Appalling pregnancy outcomes in flood-affected areas.

Abstract

Respected Madam, Floods are one of the most common types of natural disasters leading to enormous morbidity and mortality in a developing country like Pakistan. Pakistan is ranked 9th among flood-affected countries worldwide and in 2022 floodwater has submerged over one-third of the country in water, killing over 1,000 and impacting 33 million people. (1) Flood-affected areas serve as ideal breeding grounds for pathogens, severely disrupting livelihoods and impacting the health of the vast majority and adversely influencing the lives of pregnant women. In 2021 Erin et al. reported the impact of the flood on pregnancy, health, birth outcomes and postpartum mental health. They stated that pregnant women in the first trimester are at high risk of having low birth weight (LBW) babies and a reduction in fetal growth rate in areas of major floods. (2) This is not the only study to show these results. A systematic review shows the increased prevalence of preterm birth, at the same time, highlighting increasing incidents of gestational hypertension, increased rate of LBW birth, gestational hypertension, preeclampsia and eclampsia after the flood. (3) A study published after the 2012 floods in Pakistan raised serious concerns regarding diarrhoea, skin & eye infections, leptospirosis, malaria, leishmaniasis, respiratory infections and hepatitis being prevalent in flooded areas of Pakistan. (4) The major concern author wants to highlight is the health of pregnant women and growing fetuses being particularly vulnerable to direct and indirect impacts of natural disasters. The poor standards of hygiene in camps set up for women displaced by the floods also contribute to pregnancy-related complications including sepsis. A recent report by the United Nations Population Fund (UNFPA) has stated s a need for providing healthcare facilities to almost 650,000 pregnant women in flood-affected areas in Pakistan. (5) Flood-affected areas need medical aid to mitigate pregnancy-related complications in relief camps. But no research done on the Pakistani population in flood-affected areas directly highlights the outcome of flood on pregnancy and fetal well-being. The author suggests a data collection and assessment approach and reporting system to evaluate pregnancy-related complications in flood-affected areas; so that future policy, clinical and research strategies are based on research and get adopted to mitigate the effects of future floods on pregnancy outcomes. In addition to this, trained healthcare workers, robust health systems and gender-sensitive responses should be set in place in responding to flood emergencies.