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ABSTRACT Aims To investigate associations between maternal stress and smoking prior to, during and 6 months after the pregnancy. Design A prospective population-based cohort study. Setting Norway. Participants A total of 71 757 women in the Norwegian Mother and Child Cohort Study (MoBa) participating twice during pregnancy and at 6 months postpartum. Measurements Respondents' estimates of anxiety and depression, relationship discord and negative life events were measured, along with self-reports of smoking behaviour and demographic variables. Smoking was assessed at gestation weeks 17 and 30 and at 6 months postpartum. Findings Of the 27.5% women who smoked at conception, 55.8% quit smoking during pregnancy. At 6 months postpartum, 28.9% of quitters had relapsed to smoking. In total, 12.9% of the sample reported smoking during the pregnancy. Adjusted for well-known risk factors, women reporting high levels of anxiety and depression had a decreased likelihood of quitting smoking during pregnancy [odds ratio (OR) 0.80, 95% confidence interval (CI): 0.73, 0.88) and an increased likelihood of relapsing after delivery (OR 1.26, 95% CI: 1.11, 1.44). Both relationship discord (OR 0.82, 95% CI: 0.75, 0.90) and exposure to negative life events (OR 0.93, 95%: CI 0.90, 0.96) had a negative influence on quitting smoking during pregnancy but had no influence on relapse to smoking postpartum. Conclusions Maternal stress and relationship discord may inhibit smoking cessation during pregnancy and promote resumption of smoking after pregnancy in women who have achieved abstinence. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effectiveness of the International Child Development Programme (ICDP), a group‐based parenting programme used internationally and implemented nationally in Norway. We used a cluster randomized controlled trial in which 81 groups were randomly assigned to either the intervention or waitlist control condition after the baseline data collection. A total of 590 parents completed at least one of three questionnaires (administrated before and after ICDP and 4 months after completing the intervention). Primary outcomes included parental self‐efficacy, parental emotion sensitivity and positive involvement with their child. Secondary outcomes included parents' perceptions of their relationship with the child, child‐rearing conflicts and the child's psychosocial health. We found significant effects favouring the intervention arm following the intervention and at follow‐up on two primary outcomes (parental self‐efficacy and emotion sensitivity). For the secondary outcomes, we found a significant reduction in child‐rearing conflict at the 4‐month follow‐up, increased closeness to the child, reduced child internalizing difficulties and increased prosocial behaviour immediately following the intervention. However, ICDP seems to have limited effects on parent‐reported changes in children. We conclude that ICDP as a universal preventive programme offered to parents in groups can be effective in strengthening parental self‐efficacy and improving parental emotion sensitivity. [ABSTRACT FROM AUTHOR]

Previous studies of the relationship between maternal eating disorders and adverse perinatal outcomes have failed to control for familial transmission of perinatal phenotypes, which may confound the reported association. In a unique design afforded by the Norwegian Mother and Child Cohort Study and Medical Birth Registry of Norway, we linked three generations through birth register records and maternal-reported survey data to investigate whether maternal eating disorders increase risk after parsing out the contribution of familial transmission of perinatal phenotypes. The samples were 70,881 pregnancies in grandmother-mother-child triads for analyses concerning eating disorder exposure during pregnancy and 52,348 for analyses concerning lifetime maternal eating disorder exposure. As hypothesized, eating disorders predicted a higher incidence of perinatal complications even after adjusting for grandmaternal perinatal phenotypes. For example, anorexia nervosa immediately prior to pregnancy was associated with smaller birth length (relative risk = 1.62; 95% CI [1.20, 2.14]), bulimia nervosa with induced labor (relative risk = 1.21; 95% CI [1.07, 1.36]), and binge-eating disorder with several delivery complications, larger birth length (relative risk = 1.25; 95% CI [1.17, 1.34]), and large-for-gestational-age (relative risk = 1.04; 95% CI [1.01, 1.06]). Maternal pregravid body mass index and gestational weight mediated most associations. Our results support that exposure to eating disorders increases the risk for negative health outcomes in pregnant women and their babies. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

