Angelica Lindén Hirschberg
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2015
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-015-0741-7

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