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. 2023 Nov-Dec;138(6):916-924.
doi: 10.1177/00333549221142571. Epub 2023 Jan 6.

Pregnant Women's Experiences During and After Hurricanes Irma and Maria, Pregnancy Risk Assessment Monitoring System, Puerto Rico, 2018

Regina M Simeone  1 , L Duane House  1 , Beatriz Salvesen von Essen  1   2 , Katherine Kortsmit  1 , Wanda Hernandez Virella  3 , Manuel I Vargas Bernal  3 , Romeo R Galang  1 , Denise V D'Angelo  1 , Carrie K Shapiro-Mendoza  1 , Sascha R Ellington  1
Affiliations

Pregnant Women's Experiences During and After Hurricanes Irma and Maria, Pregnancy Risk Assessment Monitoring System, Puerto Rico, 2018

Regina M Simeone et al. Public Health Rep. 2023 Nov-Dec.

Abstract

Objective: Exposure to natural disasters during and after pregnancy may increase adverse mental health outcomes. Hurricanes Irma and Maria struck Puerto Rico in September 2017. Our objectives were to understand hurricane-related experiences, maternal health concerns, and the impact of hurricane experiences on postpartum depressive symptoms (PDS).

Methods: We used data from the 2018 Pregnancy Risk Assessment Monitoring System to describe differences in maternal hurricane experiences among women who were pregnant during and after the 2017 hurricanes. We assessed maternal concerns and PDS. We estimated adjusted prevalence ratios (aPRs) and 95% CIs for the associations between hurricane experiences and PDS.

Results: The most frequently reported hurricane experiences were losing power for ≥1 week (97%) and feeling unsafe due to lack of order/security (70%). Almost 30% of women who were pregnant during the hurricanes reported missing prenatal care. PDS were reported by 13% of women. Most hurricane experiences were associated with an increased prevalence of PDS. Feeling unsafe (aPR = 2.4; 95% CI, 1.2-4.9) and having difficulty getting food (aPR = 2.1; 95% CI, 1.1-4.1) had the strongest associations.

Conclusions: Most women who were pregnant during or after hurricanes Irma and Maria struck Puerto Rico reported negative hurricane experiences, and most experiences were associated with an increased prevalence of PDS. Understanding the experiences of pregnant women during and after disasters and identifying risks for adverse mental health outcomes after pregnancy are important to inform emergency preparedness and prenatal and postpartum care.

Keywords: PRAMS; disaster; hurricanes; maternal health; pregnancy; prenatal; preparedness.

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Conflict of interest statement

Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure.
Figure.
Distribution of hurricane experiences, stratified by timing of pregnancy during hurricanes, among women with recent live births responding to the 2018 Puerto Rico Pregnancy Risk Assessment Monitoring System hurricane supplement (N = 517). Women with births occurring during January–June 2018 were considered to be pregnant at hurricane landfall. Women with births occurring during July–September 2018 were considered to have become pregnant during the hurricane recovery. Error bars indicate 95% CIs. Data source: Pregnancy Risk Assessment Monitoring System, Puerto Rico, 2018.
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References

    1. RAND Corporation. Hurricanes Irma and Maria: impact and aftermath. Accessed March 17, 2022. https://www.rand.org/hsrd/hsoac/projects/puerto-rico-recovery/hurricanes...
    1. National Oceanic and Atmospheric Administration. Saffir-Simpson Hurricane Wind Scale. Accessed November 16, 2021. https://www.nhc.noaa.gov/aboutsshws.php
    1. Federal Emergency Management Agency. Hurricanes Irma and Maria in Puerto Rico: mitigation assessment team report. FEMA P-2020. October 2018. Accessed March 21, 2022. https://www.fema.gov/sites/default/files/2020-07/mat-report_hurricane-ir...
    1. US Department of Housing and Urban Development. Housing damage assessment and recovery strategies report: Puerto Rico. June 29, 2018. Accessed October 18, 2021. http://spp-pr.org/wp-content/uploads/downloads/2018/07/HUD-Housing-Damag...
    1. García-López GA. The multiple layers of environmental injustice in contexts of (un)natural disasters: the case of Puerto Rico post–Hurricane Maria. Environ Just. 2018;11(3):101-108. doi:10.1089/env.2017.0045 - DOI

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