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

Abstract

: Background : The Fukushima Pregnancy and Birth Survey was launched to monitor pregnant mothers' health after the Great East Japan Earthquake and Fukushima Daiichi Nuclear Power Plant (NPP) accident. Several lines of investigations have indicated that a disaster impacts maternal mental health with childbirth. However, there is no research regarding mental health of mothers with fetal loss after a disaster. In this report, we focus on those women immediately after the Great East Japan Earthquake and Fukushima NPP accident and discuss their support needs. Materials and Methods : Data regarding 61 miscarriages, 5 abortions, and 22 stillbirths were analyzed among the women who were pregnant at the time of the accident in the present study. We used a two -item case -finding instrument for depression screening, and compared the childbirth group with the fetal loss groups. We also analyzed mothers' opinions written as free -form text. Results : Among the three fetal loss groups, the proportion of positive depression screens was significantly higher in the miscarriage and stillbirth group than in the childbirth group. Mothers' opinions were grouped into six categories, with pregnancy -related items being most common, especially in the miscarriage and stillbirth groups. Conclusion : A higher proportion of Fukushima mothers with fetal loss, especially those with miscarriage and stillbirth, had depressive symptoms compared to those who experienced childbirth. Health care providers need to pay close attention to this vulnerable group and respond to their concerns regarding the effects on their fertility.

Pregnancy and Birth Survey of the Fukushima Health Management Survey

“…21 Moreover, the proportion of mothers identified as depression positive (using the 2-item screening measure 13 ) was higher among mothers who experienced miscarriages and stillbirths than among mothers who had live births. 22 Results from analyses of maternal confidence have been reported in more detail elsewhere, 23 The proportion of breast-feeding mothers increased over the study period, while the proportion of mothers choosing formula feeding due to concerns about the adverse effects of radiation decreased substantially (Table 4). 24 However, when delivery dates were divided into 4 periods during the first year after the disaster, an increase was seen in the proportion of mothers in the affected area (Soso region) who chose formula feeding exclusively, while no such trend was observed in the less-affected area (Aizu region).…”

“…21 Moreover, the proportion of mothers identified as depression positive (using the 2-item screening measure 13 ) was higher among mothers who experienced miscarriages and stillbirths than among mothers who had live births. 22 Results from analyses of maternal confidence have been reported in more detail elsewhere, 23 but in brief, over 40% of mothers (no question in FY 2011; 45.9% in FY 2012; 44.9% in FY 2013; and 41.4% in FY 2014) have stated that they were not confident of childrearing. 10…”

Postpartum Mental Health of Mothers in Fukushima: Insights From the Fukushima Health Management Survey’s 8-year Trends

“… 14 Furthermore, a higher proportion of depressive symptoms was observed among mothers who experienced miscarriage (41%, P < 0.01) or stillbirth (55%, P < 0.01) than among those who had a live birth (28%). 15 Even using data from FY 2011–2018, the proportion of depressive symptoms in respondents who had a miscarriage (34%, P < 0.001) or stillbirth (50%, P < 0.001) was higher than in those who had a live birth (23%).…”

Effects of External Radiation Exposure on Perinatal Outcomes in Pregnant Women After the Fukushima Daiichi Nuclear Power Plant Accident: the Fukushima Health Management Survey

“… 8 Depressive symptoms were observed in some new mothers in Fukushima Prefecture, 10 particularly those living near the power plant or who experienced miscarriage or stillbirth. 11 Pregnant women living near the earthquake epicenter during their third trimester were at a higher risk for HDP, suggesting an association with psychological stress. 12 However, no regional differences in the mothers’ and infants’ conditions were observed at 1-month postnatal check-ups.…”

“…The PBS provides data on perinatal outcomes, including preterm birth, low birth weight (LBW), small for gestational age (SGA), congenital anomalies, 5 – 9 postpartum depression, 10 , 11 hypertensive disorders of pregnancy (HDP), 12 and the impact of the earthquake on newborns. 13 Rates of stillbirth, preterm birth, LBW, and congenital anomalies did not deviate from the Japanese standard frequency, 1 , 5 and SGA incidence was not elevated by the earthquake or its aftermath.…”