[acb-hsp] Stress-related Impacts of Hurricanes on Pregnant Women

[peter altschul]

Study in hurricane region reveals effects of stress on pregnancy













Posted June 22, 2012; 03:53 p.m.  by Michael Hotchkiss
  Expectant mothers who dealt with the strain of a hurricane or 
major tropical storm passing nearby during their pregnancy had 
children who were at elevated risk for abnormal health conditions 
at birth, according to a study led by a Princeton University 
researcher that offers new insights into the effects of stress on 
pregnancy.
  The study used birth records from Texas and meteorological 
information to identify children born in the state between 1996 
and 2008 whose mothers were in the path of a major tropical storm 
or hurricane during pregnancy.  The children's health at birth 
was compared with that of siblings whose gestation didn't 
coincide with a major weather event.
  The study found that mothers living within 30 kilometers of a 
hurricane's path during their third trimester were 60 percent 
more likely to have a newborn with abnormal conditions, which are 
detailed on birth records.  Those conditions included being on a 
ventilator for more than 30 minutes or experiencing meconium 
aspiration, which occurs when a newborn breathes in a mixture of 
meconium his or early feces his and amniotic fluid around the 
time of delivery.  Increased risk was also found following 
exposure to weather-related stressors in the first trimester, 
while evidence was less clear for exposure in the second 
trimester.  The researchers were able to isolate the impact of 
stress caused by the storm from other factors, such as changes in 
the availability of health care in a storm's aftermath.
  The study breaks ground by homing in on new his and potentially 
better his ways to measure the impact of prebirth stress on 
newborns and opens avenues for further research into the 
potential impact on such children's later development, said lead 
researcher Janet Currie Princeton's Henry Putnam Professor of 
Economics and Public Affairs at the Woodrow Wilson School of 
Public and International Affairs and director of the Center for 
Health and Wellbeing.
  "Probably the most important finding of our study is that it 
does seem like being subjected to stress in pregnancy has some 
negative effect on the baby, but that the effect is more subtle 
than some of the previous studies have suggested," said Currie, 
who conducted the study along with Maya Rossin-Slater, a doctoral 
candidate in the Department of Economics at Columbia University.
  Anna Aizer, associate professor of economics and public policy 
at Brown University who wasn't involved in the study, said the 
research "really raises the bar in terms of identification of the 
effect of stressful events in-utero on birth outcomes."
  "Previous work has not really been able to isolate the effect 
as well as Currie and Rossin-Slater have," said Aizer, whose 
research focuses on issues related to children's well-being.
  Meconium aspiration his usually a sign of fetal distress his 
and other respiratory problems that necessitate a baby being 
placed on a ventilator can generally be treated successfully, but 
the study offers new paths for future research about the 
long-term health of children born in the wake of stressful events 
such as hurricanes.
  "I think there's every reason to believe that if you have a 
better measure of child health his like you knew this child was 
having breathing problems at birth his that might be a stronger 
predictor of longer-term outcomes," Currie said.  "There's a lot 
of interest in this whole area of how things that happen very 
early in life can affect future outcomes."
  Previous research into the impact of similar types of stress 
has found changes in length of gestation and birth weight, but 
the new study didn't find a significant effect on those measures, 
Currie said.
  Currie said one explanation for the difference is that the new 
study utilized data that allowed the researchers to control for 
changes in the population of an area around the time of a storm 
that could have affected the previous findings.  Earlier research 
hasn't been able to account for the way the population of an area 
changes around the time of a stressful event his with people of 
certain demographic groups more likely than others to move away 
or stay nearby.
  The new study included data on eight hurricanes and tropical 
storms that hit any part of Texas between 1996 and 2008 and 
caused more than $10 million damage.  The most damaging storms 
were Tropical Storm Allison in 2001, which caused more than $50 
billion in damage and 40 deaths, and Hurricane Ike, which caused 
$19.3 billion in damage and 103 deaths.
  Experiencing a hurricane or major tropical storm can have a 
significant impact on people that goes well beyond stress.  
However, Currie said the researchers were able to determine that 
findings related to abnormal health conditions at birth generally 
weren't tied to disruption of medical care or property damage 
caused by the storms, such as damage to an expectant mother's 
home that might lead to injury or increased risk of illness.  
They also found little consistent evidence that the stress 
associated with storms affected mothers' behaviors, such as 
smoking, eating as reflected in weight gain and use of prenatal 
care.
  One potential cause of the health problems found in the study 
is an increase in stress hormones caused by the storm, which 
occurred in what is known as the neuroendocrine pathway.
  "I think the takeaway finding is that it's worth doing more 
focused research on those pathways and looking for more subtle 
effects on the fetus than just looking at birth weight and 
preterm delivery," Currie said.  "And it would be really great if 
we could follow over time and see what happens to children who 
are affected by these types of events."
  Aizer said the research could also have implications beyond the 
context of natural disasters.
  "Previous work has shown poor mothers are exposed to more 
stressors.  Currie and Rossin-Slater's work suggests that 
exposure to stress might be one of the mechanisms explaining why 
poor women have worse birth outcomes," Aizer said.  "Policymakers 
concerned with improving the outcomes of poor families should 
consider these findings."
  The study, which is described in a working paper circulated in 
May by the National Bureau of Economic Research, was supported by 
funding from the Eunice Kennedy Shriver National Institute of 
Child Health and Human Development.