Eating disorders before pregnancy may raise odds for asthma
January 22, 2026
4 min read
Key takeaways:
- Researchers found a link between maternal eating disorders before pregnancy and offspring wheezing and asthma.
- Similar results were reported in an analysis without mothers with comorbid depression/anxiety.
Children with mothers who had vs. did not have an eating disorder before pregnancy had greater odds for preschool wheezing and school-age asthma, according to results published in Thorax.
“For clinicians, the key implication is that maternal eating disorders may have consequences that extend beyond the mother and influence the child’s respiratory health,” Maja Popovic, MD, PhD, assistant professor in the department of medical sciences at the University of Turin, told Healio. “This reinforces the importance of taking a holistic view of maternal well-being during pregnancy — not only physical health, but also psychological and nutritional factors.
“Awareness of these potential impacts can help clinicians better understand the broader context of early respiratory vulnerabilities in children and encourage more integrated care for mothers who have experienced eating disorders,” Popovic said.
Using seven cohorts from the EU Child Cohort Network, Popovic and colleagues evaluated 131,495 mother-child pairs to determine how maternal eating disorders before pregnancy impact the odds for preschool wheezing and school-age asthma in offspring.
Popovic told Healio the above study stemmed from earlier work in one of the cohorts in the EU Child Cohort Network: The Italian Nascita e INFanzia: gli Effetti dell’Ambiente (NINFEA) birth cohort. The link between maternal mental health and childhood health outcomes has been the focus of this cohort.
“A previous NINFEA study — essentially a pilot for this project — suggested that maternal eating disorders were linked to infant wheezing,” Popovic said. “However, unlike depression or anxiety, eating disorders have been far less studied, and these findings had not been replicated or extended to other respiratory outcomes or older ages.
“Moreover, because eating disorders are relatively rare, single cohorts often lack the power to explore these associations in depth,” she continued.
Across the included cohorts, the lowest proportion of women with an eating disorder before pregnancy was 0.8%, whereas the highest was 17%. The study outlined that the lowest reported prevalence was taken from health records, and the highest prevalence was based on self-reported lifetime eating disorders.
When analyzing offspring respiratory outcomes, researchers found that preschool wheezing was more prevalent than school-age asthma (20.7%-49.6% vs. 2.1%-17.3%).
Children with mothers who had vs. did not have an eating disorder before pregnancy faced an elevated likelihood for preschool wheezing (OR = 1.25; 95% CI, 1.06-1.47). This was also the case for current school-age asthma, as the odds for this outcome were heightened in offspring with mothers who had vs. did not have an eating disorder before pregnancy (OR = 1.26; 95% CI, 1.1-1.46).
Notably, the study reported that heterogeneity was substantial across cohorts in the link found between maternal eating disorders before pregnancy and preschool wheezing (I2 = 74%), whereas heterogeneity was minimal in the link found between maternal eating disorders before pregnancy and school-age asthma (I2 = 9%).
“Although the estimates for wheezing showed greater heterogeneity across cohorts, they were qualitatively consistent with the asthma findings, with the odds ratio greater than one in five of the six cohorts,” Popovic and colleagues wrote.
In an analysis without mothers with comorbid depression/anxiety, researchers continued to observe elevated odds for preschool wheezing and school-age asthma in offspring with mothers who had vs. did not have an eating disorder before pregnancy (wheezing, OR = 1.19; 95% CI, 0.99-1.44; I2 = 76.4%; asthma, OR = 1.24; 95% CI, 1-1.54; I2 = 39.3%).
When eating disorders before pregnancy were broken down into anorexia nervosa (AN) and bulimia nervosa (BN), the study reported comparable findings to the overall result for school-age asthma (AN: OR = 1.34; 95% CI, 1.06-1.69; I2 = 6%; BN: OR = 1.28; 95% CI, 1.04-1.57; I2 = 0%). For preschool wheezing, BN before pregnancy was linked to this outcome (OR = 1.21; 95% CI, 1.06-1.39; I2 = 27.4%), but AN before pregnancy was not.
In the analysis of eating disorders during pregnancy, a link was observed between this exposure period and preschool wheezing in the meta-analysis of four studies (OR = 1.14; 95% CI, 1.05-1.23; I2 = 0%) but not to school-age asthma in the meta-analysis of three studies.
One study had data on eating disorders before, during and after pregnancy. Across the three exposure periods, researchers found similar links to preschool wheezing, whereas for school-age asthma, the link was strongest with eating disorders after pregnancy (OR = 1.41; 95% CI, 1.16-1.73) vs. during (OR = 0.99; 95% CI, 0.82-1.21) and before pregnancy (OR = 1.16; 95% CI, 0.96-1.41).
Lastly, maternal eating disorders before pregnancy were weakly positively linked to offspring school-age lung function using data from two studies.
“Maternal mental health is already recognized as an important determinant of children’s respiratory health, so our findings align with this broader literature,” Popovic told Healio. “What is new here is the focus on maternal eating disorders.
“While children of mothers with eating disorders consistently show higher risks of cognitive, social, emotional, behavioral and eating difficulties, evidence for physical health outcomes has been less consistent,” she said. “For this reason, the associations we observed with respiratory outcomes are novel but not entirely surprising. They fit within a wider pattern showing that maternal eating disorders can have far-reaching effects on child health.”
Looking ahead, Popovic told Healio there are still important questions to be answered.
“Future research should examine specific eating disorder subtypes in more depth and clarify the mechanisms underlying the association,” Popovic said. “Maternal eating disorders may influence offspring respiratory health through multiple possible pathways, including direct stress-related in-utero effects, maternal behavioral and lifestyle factors, perinatal outcomes such as prematurity, and low birth weight — all well-known risk factors for childhood wheezing and asthma.
“Disentangling these biological and behavioral pathways will be an essential step for future research,” she told Healio.
For more information:
Maja Popovic, MD, PhD, can be reached at [email protected].
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