Poster #73 - Perinatal Health Outcomes of Mother-Child Dyad After Hurricane Maria

• In Event: Poster Session 04

Abstract

Purpose

Previous studies suggest that exposure to hurricane related adverse events can be detrimental for women in the perinatal period and lead to poor birth outcomes. Such has been found more evident in women with trauma-related mental health disorders (Jeffers & Glass 2020). In 2017, Hurricane Maria (HM) ravaged through Puerto Rico. A retrospective cross sectional study design will assess if exposure to severe hurricane-related experiences (HRE) in Hispanic/Latinx women, who were pregnant during HM or up to 3 months after are related to poorer childbirth outcomes (gestational age (GA) at birth, birth length (BL), birth weight (BW), and head circumference (HC). Further, we will analyze if symptoms of post-traumatic stress disorders and depression act as confounders in such associations. We hypothesize that exposure to more HREs will predict poorer birth outcomes and that pre-existing symptoms of PTSD/Depression mediate the relationship between HRE exposure and birth outcomes.

Methods / Participants

Latinx/Hispanic mother-child dyads (n=187) were recruited as part of the HELiOS study which assessed hurricane experience, birth outcomes (mean maternal age at birth 29.17 (±5.55), and development of mother-child dyads after Hurricane Maria (26% of sample where on 3rd trimester at day of exposure), data was analyzed after collection through RedCap. Maternal exposure was determined using the CDC (Centers for Disease Control) Exposure Disaster Scale adapted to Spanish, which assessed 10 possible experiences. Exposure was measured from answers to both Yes/No questions and questions graded from 1-5, where 1= absent, 5=severe (≥3 was considered positive for the exposure). Hurricane exposure was divided into mild (0-3 exposures), moderate (4-6 exposures), and severe (7-10 exposures). Birth outcomes were assessed with GA, BW, BL, and HC, obtained from birth certificates. Patient Health Questionnaire (PHQ-9) was used to assess depressive symptoms; and the PTSD Checklist for DSM-5 (PCL5) was used to assess for PTSD symptoms. These were incorporated as confounding variables in our models. Statistical analyses will be conducted using IBM-SPSS 28.0. Descriptive statistics will be calculated, correlations between exposures and outcomes will be performed. One-way ANOVA tests will be performed to compare birth outcomes between the three exposure severity groups. If the groups differ in these variables, these variables will be entered first in the multilevel analyses, where mental health symptoms will be incorporated as mediating variables.


Anticipated results
We expect to find that infants of mothers exposed to greater levels of HREs will have lower mean GA, BW, BL, and HC at birth which will be mediated by preexisting trauma-related and mental health disorders.


Discussion
This study provides insight into the effects natural disasters have on mother-childbirth outcomes, particularly in the context of preexisting trauma and in minority populations. If our hypotheses are confirmed, surveillance measures should be developed to minimize the negative impact of future disasters on pregnant Hispanic/Latinx childbirth outcomes. This is of importance as child development (from physical to socio-emotional) can be negatively affected from these prenatal experiences. Prevention may decrease these negative impacts by focusing on maternal mental health when facing natural disasters.

Authors

• Maria José Rivera-Criado, University of Puerto Rico School of Medicine
  Presenting Author

• Polaris Gonzalez-Barrios, University of Puerto Rico Medical Sciences Campus

• Karen G Martinez-Gonzalez, University of Puerto Rico