Relation of Disaster Exposure With Maternal Characteristics and Obstetric Outcomes: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study.

Mami Ishikuro,Keiko Murakami,Shinichi Kuriyama,Masahiro Kikuya,Hirohito Metoki,Junichi Sugawara,Fumihiko Ueno,Aoi Noda,Taku Obara

doi:10.2188/jea.je20210052

Abstract

The present study analyzed the relation of disaster exposure prior to pregnancy with maternal characteristics and obstetric outcomes. The participants were 13,148 pregnant women recruited from 2013 to 2017. The women were classified into three groups by the severity of housing damage caused by the Great East Japan Earthquake of 2011: group A, house was not destroyed/did not live in the disaster area; group B, half/part of the house was destroyed; and group C, house was totally/mostly destroyed. Maternal characteristics, hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), and gestational weeks were obtained using questionnaires and medical records. Multiple logistic regression analyses were performed to investigate the relation between disaster exposure and maternal characteristics, HDP, and GDM. A structural equation model was applied to investigate the relation of disaster exposure with HDP and gestational weeks. The homes of about 11% of the women were totally/mostly destroyed. For groups B and C compared with those in group A, the adjusted ORs for HDP were 1.04 and 1.26 (P for trend = 0.01), and for GDM were 0.89 and 1.14 (P for trend = 0.9), respectively. Pre-pregnancy body mass index (BMI) mediated 23.2% of the relation between disaster exposure and HDP. Disaster exposure was associated with gestational weeks. Disaster exposure at least 2.5 years before pregnancy was found to be associated with maternal characteristics and the prevalence of HDP. Pre-pregnancy BMI mediated the relation between disaster exposure and the prevalence of HDP, and gestational weeks were reduced through HDP.

Highlights

Catastrophic disasters affect the health and lives of people around the world, and these effects sometimes continue over the long term
This study investigated maternal characteristics and the associations between maternal disaster exposure before pregnancy and obstetric outcomes typically affected by maternal characteristics from at least 2.5 years after the Great East Japan Earthquake (GEJE)
Disaster exposure and maternal characteristics from at least 2.5 years after the disaster The proportion of women with a pre-pregnancy body mass index (BMI) ≥25 kg=m2 was higher in group C than in groups A and B (Table 1)

Summary

Introduction

Catastrophic disasters affect the health and lives of people around the world, and these effects sometimes continue over the long term. Few studies have investigated the associations between disaster exposure, health-related status, and subsequent risk factors during pregnancy.[5] A previous study investigating the effects of Hurricane Katrina on birth outcomes reported that experience of injury and the presence of continuous physiological distress led to reduce gestational age among pregnant women even at 5–7 years after the disaster.[5] more evidence regarding the long-term effects of a disaster on pregnancy and childbirth needs to be accumulated to help prevent subsequent generations from suffering ongoing adverse health effects. The present study analyzed the relation of disaster exposure prior to pregnancy with maternal characteristics and obstetric outcomes

Methods

Results

Conclusion