Abnormal labor outcomes as a function of maternal exposure to a catastrophic hurricane event during pregnancy

Abstract

Hurricane Andrew, which made landfall on August 24, 1992, was one of the most destructive hurricanes in American history, causing atypically high levels of psychological and physical health impairment among the resident population and especially among vulnerable groups. This article investigates whether maternal exposure to Hurricane Andrew during pregnancy increased the risk of dystocia (or dysfunctional labor) and infant delivery by cesarean section, the standard medical response to abnormal labor progression. We analyze 297,996 birth events in Miami-Dade and Broward counties in Florida from 1992 to 1993 using propensity score methodology with stratification and nearest-neighbor matching algorithms. Results show that hurricane-exposed pregnant women were significantly more likely to experience stress-induced abnormal labor and cesarean delivery outcomes as compared to statistically matched comparison groups. The conclusion details the policy implications of our results, with particular attention to the importance of maternal prenatal care in the aftermath of disasters.