Maternal Eating Disorders Linked to Higher Asthma Risk in Children

Adobe Stock/Alena Ozerova

Maternal eating disorders (EDs) — even before pregnancy — were linked to poorer respiratory outcomes in children, independent of depression and anxiety, according to research published in Thorax.

Previous research has indicated that maternal perinatal mental health has been linked to an increased risk of wheezing, asthma and reduced lung function in children. However, these studies have mainly focused on depression, anxiety and stress.

“There is a need to include maternal EDs in research on early-life respiratory risk factors and to integrate ED screening and support into maternal healthcare to improve respiratory outcomes in offspring,” wrote lead investigator Maja Popovic, Ph.D., a researcher at the University of Turin, Italy.

Investigators assessed whether a mother’s history of an ED could affect her child’s respiratory health, such as wheezing in early childhood or asthma later on. They analyzed data from 131,495 mother-and-child pairs across seven European cohorts from the EU Child Cohort Network, giving them a wide and diverse sample to better understand the connection. The study further explored different types of eating disorders, including anorexia nervosa and bulimia nervosa, maternal psychiatric comorbidities (depression and anxiety), timing of the exposure and childhood lung function.

Before pregnancy, ED prevalence in the cohort ranged from 0.8% (according to health records) to 17% (self-reported lifetime EDs). Wheezing prevalence in preschool-aged kids (defined as 0 to 4 years) ranged from 20.7% and 49.6%, and school-age asthma was between 2.1% and 17.3%.

Results demonstrated that children whose mothers had an ED before pregnancy were more likely to experience breathing issues. Specifically, maternal EDs were linked to a higher risk of preschool wheezing and asthma during school-age years. These associations remained even when researchers excluded mothers who also had depression or anxiety, suggesting that eating disorders themselves — not just co-occurring mental health conditions — may play a role.

When looking at different types of eating disorders, investigators found similar patterns across subtypes. They also explored different time windows — before pregnancy, during pregnancy and after — but did not see a clear trend suggesting one period was more influential than another.

In two of the cohorts, researchers also examined children’s lung function and found a weak but positive link between maternal EDs and reduced lung performance. While the association wasn't strong, it points toward potential long-term effects.

The team said the study’s biggest strength is that it used a very large set of data from multiple countries, all organized under the same research protocol. Although not every group had the same background information available, investigators were still able to adjust for as many factors as possible in each data set.

There were differences between countries in how common eating disorders and childhood breathing problems were, likely due to cultural factors, different medical practices and how information was collected, but the overall findings still pointed in the same direction. Additionally, most of the eating disorder data came from self-reported questionnaires, which may actually capture more cases than medical records, since many eating disorders are never formally diagnosed.

The team noted that more research is needed to understand why this happens and how to best support both mothers and children.

“These findings highlight the need to understand mechanisms and long-term respiratory consequences of maternal EDs to inform interventions for improving offspring respiratory health,” concluded investigators.