Objective: We hypothesized that women with eating disorders would be more likely to rate their infants' temperament higher on negative emotionality than women without eating disorders. Method: Of 3,013 mothers with eating disorders, 44 reported anorexia nervosa (AN), 436 bulimia nervosa (BN), 2,475 binge eating disorder (BED), and 58 EDNOS purging type (EDNOS-P). The referent group comprised 45,964 mothers with no eating disorder. A partial proportional odds model was used to estimate the relation among maternal eating disorder presentations and infant temperament ratings while adjusting for covariates. Results: Women with AN, BN, EDNOS-P, and BED were 2.3, 1.4, 2.8, and 1.4 times more likely to report extreme fussiness than the referent group of women with no eating disorder, respectively. Discussion: Mothers with eating disorders may rate their infants as more difficult because of information-processing biases or because their infants are emotionally difficult. Maternal perception of infant temperament may be a risk factor for children's emotional development. © 2012 by Wiley Periodicals, Inc. (Int J Eat Disord 2012) [ABSTRACT FROM AUTHOR]

Using data from the longitudinal Norwegian Mother and Child Cohort Study, the aims of the current study were to examine associations between postnatal maternal heavy alcohol use and toddler behavior problems, taking both observed and unobserved confounding factors into account by employing fixed effects regression models. Postnatal maternal heavy alcohol use (defined as drinking alcohol 4 or more times a week, or drinking 7 units or more per alcohol use episode) and toddler internalizing and externalizing behavior problems were assessed when the toddlers were aged 18 and 36 months. Maternal psychopathology, civil status and negative life events last year were included as time-variant covariates. Maternal heavy alcohol use was associated with toddler internalizing and externalizing behavior problems ( p < 0.001) in the population when examined with generalized estimating equation models. The associations disappeared when observed and unobserved sources of confounding were taken into account in the fixed effects models [( p = 0.909 for externalizing behaviors ( b = 0.002, SE = 0.021), p = 0.928 for internalizing behaviors ( b = 0.002, SE = 0.023)], with an even further reduction of the estimates with the inclusion of time-variant confounders. No causal effect was found between postnatal maternal heavy alcohol use and toddler behavior problems. Increased levels of behavior problems among toddlers of heavy drinking mothers should therefore be attributed to other adverse characteristics associated with these mothers, toddlers and families. This should be taken into account when interventions aimed at at-risk families identified by maternal heavy alcohol use are planned and conducted. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective The aim of this paper was to internally validate previously reported relations (Knoph Berg et al., Aust N Z J Psychiatry, 42, 396-404, 2008) between psychosocial factors and bulimia nervosa (BN) outcomes during pregnancy. Method This study is based on the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Participants were women enrolled during pregnancy ( N = 69,030). Internal validity was evaluated by way of bootstrapped parameter estimates using the overall sample and a split sample calibration approach. Results Bootstrap bias estimates were below the problematic threshold, and extend earlier findings (Knoph Berg et al., Aust N Z J Psychiatry, 42, 396-404, 2008) by providing support for the validity of the models at the population level of all pregnant women in Norway. Bootstrap risk ratios indicated that prevalence, incidence, and remission of BN during pregnancy were significantly associated with psychosocial factors. The split sample procedure showed that the models developed on the training sample did not predict risks in the validation sample. Discussion This study characterizes associations between psychosocial exposures and BN outcomes among pregnant women in Norway. Women with lifetime and current self-reported psychosocial adversities were at a much higher risk for BN during pregnancy. Psychosocial factors were associated with BN remission during pregnancy, inviting the prospect of enhancing therapeutic interventions. We consider the findings in the context of reproducibility in science. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:654-662) [ABSTRACT FROM AUTHOR]

