School of Pharmacy Research Links Hurricanes Katrina and Rita to Stillbirths
Hurricanes Katrina and Rita may be responsible for up to half of the
stillbirths in the areas hardest hit by the storms, according to a new
study co-authored by Ian Breunig, PhD,
a postdoctoral fellow in the Department
of Pharmaceutical Health Services Research (PHSR) and the Center for
Innovative Pharmacy Solutions in the Department
of Pharmacy Practice and Science (PPS) at the School of Pharmacy.
The study, published in the Journal of Epidemiology and Community
Health, aimed to uncover information about how fetal health
is influenced by the stress imposed on expectant mothers affected by
natural disasters, specifically Hurricane Katrina. Katrina struck the
state of Louisiana on August 29, 2005; Hurricane Rita hit one month
later on September 24. Hurricane Katrina was the costliest natural
disaster in American history, while Hurricane Rita was the fourth most
intense hurricane ever recorded.
"Most research that examines the public health impacts of natural
disasters focuses on the well-being of adults and their living
children," says Breunig. "However, we suspected that the stress,
depression, and trauma often experienced by expectant mothers after
natural disasters, such as hurricanes, could also be detrimental to the
health of an unborn child -- the most serious consequence of which
would be its death, or stillbirth. If we ignore this relationship, the
statistics that we collect after natural disasters will underestimate
the true loss of life."
Information gathered by the researchers showed that, together, the
hurricanes caused measureable damage to 38 out of 64 towns -- also
known as parishes -- in the state, leaving more than 200,000 housing
units affected. Four parishes saw damage to more than half of their
local housing stock, while three parishes incurred damage that ranged
between 10-50 percent of their housing stock.
Other parishes experienced varying levels of damage that ranged between
1-10 percent or less than one percent.
Researchers analyzed all birth data between 1999 and 2009 in Louisiana,
during which time 5,194 stillbirths were recorded. They used this data
to calculate the odds of a pregnancy resulting in a stillbirth in both
damaged and undamaged areas in the 20 months before, as well as the 28
months after Hurricane Katrina struck. Space-time models were then
strategically used to assess whether fetal death correlated to the
extent of damage caused by the two storms.
The findings were surprising.
"Not only did we find that the chance of stillbirth significantly
increased among expectant mothers residing in areas damaged by
Hurricanes Katrina and Rita, but we also found that the risk of
stillbirth increased proportionately with the magnitude of the damage
in a parish," says Breunig. "The risk of an expectant mother
experiencing a stillbirth was nearly 40 percent higher in parishes that
suffered damage to 10-50 percent of their housing stock. In addition,
it was nearly twice as high in parishes where more than half of the
housing stock was damaged by the hurricanes."
The researchers estimate that approximately half of the 410 recorded
stillbirths in damaged parishes during this time can be attributed to
Hurricanes Katrina and Rita and the subsequent devastation. This number
is between 20-30 percent of the number of human deaths attributed to
However, they also note that the true fetal death toll could be much
higher, due to the displacement of residents whose homes and
livelihoods were swept away with the storms.
"This study reminds us that natural disasters often impose intangible,
but long-lasting effects on people," says Breunig. "However, because
these effects can be difficult to measure, the economic and emotional
costs that they impose can be overlooked. Unfortunately, this also
means that strategies to help reduce these costs are often not
implemented with other disaster preparedness efforts."
With climate scientists predicting that the frequency, duration, and
intensity of hurricanes will continue to increase as a result of
climate change, Breunig adds that it would be beneficial for
governments and other local agencies to implement early warning systems
that alert expectant mothers residing in the path of a natural disaster
to the increased risk to their pregnancy.
"It is our hope that this research will help inform disaster response
programs about how best to mobilize medical and mental health care
services to reach expectant mothers after catastrophic events," Breunig
Researchers from Colorado State University, Columbia University, and
Tulane University contributed to the study.
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