Patient-Focused Disaster Preparedness
Exposure to Hurricane Katrina, Post-traumatic Stress Disorder and Birth Outcomes

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ABSTRACT

Background

Little is known about the effects of natural disasters on pregnancy outcomes. We studied mental health and birth outcomes among women exposed to Hurricane Katrina.

Methods

We collected data prospectively from a cohort of 301 women from New Orleans and Baton Rouge. Pregnant women were interviewed during pregnancy about their experiences during the hurricane, and whether they had experienced symptoms of post-traumatic stress disorder (PTSD) and/or depression. High hurricane exposure was defined as having 3 or more of the 8 severe hurricane experiences, such as feeling that one’s life was in danger, walking through floodwaters, or having a loved one die.

Results

The frequency of low birth weight was higher in women with high hurricane exposure (14.0%) than women without high hurricane exposure (4.7%), with an adjusted odds ratio (aOR): 3.3; 95% confidence interval (CI): 1.13–9.89; P < 0.01. The frequency of preterm birth was higher in women with high hurricane exposure (14.0%) than women without high hurricane exposure (6.3%), with aOR: 2.3; 95% CI: 0.82–6.38; P > 0.05. There were no significant differences in the frequency of low birth weight or preterm birth between women with PTSD or depression and women without PTSD or depression (P > 0.05).

Conclusions

Women who had high hurricane exposure were at an increased risk of having low birth weight infants. Rather than a general exposure to disaster, exposure to specific severe disaster events and the intensity of the disaster experience may be better predictors of poor pregnancy outcomes. To prevent poor pregnancy outcomes during and after disasters, future disaster preparedness may need to include the planning of earlier evacuation of pregnant women to minimize their exposure to severe disaster events.

Section snippets

Methods

We conducted a prospective cohort study at the prenatal care clinics at Tulane-Lakeside Hospital in New Orleans and Woman’s Hospital in Baton Rouge (about 120 km away from New Orleans and less exposed to Hurricane Katrina) between January 2006 and June 2007. Two hundred twenty women from New Orleans and 81 women from Baton Rouge who were pregnant during Hurricane Katrina or became pregnant immediately after the hurricane were recruited. Inclusion criteria were speaking English, planning to

Results

Table 1 presents the characteristics of the study population. After excluding missing data, 7.2% were 18- to 19-years old and 19.5% were ≥35 years old; 43.8% were non-Hispanic white and 41.6% were non-Hispanic black; 45.5% were primiparous. Of the multiparous women, 5.3% had prior history of low birth weight infants. The rates of PTSD and depression were 4.4% and 14.4%. The rates of low birth weight and preterm birth were 9.7% and 9.7%.

Discussion

Hurricane Katrina affected almost everyone in the New Orleans area, through the stress of relocation, uncertainty, discontinuity in medical care, social network disruption, and loss of lives, jobs, and property. Although the exposure to such a devastating disaster as Hurricane Katrina could potentially have substantial effects, we do not see a significantly increased rate overall of low birth weight (9.7%) or preterm birth (9.7%) in our study sample. However, our study suggested that pregnant

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    Citation Excerpt :

    These findings suggest that exposure intensity acts according to a U-shape curve, with moderate amounts of exposure being least likely to produce negative effects, and lower and high amounts promoting adverse outcomes in children. Although negative health outcomes following exposure to high amounts of distress during natural disasters are well documented [1,15,88], adverse effects of low amounts of disaster-related distress are less investigated. The present results show that low levels of maternal hardship is associated with high hair copper levels and language development deficits in boys at four years of age.

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This study was supported by NIH/NICHD 3U01HD040477-0552. Dr. Harville is a BIRCWH scholar, supported by Grant Number K12HD043451 from the National Institute of Child Health And Human Development.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Child Health And Human Development or the National Institutes of Health.

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