Presentation is loading. Please wait.

Presentation is loading. Please wait.

Growth Trajectories in Children of Mothers with Eating Disorders Institute of Psychiatry, Kings College London Abigail Easter.

Published byMelissa Schneider Modified over 10 years ago

Similar presentations

Presentation on theme: "Growth Trajectories in Children of Mothers with Eating Disorders Institute of Psychiatry, Kings College London Abigail Easter."— Presentation transcript:

1 Growth Trajectories in Children of Mothers with Eating Disorders Institute of Psychiatry, Kings College London Abigail Easter

2 Eating Disorders Anorexia Nervosa (AN) – BMI<17.5 & intense fear of fatness Bulimia Nervosa (BN) – Recurrent binge eating & compensatory behaviours Eating Disorder not Otherwise Specified (EDNOS) Prevalence rates: AN - 0.3% BN - 1% EDNOS - 5-7%

3 Feeding & Diet Breastfeeding has been found to be more problematic in women with ED Higher rates of feeding difficulties identified: Small quantity feeding/not satisfied after feeding Refusal to take solids (Micali, 2009) Mothers with ED display: more restrictive feeding styles higher levels of conflict at mealtime tend to hold more distorted perceptions of their childs weight and shape (Stein, 1994;1999)

4 Growth Problems Intrauterine growth restriction at birth (Treasure & Russell 1988) 140 mothers with AN 28% had feeding and weight difficulties 17% reported failure to thrive within their first year of life (Brinch Isager & Tolstrup, 1988) lower weight gain at 1 yr in infants of ED women but, no differences at 10 yrs of age (Stein et al.,1994; 2006) Children of women with BN more likely to be overweight at 9 months (Micali, 2009)

5 Aims 1. to determine whether the growth trajectories, from birth-10 yrs, differ between infants of women with and without ED 2. to establish if childhood growth trajectories vary across maternal ED classification 3. to establish if growth trajectories in children of women with ED differ from women with other psychiatric disorders (OPD)

6 Sample: Avon Longitudinal Study of Parents & Children (ALSPAC) 14,472 women enrolled at 8 weeks gestation At 12 weeks gestation asked: have you ever had: anorexia nervosa or bulimia nervosa? women divided according to lifetime Eating Disorders: AN: n=247 BN: n=194 AN+BN: n= 82 2 Control Groups control groups: Remaining sample: n=10,461 other psychiatric disorders (OPD): n=1,148

7 Sample Characteristics No EDANBNAN+BNOPD N (%) 9,847165184751085 Male offspring, (%) 51.251.449.751.253 Maternal parity, Multiparous (%) 55%52.4%51.5%53.2%59.1% * Maternal BMI (kg/m 2 ), mean 22.921.4 *23.121.4 *23.1 Maternal age (years) 28.228.928.229.228 **: p< 0.01, *: p<0.05

8 Height and Weight Measures in ALSPAC 1. Obstetric records & ALSPAC staff 2. Routine child health records 3. Research clinics - CiF and Focus 4. Questionnaires - mother-reports Height: birth-10 years (cm) Pondral Index (PI): birth - 2 years (kg/m 3 ) Body Mass Index (BMI): 2-10 years (kg/m 2 )

9 Data Available No EDANBNAN+BNOPD Height Boys Girls N= 4588 4416 N= 74 65 N= 85 82 N= 38 30 N= 501 432 PI Boys Girls 4537 4363 73 64 84 81 38 30 496 424 BMI Boys girls 4271 4117 68 61 78 35 29 452 398

10 Statistical Methods 1. Fractional Polynomial were used to estimate overall shape of curves for height, PI and BMI (Royston et al. 1999) 1. Random effects models (MLwiN) to predict growth across groups 2. Boys and girls modelled separately 3. Z-tests to assess group differences Confounders: Gestational age, maternal age, maternal education, family income and parity Mediators: maternal pre-pregnancy BMI and smoking during pregnancy (Howe et al, 2010 )

