Associations between birth characteristics and eating disorders across the life course: findings from 2 million males and females born in Sweden, 1975-1998.

Birth characteristics predict a range of major physical and mental disorders, but findings regarding eating disorders are inconsistent and inconclusive. This total-population Swedish cohort study identified 2,015,862 individuals born in 1975-1998 and followed them for anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified until the end of 2010. We examined associations with multiple family and birth characteristics and conducted within-family analyses to test for maternal-level confounding. In total, 1,019 males and 15,395 females received an eating disorder diagnosis. Anorexia nervosa was independently predicted by multiple birth (adjusted hazard ratio = 1.33, 95% confidence interval: 1.15, 1.53) for twins or triplets vs. singletons) and lower gestational age (adjusted hazard ratio = 0.96, 95% confidence interval: 0.95, 0.98) per extra week of gestation, with a clear dose-response pattern. Within-family analyses provided no evidence of residual maternal-level confounding. Higher birth weight for gestational age showed a strong, positive dose-response association with bulimia nervosa (adjusted hazard ratio = 1.15, 95% confidence interval: 1.09, 1.22, per each standard-deviation increase), again with no evidence of residual maternal-level confounding. We conclude that some perinatal characteristics may play causal, disease-specific roles in the development of eating disorders, including via perinatal variation within the normal range. Further research into the underlying mechanisms is warranted. Finally, several large population-based studies of anorexia nervosa have been conducted in twins; it is possible that these studies considerably overestimate prevalence

Early life characteristics, social mobility during childhood and risk of stroke in later life: findings from a Swedish cohort.

AIMS: To investigate if early life characteristics and social mobility during childhood are associated with incident thrombotic stroke (TS), haemorrhagic stroke (HS) and other stroke (OS). METHODS: Our study population consists of all live births at Uppsala University Hospital in 1915-1929 (Uppsala Birth Cohort; n = 14,192), of whom 5532 males and 5061 females were singleton births and lived in Sweden in 1964. We followed them from 1 January 1964 until first diagnosis of stroke (in the National Patient Register or Causes of Death Register), emigration, death, or until 31 December 2008. Data were analysed using Cox regression, stratifying by gender. RESULTS: Gestational age was negatively associated with TS and OS in women only. Women had increased risk of TS if they were born early preterm (<35 weeks) (HR 1.54 (95% CI 1.02-2.31)) or preterm (35-36 weeks) (HR 1.37 (95% CI 1.03-1.83)) compared to women born at term. By contrast, only women who were early preterm (HR 1.98 (95% CI 1.27-3.10) had an increased risk of OS. Men who were born post-term (⩾42 weeks) had increased risk of HS (HR 1.45 (95% CI 1.04-2.01)) compared with men born at term, with no association for women. TS was associated with social mobility during childhood in women: women whose families were upwardly or downwardly mobile had increased risk of TS compared to women who were always advantaged during childhood. CONCLUSIONS: Gestational age and social mobility during childhood were associated with increased risk of stroke later in life, particularly among women, but there was some heterogeneity between stroke subtypes

Socio-economic position at four time points across the life course and all-cause mortality: updated results from the Uppsala Birth Cohort Multigenerational Study

Socio-economic position (SEP) is associated with all-cause mortality across all stages of the life course; however, it is valuable to distinguish at what time periods SEP has the most influence on mortality. Our aim was to investigate whether the effect of SEP on all-cause mortality accumulates over the life course or if some periods of the life course are more important. Our study population were from the Uppsala Birth Cohort Multigenerational Study, born 1915–29 at Uppsala University Hospital, Sweden. We followed 3,951 men and 3,601 women who had SEP at birth available, during childhood (at age ten), in adulthood (ages 30–45) and in later life (ages 50–65) from 15 September 1980 until emigration, death or until 31 December 2010. We compared a set of nested Cox proportional regression models, each corresponding to a specific life course model (critical, sensitive and accumulation models), to a fully saturated model, to ascertain which model best describes the relationship between SEP and mortality. Analyses were stratified by gender. For both men and women the effect of SEP across the life course on all-cause mortality is best described by the sensitive period model, whereby being advantaged in later life (ages 50–65 years) provides the largest protective effect. However, the linear accumulation model also provided a good fit of the data for women suggesting that improvements in SEP at any stage of the life course corresponds to a decrease in all-cause mortality.</jats:p

