Background: We explored the course of broadly defined eating disorders during pregnancy in the Norwegian Mother and Child Cohort Study (MoBa) at the Norwegian Institute of Public Health.

Background We explored the impact of eating disorders on birth outcomes in the Norwegian Mother and Child Cohort Study (MoBa). Method 35,929 pregnant women in the MoBa included women with broadly defined anorexia nervosa (AN; n=35), bulimia nervosa (BN; n=304), binge eating disorder (BED; n=1,812), and EDNOS-purging type (EDNOS-P; n=36) in the six months prior to or during pregnancy and the referent group--women who reported no eating disorders (no-ED; n=33,742). Results Pre-pregnancy BMI was significantly lower in mothers with AN and higher in mothers with BED than the referent. Mothers with AN, BN, and BED reported greater weight gain during pregnancy and more mothers with eating disorders reported smoking during pregnancy than the referent. Women with BED had higher birth weight babies, lower risk of small for gestational age babies, and higher risk for large for gestational age babies and cesarean section than the referent. Conclusions BED influences birth outcomes. The absence of differences in birth outcomes in women with AN and EDNOS-P may reflect small sample size and differential severity of illness in population versus clinical samples. The detection of eating disorders in pregnancy could help identify modifiable factors (e.g., binge eating, smoking) that could influence birth outcomes.

IMPORTANCE Childhood sleep problems have been linked to a range of adverse health outcomes, but there is limited knowledge as to the temporal association between sleep problems and subsequent emotional and behavioral problems in young children. OBJECTIVE To examine whether sleep problems in toddlers aged 18 months are related to both concurrent and subsequent emotional and behavioral problems in preschool children aged 5 years. DESIGN, SETTING, AND PARTICIPANTS A large population-based longitudinal study was conducted in September 2014 using data from the Norwegian Mother and Child Cohort Study conducted at the Norwegian Institute of Public Health from June 1, 1999, to December 31, 2008. A total of 32 662 children or pregnancies were included. EXPOSURES Sleep was assessed by mother-reported child sleep duration and nocturnal awakenings. MAIN OUTCOMES AND MEASURESEmotional and behavioral problems were measured with items from the Child Behavior Checklist and operationalized according to recommended clinical cutoffs, corresponding to T scores of greater than 65 (93rd percentile). Risk ratios (RRs) were calculated using negative binomial regression, controlling for emotional and behavioral problems at 18 months and other relevant covariates.RESULTS Short sleep duration (Յ10 hours) in 556 children (1.7%) and frequent nocturnal awakenings (Ն3 times) in 1033 children (3.2%) at 18 months significantly predicted both concurrent and later incidence of emotional and behavioral problems at 5 years. The longitudinal RRs were generally larger for internalizing problems, with adjusted RRs of 1.59 (95% CI, 1.23-2.08) for both short sleep duration and 1.57 (95% CI, 1.28-1.93) for nocturnal awakenings; RRs for externalizing problems were 1.77 (95% CI, 1.37-2.30) and 1.25 (95% CI, 1.00-1.58), respectively. Additional adjustment for emotional and behavioral problems at 18 months slightly reduced the strength of these associations, and all RRs remained significant in the fully adjusted models. CONCLUSIONS AND RELEVANCEEarly sleep problems predict later development of emotional and behavioral problems. Intervention studies are needed to examine whether sleep programs targeting early childhood may avert the onset of later adverse outcomes.

Considering the chronicity of nocturnal awakening and its association with bedsharing, our findings support current recommendations of reducing bedsharing to improve sleep among infants.

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