Hurricane Michael and Adverse Birth Outcomes in the Florida Panhandle: Analysis of Vital Statistics Data.

Elaina Gonsoroski,Christopher Uejio,Emily W Harville,Samendra P Sherchan,Maureen Y Lichtveld,Ke Pan,Leslie Beitsch

doi:10.1017/dmp.2021.367

Abstract

The aim of this study was to examine birth outcomes in areas affected by Hurricane Michael. Vital statistics data of 2017-2019 were obtained from the state of Florida. Births occurring in the year before and after the date of Hurricane Michael (October 7, 2018) were used. Florida counties were divided into 3 categories reflecting extent of impact from Hurricane Michael. Birth outcomes including incidence of preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA) were also compared before and after Hurricane Michael. Spontaneous and indicated PTBs were distinguished based on previously published algorithms. Multiple regression was used to control for potential confounders. Both LBW (aRR 1.19, 95% CI: 1.07, 1.32) and SGA (aRR 1.11, 95% CI: 1.01, 1.21) were higher in the year after Michael than the year before in the most-affected area; a similar effect was not seen in other areas. A stronger effect was seen for exposure in the first trimester or in the 2 months after Michael than in the second or third trimester. Consistent with many previous studies, this study of Hurricane Michael found an effect on fetal growth.

Highlights

Disasters have been associated with poor birth outcomes
Affected areas Based on Federal Emergency Management Agency (FEMA) disaster declarations,[38] Florida counties were divided into 3 categories reflecting extent of impact from Hurricane Michael: counties receiving both public and individual assistance (Area A), counties receiving only public assistance (Area B), and counties receiving neither public nor individual assistance (Area C). (Individual assistance is provided to individuals who have sustained losses, it does not compensate for all losses caused by disaster, while public assistance funds repair or reconstruction of public facilities or infrastructure.) The category of each county can be found in Supplementary Table 1
RR, relative risk; FEMA, Federal Emergency Management Agency; BMI, body mass index; WIC, Women’s, Infants, and Children’s aLBW adjusting for: mother’s education, age, ethnicity, smoking during pregnancy, and whether in WIC program; preterm birth (PTB), small for gestational age (SGA) adjusting for: mother’s age, education, ethnicity, pre-pregnancy BMI, smoking during pregnancy, and whether in WIC program bRR compares the year after Hurricane Michael to the year before; p-value is for the interaction between effect of disaster and area months after Michael showed the highest increase in PTB compared to before the hurricane

Summary

Introduction

Disasters have been associated with poor birth outcomes. Most consistent are modest effects on birth weight, generally examined by region of residence and timing of birth. Magnitude of effect has ranged from 160 g decrement in birth weight associated with the Wenchuan and Haiti earthquakes[1,2] down to single-digit associations with wildfires,[3] landmine explosions,[4] with other examinations of earthquakes[5–7] and major disaster declarations[8] finding effect estimates that fall in between. (other studies have found no effects of hurricanes on birth weight.9–11) Effects on preterm birth (PTB)/gestational age have been found much less often.[1] Magnitude of effect has ranged from 160 g decrement in birth weight associated with the Wenchuan and Haiti earthquakes[1,2] down to single-digit associations with wildfires,[3] landmine explosions,[4] with other examinations of earthquakes[5–7] and major disaster declarations[8] finding effect estimates that fall in between. (other studies have found no effects of hurricanes on birth weight.9–11) Effects on preterm birth (PTB)/gestational age have been found much less often.[1]

Methods

Results

Discussion

Conclusion