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Maul J, Behnam S, Wimberger P, Henrich W, Arabin B. Systematic review on music interventions during pregnancy in favor of the well-being of mothers and eventually their offspring. Am J Obstet Gynecol MFM 2024; 6:101400. [PMID: 38866136 DOI: 10.1016/j.ajogmf.2024.101400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE Mental health affects maternal well-being and indirectly affects the development of fetal brain structures and motor and cognitive skills of the offspring up to adulthood. This study aimed to identify specific characteristics of music interventions that improve validated maternal outcomes. DATA SOURCES Randomized controlled trials and systematic reviews investigating music interventions during pregnancy were identified from the start of data sources up to December 2023 using MEDLINE, the Cochrane Central Register of Controlled Trials, or Web of Science. STUDY ELIGIBILITY CRITERIA Using Covidence, 2 reviewers screened for randomized controlled trials with ≥3 music interventions during pregnancy and applied either the Perceived Stress Scale score, State-Trait Anxiety Inventory score, Edinburgh Postnatal Depression Scale score, or blood pressure as outcomes. METHODS The Cochrane risk-of-bias tool 2, the checklist to assess Trustworthiness in RAndomised Clinical Trials, and the reversed Cohen d were applied. This review was registered in the International Prospective Register of Systematic Reviews (registration number: CRD42022299950). RESULTS From 251 detected records, 14 randomized controlled trials and 2375 pregnancies were included. Music interventions varied from 3 to 84 active or passive sessions with either patient-selected or preselected music and a duration of 10 to 60 minutes per session. Thereby, 2 of 4 studies observed a significant decrease in the Perceived Stress Scale, 8 of 9 studies observed a significant decrease in the State-Trait Anxiety Inventory, and 3 of 4 studies observed a significant decrease in the Edinburgh Postnatal Depression Scale. Blood pressure was significantly reduced in 3 of 4 randomized controlled trials. The Cochrane risk-of-bias tool 2 was "high" in 5 of 14 studies or "with concerns" in 9 of 14 studies. Stratifying the Cohen d in 14 intervention arms suggested a big effect in 234 of 469 mothers on blood pressure and in 244 of 489 mothers on maternal anxiety and a medium effect in 284 of 529 mothers on maternal anxiety. Small or very small effects on blood pressure, the Edinburgh Postnatal Depression Scale, and the Perceived Stress Scale were observed in 35 of 70, 136 of 277, and 374 of 784 mothers-to-be, respectively. CONCLUSION Our study found a general positive effect of music interventions on maternal stress resilience. This was independent of the music but was influenced by the frequency and empathy of the performances. How far music interventions may improve postnatal development and skills of the offspring should be increasingly evaluated with follow-ups to interrupt vicious epigenetic circles during global pandemics, violent conflicts, and natural catastrophes. El resumen está disponible en Español al final del artículo.
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Affiliation(s)
- Johanna Maul
- Clara Angela Foundation, Witten and Berlin, Germany (Maul, Behnam, Henrich, and Arabin); Technische Universtität Dresden, Dresden, Germany (Maul).
| | - Susann Behnam
- Clara Angela Foundation, Witten and Berlin, Germany (Maul, Behnam, Henrich, and Arabin)
| | - Pauline Wimberger
- Department of Obstetrics and Gynecology, Technische Universität Dresden, Dresden, Germany (Wimberger)
| | - Wolfgang Henrich
- Clara Angela Foundation, Witten and Berlin, Germany (Maul, Behnam, Henrich, and Arabin); Department of Obstetrics, University Hospital Charité Berlin, Berlin, Germany (Henrich and Arabin)
| | - Birgit Arabin
- Clara Angela Foundation, Witten and Berlin, Germany (Maul, Behnam, Henrich, and Arabin); Department of Obstetrics, University Hospital Charité Berlin, Berlin, Germany (Henrich and Arabin)
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Bansal A, Cherbuin N, Leach L, Simmons RA, Nolan CJ. Wildfires and COVID-19: syndemic impact on maternal and child health. Trends Endocrinol Metab 2023; 34:779-782. [PMID: 37658035 DOI: 10.1016/j.tem.2023.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 09/03/2023]
Abstract
The prevailing COVID-19 pandemic and climate change-mediated wildfires can combine to impact maternal-child health, yet this connection remains understudied. To shape policies and design interventions to mitigate the combined effects of future global catastrophes, it is vital to holistically evaluate the impact of syndemics on maternal-child health.
