Recent Canadian efforts to develop population-level pregnancy intervention studies to mitigate effects of natural disasters and other tragedies

Abstract

The preconception, pregnancy and immediate postpartum and newborn periods are times for mothers and their offspring when they are especially vulnerable to major stressors – those that are sudden and unexpected and those that are chronic. Their adverse effects can transcend generations. Stressors can include natural disasters or political stressors such as conflict and/or migration. Considerable evidence has accumulated demonstrating the adverse effects of natural disasters on pregnancy outcomes and developmental trajectories. However, beyond tracking outcomes, the time has arrived for gathering more information related to identifying mechanisms, predicting risk and developing stress-reducing and resilience-building interventions to improve outcomes. Further, we need to learn how to encapsulate both the quantitative and qualitative information available and share it with communities and authorities to mitigate the adverse developmental effects of future disasters, conflicts and migrations. This article briefly reviews prenatal maternal stress and identifies three contemporary situations (wildfire in Fort McMurray, Alberta, Canada; hurricane Harvey in Houston, USA and transgenerational and migrant stress in Pforzheim, Germany) where current studies are being established by Canadian investigators to test an intervention. The experiences from these efforts are related along with attempts to involve communities in the studies and share the new knowledge to plan for future disasters or tragedies.

A Canadian perspective on the developmental origins of health and disease: understanding the past as a way forward

“…In this themed issue, two studies are profiled. The article by Olson et al 23 describes efforts to improve resilience, particularly in pregnant women, in the wake of natural disasters. The article provides context for the interpretation of data and outcomes from these trials, and may also provide perspective for those without lived experience.…”

“…In this themed issue, two studies are profiled. The article by Olson et al 23 . describes efforts to improve resilience, particularly in pregnant women, in the wake of natural disasters.…”

Maternal Mental Health after a Wildfire: Effects of Social Support in the Fort McMurray Wood Buffalo Study

“…It aimed to look at the resilience of pregnant women during and after this natural disaster and to improve the health of these women and their infants using an expressive writing intervention. 36 Our goal for this study was to determine the extent to which peritraumatic reactions to the disaster would predict the mental health of pregnant women. English-speaking women who (1) were evacuated from Fort McMurray due to the May 2016 wildfire and (2) were either within 6 months of conception or pregnant with a single baby during the evacuation were eligible.…”

“…This natural disaster resulted in major destruction of the city and the evacuation of upward of 88,000 people, approximately 1,850 of whom were women who were either pregnant or preconception. 36 We hypothesized that more severe peritraumatic experiences during the disaster would predict more severe PTSD-like symptoms in pregnant and postpartum women but that social support and resilience would moderate this association. The moderators assessed here include two measures of social support (number of people and satisfaction) and a self-reported measure of resilience.…”

Exposure to Stress and Air Pollution from Bushfires during Pregnancy: Could Epigenetic Changes Explain Effects on the Offspring?

“…In the Queensland flood study, the Impacts of Events Scale Revised (IES-R) was used as a measure of subjective stress and the range of scores reported (up to 45) indicated some women experienced clinically significant post-traumatic stress disorder [ 36 ], which in some cases would be associated with suppression of the immune system [ 37 ]. An intervention to target prenatal maternal stress is already being tested in the context of several Canadian studies of prenatal exposure to natural disasters (Project Ice Storm in Montreal, Fort McMurray studies of wildfires) [ 38 ].…”