Children Born to Mothers with Diabetes Could Be at Increased Risk for Eating Disorders

New research from an analysis of more than 1 million singleton births indicates maternal diabetes could signal increased risk of feeding and eating disorders in early life.

Results from the study indicated offspring of mothers with diabetes had a 64% increased risk of developing a feeding and eating disorder before their sixth birthday and this risk grew if mothers had a history of diabetic complications.

“Our findings can inform clinical decisions for better management of maternal diabetes, in particular before pregnancy, which can reduce early neurodevelopmental problems in the offspring,” wrote investigators.

With previous research suggesting presence of maternal diabetes could impact fetal brain development, investigator hoped to further elucidate how this link might manifest in early life. With this in mind, investigators designed their study with the aim of examining. The association between maternal diabetes before or during pregnancy and feeding and eating disorders in offspring using data from national registers in Denmark.

Using a time period lasting from 1996-2015, investigates identified 1,224,358 singleton births for inclusion in their analysis. From this cohort, investigators excluded more than 60k due to missing or likely errors in gestational age, chromosomal abnormalities in children, or because of missing links to their fathers.

After application of exclusion criteria, investigators were left with a cohort of 1,193,891 patients for inclusion in their analysis. Of these, 13,588 were exposed to maternal pregestational type 1 diabetes, 7299 were exposed to maternal pregestational type 2 diabetes, 19,980 were exposed to gestational diabetes, and the remaining 1,153,024 were not exposed to maternal diabetes and used as controls.

Of note, investigators planned to use Cox propotional hazards to calculate hazard ratios for relative risk and these models were adjusted for gender of the child, calendar period of birth, parity, maternal age at birth, paternal age at birth, maternal education level, maternal cohabitation status, maternal smoking status, maternal psychiatric disorder history, and paternal psychiatric disorder history.

Upon analysis, investigators found incidence rates of feeding and eating disorders were 6.8, 4.6 and 2.9 per 10,000 person-years among children of mothers with pregestational diabetes, gestational diabetes, and no diabetes, respectively. In adjusted analyses, offspring of mothers with diabetes were at a 64% increased risk of feeding and eating disorders (HR, 1.64; 95% CI, 1.36-1.99; P <.001).

Further analysis indicated the apparent risk was greater for those born to mothers with pregestational diabetes (HR, 2.01; 95% CI, 1.59-2.56; P <.001) compared to those born to mothers with gestational diabetes (HR, 1.28; 95% CI, 0.95-1.72; P=.097). Additionally, those born to mothers with diabetic complications appeared to be at the greatest risk (HR, 2.97; 95% CI, 1.54-5.72; P=.001).

“Our findings are, in general, consistent with previous studies on the association between maternal pregestational diabetes and neurodevelopmental disorders in childhood or adolescence, but it is new to observe the elevated risk in infancy and early childhood,” wrote investigators.

Investigators cautioned clinicians to consider the limitations of their study before overinterpreting results. These limitations included the inability to include feeding and eating disorders treated in private clinics and an inability to rule out the possibility of residual confounding by unmeasured confounders.

This study, “Maternal diabetes and the risk of feeding and eating disorders in offspring: a national population-based cohort study,” was published in BMJ Open Diabetes Research and Care.