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


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          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.

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          Most cited references53

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          Disasters and perinatal health:a systematic review.

          The empirical literature on the effects of disaster on pregnancy and the postpartum period is limited. The objective of this review was to examine the existing evidence on the effect of disasters on perinatal health. A systematic review was conducted by searching electronic databases (MEDLINE, EMBASE, Cinahl, PsycInfo), including literature on disasters and pregnancy outcomes (e.g., preterm birth, low birth weight, congenital anomalies), mental health, and child development. A total of 110 articles were identified, but many published reports were anecdotes or recommendations rather than systematic studies. The final review included 49 peer-reviewed studies that met inclusion criteria. Studies addressing the World Trade Center disaster of September 11 and other terrorist attacks, environmental/chemical disasters, and natural disasters such as hurricanes and earthquakes were identified. Disasters of various types may reduce fetal growth in some women, although there does not appear to be an effect on gestational age at birth. Severity of exposure is the major predictor of mental health issues among pregnant and postpartum women. After a disaster, mental health of the mother may more strongly influence on child development than any direct effect of disaster-related prenatal stress. There is evidence that disaster impacts maternal mental health and some perinatal health outcomes, particular among highly exposed women. Future research should focus on understudied outcomes such as spontaneous abortion. Relief workers and clinicians should concentrate on the most exposed women, particularly with respect to mental health. Obstetricians & Gynecologists. After completion of this educational activity, the obstetrician/gynecologist should be better able to compare and contrast the effects of different types of disasters (hurricanes, earthquakes, chemical spills) on pregnant and postpartum women in order to prepare for patient care in the aftermath of such disasters; differentiate the birth outcomes likely to be affected by disaster, in order to identify patients likely to be at high risk; and assess the extent to which pregnant and postpartum women are a uniquely vulnerable population after disaster, to assist in organizing care under such circumstances. 2010 Lippincott Williams & Wilkins, Inc.
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            The Adequacy of Prenatal Care Utilization Index: its US distribution and association with low birthweight.

            The proposed Adequacy of Prenatal Care Utilization Index is applied to data from the 1980 National Natality Survey to assess the adequacy of prenatal care utilization and its association with low birthweight in the United States. The index suggests that only 61.1% of women received adequate prenatal care, including 17.7% with more intensive care; 16.7% received inadequate care. More White women (63.4%) than Black women (51.9%) received adequate prenatal care. Low-birthweight rates were elevated among women with inadequate prenatal care and among those who received more intensive prenatal care.
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              When stress happens matters: effects of earthquake timing on stress responsivity in pregnancy.

              The purpose of the study was to assess the effects of the timing of stress during pregnancy on emotional responses and birth outcome. We hypothesized that as pregnancy advanced women would become increasingly resistant to the adverse effects of stress, and so early stress would have more profound effects than later stress. Forty pregnant women who had experienced an earthquake during pregnancy or shortly afterward were identified. Using regression analyses we determined whether the timing of the earthquake was related to an affective response to this event and to length of gestation. The earthquake was rated as more stressful when it occurred early in pregnancy compared with late in pregnancy, and postpartum ratings were similar to first-trimester ratings (r (quad) =.39; P <.05). Stress experienced early in pregnancy was associated with shorter gestational length (r =.35; P <.05). As pregnancy advances, women become decreasingly sensitive to the effects of stress. This decrease in vulnerability may reflect increasing protection of the mother and fetus from adverse influences during pregnancy.

                Author and article information

                Disaster Med Public Health Prep
                Disaster Med Public Health Prep
                Disaster medicine and public health preparedness
                21 April 2022
                03 March 2022
                03 March 2022
                04 February 2023
                : 17
                : e94
                [1 ]Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
                [2 ]Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
                [3 ]Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
                [4 ]Department of Geography, College of Social Sciences and Public Policy, Florida State University, Tallahassee, FL, USA
                [5 ]Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
                Author notes
                Corresponding author: Emily W. Harville, harville@ 123456tulane.edu
                Author information

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.


                birth weight,disaster,natural,fetal growth,preterm birth,trimester


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