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Affiliation(s)
- Amita Bansal
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT 2601, Australia; John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Canberra, ACT 2601, Australia.
| | - Nicolas Cherbuin
- National Center for Epidemiology and Population Health, Australian National University, Acton, ACT 2601, Australia
| | - Liana Leach
- National Center for Epidemiology and Population Health, Australian National University, Acton, ACT 2601, Australia
| | - Rebecca A Simmons
- Center for Research on Reproduction and Women's Health, University of Pennsylvania, Philadelphia, PA 19104, USA; Center of Excellence in Environmental Toxicology, University of Pennsylvania, Philadelphia, PA 19104, USA; Division of Neonatology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Christopher J Nolan
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT 2601, Australia; John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Canberra, ACT 2601, Australia; Endocrinology and Diabetes, The Canberra Hospital, Canberra Health Services, ACT 2601, Australia
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3
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Bansal A, Cherbuin N, Davis DL, Peek MJ, Wingett A, Christensen BK, Carlisle H, Broom M, Schoenaker DAJM, Dahlstrom JE, Phillips CB, Vardoulakis S, Nanan R, Nolan CJ. Heatwaves and wildfires suffocate our healthy start to life: time to assess impact and take action. Lancet Planet Health 2023; 7:e718-e725. [PMID: 37558352 DOI: 10.1016/s2542-5196(23)00134-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 06/08/2023] [Accepted: 06/15/2023] [Indexed: 08/11/2023]
Abstract
Adverse environmental exposures in utero and early childhood are known to programme long-term health. Climate change, by contributing to severe heatwaves, wildfires, and other natural disasters, is plausibly associated with adverse pregnancy outcomes and an increase in the future burden of chronic diseases in both mothers and their babies. In this Personal View, we highlight the limitations of existing evidence, specifically on the effects of severe heatwave and wildfire events, and compounding syndemic events such as the COVID-19 pandemic, on the short-term and long-term physical and mental health of pregnant women and their babies, taking into account the interactions with individual and community vulnerabilities. We highlight a need for an international, interdisciplinary collaborative effort to systematically study the effects of severe climate-related environmental crises on maternal and child health. This will enable informed changes to public health policy and clinical practice necessary to safeguard the health and wellbeing of current and future generations.
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Affiliation(s)
- Amita Bansal
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Deborah L Davis
- Midwifery, University of Canberra, ACT, Australia; ACT Government, Health Directorate, ACT, Australia
| | - Michael J Peek
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; The Canberra Hospital, Canberra Health Services, ACT, Australia
| | - Amanda Wingett
- National Aboriginal Community Controlled Health Organisation, Canberra, ACT, Australia
| | - Bruce K Christensen
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Hazel Carlisle
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; The Canberra Hospital, Canberra Health Services, ACT, Australia
| | - Margaret Broom
- Midwifery, University of Canberra, ACT, Australia; The Canberra Hospital, Canberra Health Services, ACT, Australia
| | - Danielle A J M Schoenaker
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK; School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Jane E Dahlstrom
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; The Canberra Hospital, Canberra Health Services, ACT, Australia
| | - Christine B Phillips
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; Companion House Refugee Medical Service, Canberra, ACT, Australia
| | - Sotiris Vardoulakis
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Ralph Nanan
- Sydney Medical School and Charles Perkins Center Nepean, University of Sydney, NSW, Australia
| | - Christopher J Nolan
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; The Canberra Hospital, Canberra Health Services, ACT, Australia.