ABSTRACT Objective To describe weight-for-length (WFL) trajectories in the children (birth-12 months) of mothers with and without eating disorders. Method This study is based on the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. We categorized women ( N = 57,185) based on diagnosis prior to and during pregnancy: anorexia nervosa, bulimia nervosa, eating disorder not otherwise specified-purging subtype, binge eating disorder, or no eating disorder. The primary analysis included a shape invariant model fitted with nonlinear mixed effects to compare growth rates across eating disorder subtypes. Results The children of mothers reporting any eating disorder had a lower WFL growth rate from birth to 12 months than the children of mothers without eating disorders, even after adjusting for relative birth weight and some confounders known to affect growth. Discussion In this cohort, child WFL was related to maternal eating disorder status before and/or during pregnancy. These differences in growth trajectories warrant further study of long-term health outcomes and, if replicated, tailoring counseling to mothers with eating disorders during pregnancy. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:406-414) [ABSTRACT FROM AUTHOR]

This study explored the developmental trajectories of postpartum weight from 0.5 to 3 years after childbirth, and aimed to determine the associations between postpartum weight trajectories and prepregnancy body mass index and adequacy of gestational weight gain (GWG). Data from the Norwegian Mother and Child Cohort study were used, following 49,528 mothers 0.5, 1.5, and 3 years after childbirth. Analyses were performed using latent growth mixture modeling. Three groups of developmental trajectories of postpartum weight were found, with most women (85.9 %) having a low level of weight retention initially and slight gain over 3 years, whereas 5.6 % of women started at a high postpartum weight retention (on average 7.56 kg) at 0.5 years but followed by a marked weight loss over time (2.63 kg per year on average), and the third trajectory represented women (8.5 %) who had high weight retention high initially (on average 4.67 kg at 0.5 years) and increasing weight over time (1.43 kg per year on average). Prepregnancy overweight and obesity and excessive GWG significantly predicted a high postpartum weight trend. Women had substantial variability in postpartum weight development-both initially after birth and in their weight trajectories over time. Early preventive interventions may be designed to assist women with prepregnancy overweight and obesity and excessive GWG, which helps to reduce the increasing trend for postpartum weight. [ABSTRACT FROM AUTHOR]

Background Although pregnancy can be associated with adaptive changes in weight and eating behaviour for women with eating disorders, less is known about whether these changes are maintained in the postpartum period. We used a longitudinal design to examine gestational and postpartum weight trajectories in mothers with and without eating disorders in the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Methods Fifty-six women reported anorexia nervosa (AN), 636 bulimia nervosa, 3327 binge eating disorder and 69 eating disorder not otherwise specified, purging type. The referent group included 61 233 mothers with no eating disorder. We used a mixed effects model to predict weight change over time by eating disorder subtype. Results Mothers with AN, bulimia nervosa, binge eating disorder and eating disorder not otherwise specified had greater increases in body mass index (BMI) during pregnancy and greater decreases in BMI over the first 6 months postpartum. Women with AN shifted from the underweight BMI range before pregnancy to the normal weight range at 36 months postpartum Conclusions Patterns of maternal weight gain and retention during the perinatal period vary across eating disorder subtype and warrant clinical attention. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Objective: To investigate course and predictors of eating disorders in the postpartum period. Method: A total of 77,807 women, participating in the Norwegian Mother and Child Cohort Study (MoBa), completed questionnaires during pregnancy including items covering DSM-IV criteria for prepregnancy anorexia nervosa (AN), bulimia nervosa (BN), eating disorder not otherwise specified (EDNOS-P), and binge eating disorder (BED). Additional questionnaires were completed at 18 and 36 months postpartum. Results: Proportions of women remitting at 18 months and 36 months postpartum were 50% and 59% for AN, 39% and 30% for BN, 46% and 57% for EDNOS-P, and 45% and 42% for BED, respectively. However, disordered eating persisted in a substantial proportion of women meeting criteria for either full or subthreshold eating disorders. BN during pregnancy increased the risk for continuation of BN. BMI and psychological distress were significantly associated with course of BED. Discussion: This is the first large-scale population-based study on course of eating disorders in the postpartum period. The results indicated that disordered eating persists in a substantial proportion of women with prepregnancy eating disorders. Health care professionals working with women in this phase of life need to pay specific attention to eating disorder symptoms and behaviors. © 2013 by Wiley Periodicals, Inc. (Int J Eat Disord 2013) [ABSTRACT FROM AUTHOR]