Social and psychological predictors of body mass index among South Africans 15 years and older: Sanhanes-1

This study investigated how psychological distress and the proxies for social position combine to influence the risk of both underweight and overweight in South Africans aged 15 years and older. This was a cross-sectional study that included 2254 men and 4170 women participating in the first South African National Health and Nutrition Examination Survey (SANHANES-1). An analysis exploring the associations of social and mental health characteristics with body mass index (BMI) was conducted using binary and multinomial logistic regressions. Results suggested that, overall, women had a higher risk of overweight/obesity compared to men (age-adjusted odds ratio [AOR] 4.65; 95% confidence intervals [CI] 3.94–5.50). The gender effect on BMI was smaller in non-African participants (AOR 3.02; 95% CI 2.41–3.79; p-value for interaction = 0.004). Being employed and having a higher level of education were associated with higher risks of overweight and obesity and a lower risk of underweight. Being single or without a spouse and poor mental health were found to increase the odds of being underweight, especially in men. To conclude, there are strong social gradients and important gender and ethnic differences in how BMI is distributed in the South African population

Childhood and adulthood socio-economic position and hypertensive disorders in pregnancy: the Uppsala Birth Cohort Multigenerational Study

Background Childhood and adulthood socio-economic position (SEP) is associated with cardiovascular disease in later life, but associations with hypertensive disorders in pregnancy are not well established

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SIGLEAvailable from TIB Hannover: DW 5696 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

Associations between parental educational level and ED in daughters, comparing associations across ED subtypes and across birth years.

<p>CI = confidence interval, ED = eating disorder, EDNOS = eating disorder not otherwise specified. All models adjust for all parent SEP variables (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0106475#pone-0106475-t001" target="_blank">Table 1</a>) plus parental age and the index cohort member's birth year. †Analyses comparing ED subtypes exclude those born before 1985 because the three-way division of these subtypes only became possible in 1997 when ICD-10 was introduced. N = 4362 females for anorexia nervosa; N = 1169 for bulimia nervosa; and N = 4607 for EDNOS. ‡Results very similar if restricted to inpatient diagnoses, which were available across all years for all cohort members.</p

Parental and grandparental predictors of rates of eating disorder hospitalisation among Swedish males born 1975–1998.

<p>*p<0.05, **p<0.01, ***p<0.001 for heterogeneity. ED = eating disorder not-otherwise-specified, CI = confidence interval. Basic education is up to age 16, Secondary education is up to age 18–19. Adjusted analyses adjust for all variables in the column plus the age of the grandparents and parents at the birth of their son, and the birth year of the index cohort member. Note that the birth years are restricted to 1975–1998, as it is for males born in in these years that the distinction between anorexia and non-anorexia ED was always available in the contemporary ICD version.</p><p>Parental and grandparental predictors of rates of eating disorder hospitalisation among Swedish males born 1975–1998.</p

Association between maternal grandparent education and ED in granddaughters, stratifying by whether the grandparent was alive when the granddaughter turned 12 (N = 1,040,165 females).

<p>CI = confidence interval, ED = eating disorder.</p

Association between parent SEP and duration of first ED inpatient hospitalisation, among 5867 Swedish males and females born 1973–1998.

†<p>From linear regression predicting to log-transformed mean duration of hospitalisation, adjusting for the child's birth year, type of disorder and age at admission. Note these analyses use the duration of the first inpatient hospitalization, not excluding individuals who had previously received an outpatient diagnosis: the total number of inpatient cases is therefore higher than the 4177 cases <i>first</i> identified in the inpatient register.</p><p>Association between parent SEP and duration of first ED inpatient hospitalisation, among 5867 Swedish males and females born 1973–1998.</p