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Severson E, Olson JK, Hyde A, Brémault-Phillips S, Spiers J, King S, Bick J, Lipschutz R, Verstraeten BSE, Olson DM. Experiencing Trauma During or Before Pregnancy: Qualitative Secondary Analysis After Two Disasters. Matern Child Health J 2023; 27:944-953. [PMID: 36897470 DOI: 10.1007/s10995-023-03625-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Despite the existing knowledge about stress, trauma and pregnancy and maternal stress during natural disasters, little is known about what types of trauma pregnant or preconception women experience during these disasters. In May 2016, the worst natural disaster in modern Canadian history required the evacuation of nearly 90,000 residents of the Fort McMurray Wood Buffalo (FMWB) area of northern Alberta. Among the thousands of evacuees were an estimated 1850 women who were pregnant or soon to conceive. In August 2017, Hurricane Harvey devastated areas of the United States including Texas, with 30,000 people forced to flee their homes due to the intense flooding. OBJECTIVE To explore immediate and past traumatic experiences of pregnant or preconception women who experienced one of two natural disasters (a wildfire and a hurricane) as captured in their expressive writing. Research questions were: (1) What trauma did pregnant or preconception women experience during the fire and the hurricane? (2) What past traumatic experiences, apart from the disasters, did the women discuss in their expressive writing? METHODS A qualitative secondary analysis of expressive writing using thematic content analysis was conducted on the expressive writing of 50 pregnant or preconception women who experienced the 2016 Fort McMurray Wood Buffalo Wildfire (n = 25) and the 2017 Houston Hurricane Harvey (n = 25) Narrative data in the form of expressive writing entries from participants of two primary studies were thematically analyzed. One of the expressive writing questions was used in this analysis: "What is the most traumatic, upsetting experience of your entire life, especially that you have never discussed in great detail with others?" NVivo 12 supported thematic content analysis. RESULTS For some women, the disasters elicited immense fear and anxiety that surpassed previous traumatic life events. Others, however, disclosed significant past traumas that continue to impact them, including betrayal by a loved one, abuse, maternal health complications, and illness. CONCLUSION We recommend a strengths-based and trauma-informed care approach in both maternal health and post-disaster relief care.
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Affiliation(s)
- Emily Severson
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Joanne K Olson
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Ashley Hyde
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Suzette Brémault-Phillips
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Jude Spiers
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Suzanne King
- Douglas Hospital Research Centre & Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Johanna Bick
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Rebecca Lipschutz
- Department of Clinical Psychology, University of Houston, Houston, TX, USA
| | | | - David M Olson
- Departments of Obstetrics and Gynecology, Pediatrics and Physiology, University of Alberta, Edmonton, AB, Canada.
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Di Paolo AL, King S, McLean MA, Lequertier B, Elgbeili G, Kildea S, Dahlen HG. Prenatal stress from the COVID-19 pandemic predicts maternal postpartum anxiety as moderated by psychological factors: The Australian BITTOC Study. J Affect Disord 2022; 314:68-77. [PMID: 35760187 PMCID: PMC9232265 DOI: 10.1016/j.jad.2022.06.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/01/2022] [Accepted: 06/20/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND While there have been reports of increased perinatal anxiety during the COVID-19 pandemic (Stepowicz et al., 2020), there has been a lack of research on the relative importance of objective hardship and subjective distress. In this study, we explored the extent to which resilience, tolerance of uncertainty, and cognitive appraisal of the pandemic's consequences moderate the effect of prenatal objective hardship and subjective distress due to the pandemic on 2-month postpartum anxiety. METHODS Data were collected as part of the Birth in the Time of COVID (BITTOC) study. We measured objective hardship and subjective distress, mental health, and potential psychological moderators in 419 pregnant women residing in Australia, and at two months postpartum. Hierarchical multiple regressions were used. RESULTS Objective hardship and subjective distress independently predicted postpartum anxiety. All three psychological factors moderated the effect of objective hardship on anxiety. For women with low/neutral resilience, or low/moderate tolerance of uncertainty, or a negative cognitive appraisal, greater objective hardship predicted higher postpartum anxiety. Conversely, for women with high resilience, or high tolerance of uncertainty, or neutral/positive cognitive appraisal, there was no association. Only a neutral/positive cognitive appraisal significantly buffered the effect of subjective distress on anxiety. LIMITATIONS Participants self-selected themselves into the study. The generalizability of our results could be restricted to women of higher socio-economic status. CONCLUSIONS These findings help us better understand options for intervention and assessment of vulnerable women during times of stress, along with the mechanisms by which COVID-related stress during pregnancy contributes to postpartum anxiety.
