# Maternal Gestational Low‐Grade Inflammation and the Risk of Anorexia Nervosa in Daughters

## TL;DR

Higher maternal inflammation during pregnancy is linked to lower risk of anorexia in daughters.

## Contribution

Shows that lower gestational inflammation is associated with increased anorexia risk in daughters.

## Key findings

- Higher maternal hs-CRP was associated with decreased anorexia risk in daughters.
- Lowest hs-CRP tertile showed increased anorexia risk compared to highest tertile.
- No evidence that higher inflammation increases anorexia risk.

## Abstract

Prenatal exposures have been suggested to have a programming effect on neural and metabolic development, which may affect the risk of eating disorders. We investigated the association between prospectively measured maternal gestational high‐sensitivity C‐reactive protein (hs‐CRP), an established inflammatory biomarker, and subsequent risk of AN in daughters.

This nested case–control study with sibling‐comparison design used systematic sampling from a register‐based cohort including all eating disorder patients in Finland born 1991–2000 and diagnosed in specialized health care. Final sample included 150 full triads of females with severe AN (ICD‐10 code F50.0), age‐ and sex‐matched population controls, and biological sister controls (total N = 450).

Mean gestational hs‐CRP values were 4.10 mg/L (SD 5.22), 4.83 mg/L (SD 4.88), and 5.53 mg/L (SD 10.36), for individuals with AN, population controls, and sister controls, respectively. Higher hs‐CRP was associated with decreased risk for AN when compared to sister controls (adjusted OR 0.68, 95% Cl 0.48–0.97, p = 0.03). Analyzing hs‐CRP in tertiles, maternal hs‐CRP in the highest tertile (≥ 5.13 mg/L) versus lowest tertile (≤ 1.94 mg/L) was associated with decreased risk for AN compared to sisters (adjusted OR 0.35, 95% Cl 0.15–0.80, p = 0.01), and to all controls combined (adjusted OR 0.52, 95% Cl 0.29–0.93, p = 0.03).

We found no evidence that higher gestational CRP would increase the later risk of AN. On the contrary, lower maternal low‐grade inflammation early in pregnancy was associated with an increased risk of AN in daughters.