Harville E W, Pan K, Beitsch L, Uejio C K, Lichtveld M, Sherchan S, Timuta C
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St. #8318, 70112, New Orleans, LA, USA.
Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA.
Matern Child Health J. 2023 Apr;27(4):680-689. doi: 10.1007/s10995-023-03596-6. Epub 2023 Feb 13.
To assess changes in mental health and social risk factors in pregnant women in counties affected by Hurricane Michael (October 2018).
Data from the Universal Perinatal Risk Screen (UPRS) and vital statistics for the state of Florida were obtained. Prenatal risk factors (unplanned pregnancy, mental health services, high stress, use of tobacco or alcohol, young children at home or with special needs, trouble paying bills) were compared in the year before and year after Hurricane Michael in affected counties (n = 18,887). Log-Poisson regression with robust variance was used for binary outcomes, adjusting for maternal age, race, BMI, and education.
A smaller proportion of pregnant women were screened in the months after the hurricane. No changes were seen in overall scores. The proportion referred was lower in the 1 month after Michael compared to that in 1 month before Michael (RR 0.78, 95% CI = 0.71, 0.86), but greater in the year after (RR = 1.07, 95% CI: 1.04, 1.10). Most individual risk factors on the screener did not change significantly, except having an illness that required ongoing medical care was less common in the short term (3 months after vs. 3 months before: aRR = 0.76, 95% CI: 0.66, 0.87), and more common in the longer term (1 year after vs. 1 year before, aRR = 1.09, 95% CI: 1.02, 1.18). Birth certificate data suggested smoking during pregnancy was higher among women who experienced Michael during their pregnancies (aRR = 1.15, 95% CI: 1.01, 1.32).
Perinatal screening and referral declined in the short-term aftermath of Hurricane Michael.
评估受迈克尔飓风（2018年10月）影响各县孕妇心理健康和社会风险因素的变化。
获取了佛罗里达州的通用围产期风险筛查（UPRS）数据和生命统计数据。比较了受影响各县（n = 18887）在迈克尔飓风来临前一年和后一年的产前风险因素（意外怀孕、心理健康服务、高压力、吸烟或饮酒、家中有幼儿或有特殊需求、支付账单困难）。采用具有稳健方差的对数泊松回归分析二元结局，并对产妇年龄、种族、体重指数和教育程度进行了调整。
飓风过后数月接受筛查的孕妇比例较小。总体得分未见变化。与迈克尔飓风来临前1个月相比，飓风过后1个月转诊比例较低（风险比0.78，95%置信区间为0.71, 0.86），但在飓风过后一年更高（风险比 = 1.07，95%置信区间：1.04, 1.10）。筛查中的大多数个体风险因素没有显著变化，除了需要持续医疗护理的疾病在短期内（飓风过后3个月与之前3个月相比：调整后风险比 = 0.76，95%置信区间：0.66, 0.87）不太常见，而在长期内（飓风过后1年与之前1年相比，调整后风险比 = 1.09，95%置信区间：（1.02, 1.18）更常见。出生证明数据表明，孕期经历过迈克尔飓风的女性孕期吸烟率更高（调整后风险比 = 1.15，95%置信区间：1.01, 1.32）。
在迈克尔飓风过后的短期内，围产期筛查和转诊有所下降。
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