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Affiliation(s)
- Amber-Lee Di Paolo
- Douglas Institute Research Centre, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada
| | - Suzanne King
- Douglas Institute Research Centre, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada; Department of Psychiatry, McGill University, 1033 Avenue des Pins, Montreal, QC H3A 1A1, Canada.
| | - Mia A McLean
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada; BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Belinda Lequertier
- Molly Wardaguga Research Centre, School of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia
| | - Guillaume Elgbeili
- Douglas Institute Research Centre, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada
| | - Sue Kildea
- Molly Wardaguga Research Centre, School of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia
| | - Hannah G Dahlen
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
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Arabin B, Hellmeyer L, Maul J, Metz GAS. Awareness of maternal stress, consequences for the offspring and the need for early interventions to increase stress resilience. J Perinat Med 2021; 49:979-989. [PMID: 34478615 DOI: 10.1515/jpm-2021-0323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 12/31/2022]
Abstract
Experimental and clinical studies suggest that prenatal experiences may influence health trajectories up to adulthood and high age. According to the hypothesis of developmental origins of health and disease exposure of pregnant women to stress, nutritional challenges, infection, violence, or war may "program" risks for diseases in later life. Stress and anxieties can exist or be provoked in parents after fertility treatment, after information or diagnosis of fetal abnormalities and demand simultaneous caring concepts to support the parents. In vulnerable groups, it is therefore important to increase the stress resilience to avoid harmful consequences for the growing child. "Enriched environment" defines a key paradigm to decipher how interactions between genes and environment change the structure and function of the brain. The regulation of the fetal hippocampal neurogenesis and morphology during pregnancy is one example of this complex interaction. Animal experiments have demonstrated that an enriched environment can revert consequences of stress in the offspring during critical periods of brain plasticity. Epigenetic markers of stress or wellbeing during pregnancy might even be diagnosed by fragments of placental DNA in the maternal circulation that show characteristic methylation patterns. The development of fetal senses further illustrates how external stimulation may impact individual preferences. Here, we therefore not only discuss how maternal stress influences cognitive development and resilience, but also design possibilities of non-invasive interventions for both mothers and children summarized and evaluated in the light of their potential to improve the health of future generations.
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Affiliation(s)
- Birgit Arabin
- Clara Angela Foundation, Berlin, Germany.,Department of Obstetrics, Charité, Humboldt University Berlin, Berlin, Germany
| | - Lars Hellmeyer
- Clara Angela Foundation, Berlin, Germany.,Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | | | - Gerlinde A S Metz
- Clara Angela Foundation, Berlin, Germany.,Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, AB, Canada
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7
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Silva-Suarez G, Rabionet SE, Zorrilla CD, Perez-Menendez H, Rivera-Leon S. Pregnant Women's Experiences during Hurricane Maria: Impact, Personal Meaning, and Health Care Needs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8541. [PMID: 34444290 PMCID: PMC8394861 DOI: 10.3390/ijerph18168541] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 01/18/2023]
Abstract
During a disaster, pregnant women are considered among the most vulnerable. BACKGROUND On 20 September 2017, the Caribbean was hit by a category 4 hurricane. The purpose of the study was to explore the impact on pregnant women during and after the hurricane regarding access to health care, social services, and support systems. METHODS In-depth interviews were conducted to 10 women that were pregnant during the event. Qualitative inquiry based on the Interpretative Phenomenological Analysis framework was used to interpret the narratives. RESULTS Five major themes emerged: meaning of living through a disaster, fear, the dual burden of protecting themselves and their unborn baby, disruption in health care, and coping mechanisms. Despite the negative feelings, most participants experienced positive transformations. They narrated how they stayed calm and coped in order to protect their pregnancy. Their overall evaluation of the healthcare system was positive. The support of friends and family was crucial pre and post-disaster. CONCLUSIONS The interviews provided a wealth of firsthand information of women experiencing a natural disaster while pregnant. The findings underscore the need to incorporate emotional support in the preparedness and response plans for pregnant women. Educating, empowering, and incorporating families and communities is vital in these efforts.
