Health behavior after intrahepatic cholestasis of pregnancy

Background: Pregnancy is an opportunity to adopt favorable health behaviors. We studied whether intrahepatic cholestasis of pregnancy (ICP) promotes favorable health behavior in later life. Design: A prospective controlled cohort study. The method was a questionnaire survey in 2010 among 575 women with ICP and 1374 controls, all having delivered between the years 1969 and 1988 in Tampere University Hospital in Finland. Questionnaires were sent to 544 ICP patients and 1235 controls. Responses were received from 1178 (response rate 66.2%). The main outcome measures concerning recent or current health behavior were smoking, alcohol consumption, physical activity, body mass index (BMI) and special diet. Results: Current smoking was less common in the ICP group than among controls (10.5% vs 15.7%, p = 0.017). Assessed by smoking pack years there was a similar difference: in the ICP group 11.7% of women had at least 10 smoking pack years compared to 18.0% of the controls (p = 0.006). Recent alcohol consumption did not separate the two groups. The groups did not differ as to reported physical activity assessed in MET units. Fewer ICP women had had BMIs of 30 or more during pregnancy compared with controls (18.8% vs 25.1%, p = 0.023). In other points of life the BMI differences were not statistically significant. Weight-loss diet and gallbladder diet were more common in the ICP group (6.3% vs 3.6%, p = 0.044, and 3.0% vs 1.3%, p = 0.038). Conclusions: Having developed ICP two to four decades earlier seemed to constitute an effective intervention for smoking habits but not for other aspects of health behavior.

Mother’s intrahepatic cholestasis does not affect her daughter’s health

Objective: To establish whether a mother’s intrahepatic cholestasis of pregnancy (ICP) has connections to her daughter’s health. Design: A retrospective study of daughters to ICP mothers. Setting: The region of Tampere University Hospital in Finland. Subjects: The study population comprised 575 women diagnosed with ICP during at least one pregnancy in the obstetric department of Tampere University Hospital in the period 1969-1988, and two controls chosen for each. Questionnaires were sent to these women and to their daughters: 305 daughters to ICP mothers and 642 to controls in autumn 2010. Eventually 187 daughters to ICP mothers responded (61.3%) and 373 to controls (58.1%). Main Outcome Measures: Evaluated health, symptoms and complaints, diagnosed diseases, mental health and use of medicines. Results: Only minor differences were detected between the two groups regarding the majority of items inquired. The only prominent difference between daughters to ICP mothers and those to controls concerned epilepsy, which was significantly more frequent among ICP mothers’ daughters, the prevalence being fourfold (3.2% vs 0.8%, p = 0.033). Conclusion: A mother’s ICP does not generally affect her daughter’s health. This can be considered an encouraging new finding for mothers with ICP in primary health care.

Childhood Adversities Associated with Eating Disorders Reported by Adults

Background: It has been suggested that childhood events increase the risk of suffering from an eating disorder (ED) in adolescence or young adulthood. Our study here aimed at investigating whether there was an association between stressful childhood events and eating disorders later in life. Methods: Our population-based study was a part of the HeSSup (The Health and Social Support) postal survey in 2003, a follow-up survey with a random sample of working-aged subjects drawn from the Finnish Population Register in 1998. Participants in this study reported having been suffering from ED (N = 374), while controls (N = 18,639) reported no history of eating disorder in the questionnaire both in 1998 and 2003. The questionnaire included six questions related to childhood adversities. Results: Each childhood stressor increased the risk of developing ED cumulatively (one adversity OR 1.7 versus all six OR 8.3). Intrafamiliar conflicts (OR 2.0), being afraid of a family member (OR 1.5) or long-term illnesses in the family (OR 1.4) increased the ED-risk statistical significantly. Conclusion: Children exposed to stress are more likely to suffer from eating disorders as adults than those not exposed.