Hyde Ashley, Verstraeten Barbara S E, Olson Joanne K, King Suzanne, Brémault-Phillips Suzette, Olson David M
Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB, Canada.
Front Public Health. 2021 Jun 17;9:601375. doi: 10.3389/fpubh.2021.601375. eCollection 2021.
Data show that maternal stress triggered by exposure to a natural disaster before, during or just after pregnancy is associated with adverse pregnancy and newborn outcomes. In this paper, the first aim is to describe our efforts to test a simple, low-cost intervention to large numbers of women following a major natural disaster. The second aim is to outline the challenges faced and lessons learned during the execution of this natural disaster study. The setting was the May 2016 Fort McMurray Wood Buffalo wildfire in northern Alberta, Canada. Women who were pregnant or preconception at the time of the disaster were invited to participate via social media. This prospective cohort study included a randomized controlled trial to test the effectiveness of an expressive writing intervention on the levels of prenatal maternal stress and maternal, birth, and early childhood outcomes. At recruitment and at multiple timepoints postpartum, a battery of questionnaires was administered to evaluate objective and subjective stress exposure to the fire as well as maternal mental health, resilience and its contributing factors as well as infant developmental milestones. Qualitative content analysis of the expressive writing was conducted. There is an increasing need to develop effective, wide-spread, rapid, and low-cost interventions to reduce prenatal maternal stress, increase resilience, and improve pregnancy outcomes following a natural disaster. Though analysis of data is ongoing, we highlight the strengths of this study which include strong community participation, rapid recruitment of eligible participants, low-cost intervention and data acquisition, and successful testing of the intervention. We acknowledge the challenges we encountered including the high rate of participant disqualifications or losses due to incomplete collection of online data; evacuation, dispersal, and inconsistent return to homes; and the high levels of stress accumulated post-disaster which led to inability to complete the study. Despite potential challenges, there remains a need for such research amid natural disasters.
数据显示，孕期之前、期间或刚结束时接触自然灾害所引发的母体应激与不良妊娠及新生儿结局相关。在本文中，首要目标是描述我们为在一场重大自然灾害后对大量女性测试一种简单、低成本干预措施所做的努力。第二个目标是概述在开展这项自然灾害研究过程中所面临的挑战及汲取的经验教训。研究背景是2016年5月加拿大艾伯塔省北部麦克默里堡伍德布法罗市的森林大火。通过社交媒体邀请在灾难发生时处于孕期或孕前的女性参与。这项前瞻性队列研究包括一项随机对照试验，以测试一项表达性写作干预措施对产前母体应激水平以及母体、分娩和幼儿期结局的有效性。在招募时以及产后多个时间点，发放一系列问卷以评估对火灾的客观和主观应激暴露情况、母体心理健康、复原力及其影响因素以及婴儿发育里程碑。对表达性写作进行了定性内容分析。越来越需要开发有效、广泛、快速且低成本的干预措施，以减轻产前母体应激、增强复原力并改善自然灾害后的妊娠结局。尽管数据仍在分析中，但我们强调了本研究的优势，包括强大的社区参与度、快速招募符合条件的参与者、低成本干预和数据采集，以及干预措施的成功测试。我们承认遇到的挑战，包括由于在线数据收集不完整导致的参与者不合格或流失率高；疏散、分散以及返回家园情况不一致；以及灾后积累的高度应激导致无法完成研究。尽管存在潜在挑战，但在自然灾害期间仍需要此类研究。