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Affiliation(s)
- Georgina Silva-Suarez
- Department of Sociobehavioral and Administrative Pharmacy, Nova Southeastern University, San Juan, PR 00926, USA
| | - Silvia E. Rabionet
- Department of Sociobehavioral and Administrative Pharmacy, Nova Southeastern University, Davie, FL 33328, USA;
- School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR 00936, USA; (H.P.-M.); (S.R.-L.)
| | - Carmen D. Zorrilla
- School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, PR 00936, USA;
| | - Hulda Perez-Menendez
- School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR 00936, USA; (H.P.-M.); (S.R.-L.)
| | - Solaritza Rivera-Leon
- School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR 00936, USA; (H.P.-M.); (S.R.-L.)
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Verstraeten BSE, Elgbeili G, Hyde A, King S, Olson DM. Maternal Mental Health after a Wildfire: Effects of Social Support in the Fort McMurray Wood Buffalo Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2021; 66:710-718. [PMID: 33172310 PMCID: PMC8320544 DOI: 10.1177/0706743720970859] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Following disasters, perinatal women are vulnerable to developing post-traumatic stress disorder (PTSD)-like symptoms. Little is known about protective factors. We hypothesized that peritraumatic stress would predict PTSD-like symptoms in pregnant and postpartum women and would be moderated by social support and resilience. METHOD Women (n = 200) who experienced the 2016 Fort McMurray Wood Buffalo wildfire during or shortly before pregnancy completed the Peritraumatic Distress Inventory (PDI), Peritraumatic Dissociative Experiences Questionnaire, and the Impact of Event Scale-Revised for current PTSD-like symptoms. They also completed scales of social support (Social Support Questionnaire-Short Form) and resilience (Connor-Davidson Resilience Scale). RESULTS Greater peritraumatic distress (r = 0.56) and dissociative experiences (r = 0.56) correlated with more severe PTSD-like symptoms. Greater social support satisfaction was associated with less severe post-traumatic stress symptoms but only when peritraumatic distress was below average; at more severe levels of PDI, this psychosocial variable was not protective. CONCLUSIONS Maternal PTSD-like symptoms after a wildfire depend on peritraumatic distress and dissociation. Higher social support satisfaction buffers the association with peritraumatic distress, although not when peritraumatic reactions are severe. Early psychosocial interventions may protect perinatal women from PTSD-like symptoms after a wildfire.