11 Boys Height: Mean difference from controls **: p< 0.01, *: p<0.05 Adjusted for confounders Height (cm) No EDANBNAN+BNOPD Birth 50.26+0.137+0.174-0.102-0.198 * 1 year 76.10+0.327+0.051-0.094-0.284 * 2 years 87.32+0.400+0.011-0.095-0.323 * 5 years 110.22+0.391+0.151-0.173-0.416 * 10 years 140.68-0.716+1.883 *-0.814-0.643

12 Girls Height Mean difference from controls **: p< 0.01, *: p<0.05 Adjusted for confounders Height (cm) No EDANBNAN+BNOPD Birth 49.73-0.471*-0.078+0.231-0.161 1 year 74.25-0.265+0.048-0.732-0.184 2 years 85.63-0.240+0.020-0.931-0.184 5 years 109.61-0.309-0.184-0.937-0.168 10 years 138.86-0.572-0.648-0.324-0.121

13 Boys PI/BMI: Mean difference from controls **: p< 0.01, *: p<0.05 Adjusted for confounders No EDANBNAN+BNOPD PI (kg/m 3 ) N=4537N=73N=84N=38N=496 Birth 26.19-0.428-0.277+0.069+0.127 1 year 23.33-0.119+0.406+0.270+0.216 * BMI (kg/m 2 ) N=4271N=68N=78N=35N=452 2 years 16.80+0.099+0.260+0.316+0.155 5 years 15.93+0.339 *+0.122+0.491 *-0.024 10 years 17.65+0.090+0.119+0.084+0.093

14 BMI Trajectories Boys

15 Girls PI/BMI: Mean difference from controls ***: p<0.001, **: p< 0.01, *: p<0.05 Adjusted for confounders No EDANBNAN+BNOPD PI (kg/m 3 )N=4363N=64N=81N=30N=424 Birth26.24-0.070+0.480 *-0.162-0.090 1 year23.24+0.397+0.061+0.386-0.220 BMI (kg/m 2 ) N=4117N=61N=78N=29N=398 2 years16.61-0.346+0.297+0.249-0.075 5 years15.98-0.011+0.258+0.324+0.157 * 10 years18.07+0.025-0.285-0.516+0.561 *

16 BMI Trajectories: Girls

17 Summary of Findings Boys of women with ED: taller than children in unexposed group higher BMI trajectories from 2-5 in contrast, children of women with other psychiatric disorders shorter throughout childhood similar BMI trajectories throughout childhood

18 Summary of Findings Girls of women with ED: AN shorter throughout childhood Lower BMI in in early childhood but catch up BN higher PI at birth with other psychiatric disorders shorter, but higher BMI from 5 years onwards

19 Conclusions Children of mothers with ED have different BMI trajectories, particularly in early – middle childhood Male children of women with ED tend to be taller/have higher Female children of women with ED tend to be shorter with lower BMI Modelling of growth in children of women with ED later in childhood will be important

20 Strengths & Limitations Strengths longitudinal large cohort large number of measurements Limitations self reported ED status small numbers in ED groups – lacking power

21 Acknowledgements Nadia Micali Laura Howe Janet Treasure Ulrike Schmidt Kate Tilling Kate Northstone

Download ppt "Growth Trajectories in Children of Mothers with Eating Disorders Institute of Psychiatry, Kings College London Abigail Easter."

Similar presentations

He writes to his mother every week. Does he write to his mother every week? He doesnt write to his mother every week. He comes home at 5 oclock. Does he.

He writes to his mother every week. Does he write to his mother every week? He doesnt write to his mother every week. He comes home at 5 oclock. Does he.
NIHR RESEARCH METHODS INTERNSHIPS The Institute of Psychiatry (IoP), a school of Kings College London, invites applications for three Research Methods.

NIHR RESEARCH METHODS INTERNSHIPS The Institute of Psychiatry (IoP), a school of Kings College London, invites applications for three Research Methods.
Salient Features 14 year old, female Decreased Food Intake/ – Later refusal to eat Weight conscious Sad most of the day, – Progressive over months Apparent.

