The Relationship Between Obstetric Complications and Temperament in Eating Disorders: A Mediation Hypothesis

Address correspondence and reprint requests to: Paolo Santonastaso, MD, E-mail: paolo.santonastaso{at}unipd.it.

	Abstract

Objective: Recent studies have hypothesized that perinatal complications might increase the risk of developing eating disorders. However, it is unclear which pathways might link obstetric complications and eating disorders. The present study aimed at exploring the relationship between obstetric complications and temperament in eating disordered subjects. Methods: The sample was selected among subjects who took part in a prevalence study carried out on a representative sample of the general population and from among people with anorexia and bulimia nervosa referred to an outpatient specialist unit. Subjects who were born in the two obstetric wards of Padua Hospital between 1971 and 1979 and who completed the Tridimensional Personality Questionnaire were included. A blind analysis of the obstetric records of the whole sample was performed. The final sample was composed of 66 anorexia nervosa, 44 bulimia nervosa, and 257 control subjects. Results: Among the different groups of obstetric complications, only the group that included preterm birth and other signs of neonatal immaturity or dysmaturity displayed a significant relationship with harm avoidance. The use of a mediation path analytic model revealed a significant, but incomplete, mediation effect of harm avoidance in explaining the link between neonatal dysmaturity and the development of eating disorders. Maternal weight gain during pregnancy seemed to have a protective effect on harm avoidance. Conclusions: The presence of signs of neonatal dysmaturity at birth seems to influence the development of high levels of harm avoidance in eating disorders.

Key Words: anorexia nervosa, bulimia nervosa, eating disorders, obstetric complications, temperament