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Abstract
Background: Climate-related disasters such as hurricanes, and emerging diseases, such as Zika, are increasing worldwide. The resulting impact may place vulnerable populations including pregnant and postpartum women at an increased risk of adverse outcomes such as depression and other mental health conditions. We examine the effects of disasters on mental health and disaster planning among women delivering a live birth in Puerto Rico post-Hurricanes Irma and the Zika outbreak.Methods: We used data from the 2017 PRAMS-ZPER 2.0 study, conducted in Puerto Rico post Hurricanes Irma and Maria to conduct two related analyses. The first assessed exposures to hurricanes and self-reported feelings of depression postpartum among pregnant women who recently had a live birth. The second examined associations between engagement in Zika preventative measures and hurricane disaster preparedness planning. Eligible participants were women who delivered a live birth in hospitals in Puerto Rico during the study period. Sampling for the study was planned in a representative sampling of health regions in Puerto Rico.
Results: Overall, 1,230 participants were included in this analysis. In the first study, which assessed hurricane experiences during pregnancy and postpartum depressive symptoms and lack of interest, depressive symptoms were common, with 20% of study participants reporting depressive symptoms always or sometimes. Individuals experiencing 1-2 life-threatening hurricane events and disruption in their housing had an increased likelihood of sometimes experiencing depressive symptoms. The second study found that women who engaged in certain Zika precautionary measures had a higher likelihood of engaging in adequate hurricane disaster planning.
Conclusion: Pregnant women who experienced hurricane disasters were more likely to report experiencing postpartum depressive symptoms. Hence, the engagement in disaster planning and identifying signs of depression post-pregnancy post-disaster may help mitigate the risk and aid in identifying optimal care for pregnant and postpartum women most at risk for adverse mental health outcomes in post-disaster environments.