Salient Features 14 year old, female Decreased Food Intake/ – Later refusal to eat Weight conscious Sad most of the day, – Progressive over months Apparent.
Children Aged 5 to

Children Aged 5 to
WEIGHT AND EATING DISORDERS Note: This power point presentation was created by McGraw Glencoe Health company. It was downloaded from their free educator’s.

WEIGHT AND EATING DISORDERS Note: This power point presentation was created by McGraw Glencoe Health company. It was downloaded from their free educator’s.
Dr Jackie Hoare Liaison Psychiatry GSH. is an illness characterised by extreme concern about body weight with serious disturbances in eating behavior.

Dr Jackie Hoare Liaison Psychiatry GSH. is an illness characterised by extreme concern about body weight with serious disturbances in eating behavior.
Medical Assessments in Adolescence

Medical Assessments in Adolescence
ARION PROJECT INTERNATIONAL MEETING GROTTAMMARE 2007,21-25th MAY.

ARION PROJECT INTERNATIONAL MEETING GROTTAMMARE 2007,21-25th MAY.
Mental Health Legislation for those under the age of 18 Greg Richardson Consultant in Child and Adolescent Psychiatry Lime Trees CAMHS, York.

Mental Health Legislation for those under the age of 18 Greg Richardson Consultant in Child and Adolescent Psychiatry Lime Trees CAMHS, York.
Feeding & Eating Disorders B. Timothy Walsh, MD Professor of Psychiatry, Columbia University New York State Psychiatric Institute.

Feeding & Eating Disorders B. Timothy Walsh, MD Professor of Psychiatry, Columbia University New York State Psychiatric Institute.
Anorexia Nervosa – Mindmap

Anorexia Nervosa – Mindmap
HEALTHY WEIGHT… Are you?. Calorie Connection to Weight  A person maintains their weight by taking in as many calories as they use  Metabolism [def:

HEALTHY WEIGHT… Are you?. Calorie Connection to Weight  A person maintains their weight by taking in as many calories as they use  Metabolism [def:
Eating Disorders Anorexia Bulimia Binge-eating. Some Chilling Statistics Eating disorders have increased threefold in the last 50 years 10% of the population.

Eating Disorders Anorexia Bulimia Binge-eating. Some Chilling Statistics Eating disorders have increased threefold in the last 50 years 10% of the population.
Eating Disorders Behavioural explanation –Psychological disorders are the result of abnormal learning experiences –Eating disorders are a set of learned.

Eating Disorders Behavioural explanation –Psychological disorders are the result of abnormal learning experiences –Eating disorders are a set of learned.
Chapter 4.5 Managing Your Weight. Being overweight can lead to heart disease, stroke, and diabetes. Being underweight can cause fatigue (tiredness), sleeplessness,

Chapter 4.5 Managing Your Weight. Being overweight can lead to heart disease, stroke, and diabetes. Being underweight can cause fatigue (tiredness), sleeplessness,
Chapter 4 Lesson 5 Managing your weight.

Chapter 4 Lesson 5 Managing your weight.
Eating disorders and Affective disorders By: Natalia Kubinova.

Eating disorders and Affective disorders By: Natalia Kubinova.
EATING DISORDERS AWARENESS MONTH. TYPES OF EATING DISORDERS INCLUDE: Anorexia nervosa, in which you become too thin, but you don't eat enough because.

EATING DISORDERS AWARENESS MONTH. TYPES OF EATING DISORDERS INCLUDE: Anorexia nervosa, in which you become too thin, but you don't eat enough because.
What are some issues surrounding physical and cognitive development in adolescence? ~Puberty and the secular trend Difference between adolescence and.

What are some issues surrounding physical and cognitive development in adolescence? ~Puberty and the secular trend Difference between adolescence and.
Kathleen Stassen Berger The Developing Person Through the Life Span Eighth Edition Part V Adolescence: Biosocial Development Chapter Fourteen Puberty Begins.

Kathleen Stassen Berger The Developing Person Through the Life Span Eighth Edition Part V Adolescence: Biosocial Development Chapter Fourteen Puberty Begins.

Similar presentations

Ads by Google