Disasters and Perinatal Health: A Systematic Review

Abstract

Background The empirical literature on the effects of disaster on pregnancy and the postpartum period is limited. The objective of this review was to examine the existing evidence on the effect of disasters on perinatal health. Methods A systematic review was conducted by searching electronic databases (MEDLINE, EMBASE, Cinahl, PsycInfo), including literature on disasters and pregnancy outcomes (e.g., preterm birth, low birthweight, congenital anomalies), mental health, and child development. 110 articles were identified, but many published reports were anecdotes or recommendations rather than systematic studies. The final review included 49 peer-reviewed studies that met inclusion criteria. Results Studies addressing the World Trade Center disaster of September 11th and other terrorist attacks, environmental/chemical disasters, and natural disasters such as hurricanes and earthquakes were identified. Disasters of various types may reduce fetal growth in some women, though there does not appear to be an effect on gestational age at birth. Severity of exposure is the major predictor of mental health issues among pregnant and postpartum women. The mother's mental health after a disaster may more strongly influence on child development than any direct effect of disaster-related prenatal stress. Conclusions There is evidence that disaster impacts maternal mental health and some perinatal health outcomes, particular among highly-exposed women. Future research should focus on under-studied outcomes such as spontaneous abortion. Relief workers and clinicians should concentrate on the most exposed women, particularly with respect to mental health.

Pregnancy and Birth Survey After the Great East Japan Earthquake and Fukushima Daiichi Nuclear Power Plant Accident in Fukushima Prefecture

“…Several studies of terrorist attacks 4 -9) , nuclear reactor accidents 10 -16) , and natural disasters (earthquakes 17 -20) and hurricanes 21,22) ) have been identified. Disasters of various types may affect on fetal growth, although there is no clear causal link to shortened gestation or preterm birth 3) . The objective of this report is to describe some results of a pregnancy and birth survey after the disaster based on questionnaires from the Radiation Medical Science Center for the Fukushima Health Management Survey.…”

“…In general, disasters potentially influence a range of reproductive and birth outcomes. Even without direct exposure to a disaster, circumstances may lead to an increased risk of adverse outcomes, -for instance, more unplanned pregnancies and sexually transmitted infections 3) . However, the literature on disasters indicates limited effects on birth outcomes.…”

Immediate Mental Consequences of the Great East Japan Earthquake and Fukushima Nuclear Power Plant Accident on Mothers Experiencing Miscarriage, Abortion, and Stillbirth: The Fukushima Health Management Survey

“…Many studies on the effects of various disasters (including natural and human -made disasters) on maternal mental health have indicated that pregnant and postpartum women may be especially vulnerable 6) . Examples include a study after the World Trade Center disaster, which reported that pregnant women attacked directly were more likely to be depressive 15) .…”

“…Frequencies of abortions and miscarriages were reported not to have increased 4) . However, negative mental health consequences of mothers were reported after the Chernobyl accident 5) , and other disasters such as terrorist attacks, environmental disasters, earthquakes, hurricanes, and other natural disasters 6) . These investigations demonstrated that pregnant and postpartum women are vulnerable to the effects of disaster on mental health, however, as of yet there is no research on the effects of disaster on women experiencing fetal loss.…”

A systematic review of the health effects of prenatal exposure to disaster

“…Pregnant women are at increased risk for adverse health effects both during and after a disaster event due to their condition (Harville et al 2010;Nour 2011). Psychological and physiological stress, trauma, reduced access to health facilities and to medication, and disruption in prenatal services are some potential risk factors for pregnant women from disasters, and these adverse effects are likely to also affect the unborn child.…”