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Affiliation(s)
| | - Guillaume Elgbeili
- 26632Douglas Mental Health University Institute, Montréal, Québec, Canada
| | - Ashley Hyde
- 12357Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Suzanne King
- Department of Psychiatry, 5620McGill University, Montréal, Québec, Canada
| | - David M Olson
- Department of Obstetrics & Gynecology, 3158University of Alberta, Edmonton, Alberta, Canada.,Department of Pediatrics, 3158University of Alberta, Edmonton, Alberta, Canada.,Department of Physiology, 3158University of Alberta, Edmonton, Alberta, Canada
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Harville EW, Beitsch L, Uejio CK, Sherchan S, Lichtveld MY. Assessing the effects of disasters and their aftermath on pregnancy and infant outcomes: A conceptual model. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2021; 62:102415. [PMID: 34336567 PMCID: PMC8318346 DOI: 10.1016/j.ijdrr.2021.102415] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Although many studies have examined broad patterns of effects on pregnancy and infant outcomes after disasters, the causes of adverse outcomes are not always clear. Disasters cause interrelated exposure to environmental pollutants, psychological stressors, and lack of health care, and interacts with other social determinants of health. This topical review examines the short- and long-term effects of disasters on pregnancy and how they are mediated by social, behavioral, and environmental effects. In the short term, disasters are associated with physical trauma, adverse environmental exposures, and unstable housing. In the longer term, disasters may lead to relocation, changes in family functioning, and negative economic effects. These aspects of disaster exposure, in turn, lead to lack of access to health care, increased stress and negative mental health outcomes, and negative behavioral changes, including smoking and substance use, poor nutrition, physical overexertion and limited activity, and reduction in breastfeeding. All of these factors interact with social determinants of health to worsen effects on the most vulnerable women, infants, and communities. Few interventions after disasters have been tested. With the increase in disasters due to climate change and the ongoing coronavirus pandemic, the models of effects of disasters and their human health consequences need increasing refinement, and, more importantly, should be applied to interventions that improve disaster prevention, mitigation, and response.
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Affiliation(s)
- Emily W Harville
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA
| | - Leslie Beitsch
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL
| | - Christopher K Uejio
- Department of Geography, College of Social Sciences and Public Policy, Florida State University, Tallahassee, FL
| | - Samendra Sherchan
- Department of Environmental Health Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA
| | - Maureen Y Lichtveld
- Professor and Chair, Department of Environmental Health Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA; Currently Dean and professor, Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
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10
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Exposure to Stress and Air Pollution from Bushfires during Pregnancy: Could Epigenetic Changes Explain Effects on the Offspring? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147465. [PMID: 34299914 PMCID: PMC8305161 DOI: 10.3390/ijerph18147465] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/09/2021] [Accepted: 07/09/2021] [Indexed: 12/20/2022]
Abstract
Due to climate change, bushfires are becoming a more frequent and more severe phenomenon which contributes to poor health effects associated with air pollution. In pregnancy, environmental exposures can have lifelong consequences for the fetus, but little is known about these consequences in the context of bushfire smoke exposure. In this review we summarise the current knowledge in this area, and propose a potential mechanism linking bushfire smoke exposure in utero to poor perinatal and respiratory outcomes in the offspring. Bushfire smoke exposure is associated with poor pregnancy outcomes including reduced birth weight and an increased risk of prematurity. Some publications have outlined the adverse health effects on young children, particularly in relation to emergency department presentations and hospital admissions for respiratory problems, but there are no studies in children who were exposed to bushfire smoke in utero. Prenatal stress is likely to occur as a result of catastrophic bushfire events, and stress is known to be associated with poor perinatal and respiratory outcomes. Changes to DNA methylation are potential epigenetic mechanisms linking both smoke particulate exposure and prenatal stress to poor childhood respiratory health outcomes. More research is needed in large pregnancy cohorts exposed to bushfire events to explore this further, and to design appropriate mitigation interventions, in this area of global public health importance.
