Tohoku Medical Megabank Organization, Tohoku University.
Tohoku University Graduate School of Medicine.
J Epidemiol. 2023 Mar 5;33(3):127-135. doi: 10.2188/jea.JE20210052. Epub 2022 Feb 11.
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.
本研究分析了妊娠前灾害暴露与产妇特征和产科结局的关系。
参与者为 2013 年至 2017 年间招募的 13148 名孕妇。根据 2011 年东日本大地震造成的住房破坏严重程度,将这些女性分为三组:A 组,房屋未被破坏/未居住在灾区;B 组,房屋部分/一半被破坏;C 组,房屋全部/大部分被破坏。使用问卷和病历获得产妇特征、妊娠高血压疾病(HDP)、妊娠期糖尿病(GDM)和妊娠周数。采用多因素 logistic 回归分析探讨灾害暴露与产妇特征、HDP 和 GDM 的关系。应用结构方程模型探讨灾害暴露与 HDP 和妊娠周数的关系。
约 11%的女性的房屋全部/大部分被破坏。与 A 组相比,B 组和 C 组 HDP 的调整比值比(OR)分别为 1.04 和 1.26(P 趋势=0.01),GDM 的调整 OR 分别为 0.89 和 1.14(P 趋势=0.9)。孕前体重指数(BMI)部分介导了灾害暴露与 HDP 之间的关系。灾害暴露与妊娠周数有关。
妊娠前至少 2.5 年的灾害暴露与产妇特征和 HDP 的发生率有关。孕前 BMI 介导了灾害暴露与 HDP 发生率之间的关系,而 HDP 导致了妊娠周数的减少。