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Jain D, Jain AK, Metz GAS, Ballanyi N, Sood A, Linder R, Olson DM. A Strategic Program for Risk Assessment and Intervention to Mitigate Environmental Stressor-Related Adverse Pregnancy Outcomes in the Indian Population. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:673118. [PMID: 36304060 PMCID: PMC9580833 DOI: 10.3389/frph.2021.673118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/04/2021] [Indexed: 11/13/2022] Open
Abstract
The Problem: Global environmental stressors of human health include, but are not limited to, conflict, migration, war, natural disasters, climate change, pollution, trauma, and pandemics. In combination with other factors, these stressors influence physical and mental as well as reproductive health. Maternal stress is a known factor for adverse pregnancy outcomes such as preterm birth (PTB); however, environmental stressors are less well-understood in this context and the problem is relatively under-researched. According to the WHO, major Indian cities including New Delhi are among the world's 20 most polluted cities. It is known that maternal exposure to environmental pollution increases the risk of premature births and other adverse pregnancy outcomes which is evident in this population. Response to the Problem: Considering the seriousness of this problem, an international and interdisciplinary group of researchers, physicians, and organizations dedicated to the welfare of women at risk of adverse pregnancy outcomes launched an international program named Optimal Pregnancy Environment Risk Assessment (OPERA). The program aims to discover and disseminate inexpensive, accessible tools to diagnose women at risk for PTB and other adverse pregnancy outcomes due to risky environmental factors as early as possible and to promote effective interventions to mitigate these risks. OPERA has been supported by the Worldwide Universities Network, World Health Organization (WHO) and March of Dimes USA. Addressing the Problem: This review article addresses the influence of environmental stressors on maternal-fetal health focusing on India as a model population and describes the role of OPERA in helping local practitioners by sharing with them the latest risk prediction and mitigation tools. The consequences of these environmental stressors can be partially mitigated by experience-based interventions that build resilience and break the cycle of inter- and-transgenerational transmission. The shared knowledge and experience from this collaboration are intended to guide and facilitate efforts at the local level in India and other LMIC to develop strategies appropriate for the jurisdiction for improving pregnancy outcomes in vulnerable populations.
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Affiliation(s)
- Divyanu Jain
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada
- *Correspondence: Divyanu Jain
| | - Ajay K. Jain
- Department of Obstetrics & Gynecology and In-vitro Fertilization Center, Jaipur Golden Hospital, New Delhi, India
- IVF Center, Muzaffarnagar Medical College, Muzaffarnagar, India
| | - Gerlinde A. S. Metz
- Department of Neuroscience, University of Lethbridge, Lethbridge, AB, Canada
| | - Nina Ballanyi
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada
| | - Abha Sood
- Department of Obstetrics & Gynecology and In-vitro Fertilization Center, Jaipur Golden Hospital, New Delhi, India
| | - Rupert Linder
- Specialist for Gynecology, Obstetrics, Psychosomatics and Psychotherapy, Birkenfeld, Germany
| | - David M. Olson
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada
- Departments of Pediatrics and Physiology, University of Alberta, Edmonton, AB, Canada
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Giarratano G, Bernard ML, Orlando S. Psychological First Aid: A Model for Disaster Psychosocial Support for the Perinatal Population. J Perinat Neonatal Nurs 2020; 33:219-228. [PMID: 31335849 DOI: 10.1097/jpn.0000000000000419] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The psychosocial needs of childbearing families drastically change after a disaster. Perinatal nurses providing postdisaster maternal-newborn care at community shelters, field hospitals, or acute care facilities must be prepared as "first responders" to address the immediate psychological distress and social needs of women and families in the first few chaotic days or weeks. The purpose of this article is to demonstrate ways nurses can integrate psychosocial and interpersonal interventions in perinatal disaster care using the framework of Psychological First Aid (PFA) developed by a team of mental health experts, along with The National Child Traumatic Stress Network and the United States (US) National Center for posttraumatic stress disorder (PTSD). The PFA framework offers evidence-informed stepwise approaches nurses can employ within their scope of practice aimed at reducing disaster survivors' initial distress and to promote short- and long-term adaptive functioning. Purposive interactions are suggested to provide emotional support, empathy, and guidance to reduce stress, restore coping skills, and help families use their strengths to begin the recovery process. Nurse leaders engaged in hospital disaster planning need to ensure that essential resources and community networks are available to provide mental health and psychosocial support for childbearing women and families in a postdisaster environment.
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A Canadian perspective on the developmental origins of health and disease: understanding the past as a way forward. J Dev Orig Health Dis 2020; 10:1-4. [PMID: 30919803 DOI: 10.1017/s2040174419000011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Racial disparities in pregnancy outcomes: genetics, epigenetics, and allostatic load. CURRENT OPINION IN PHYSIOLOGY 2020. [DOI: 10.1016/j.cophys.2019.12.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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