Hurricane Michael and Adverse Birth Outcomes in the Florida Panhandle: Analysis of Vital Statistics Data

Harville, Emily W.; Ke, Peng; Beitsch, Leslie M.; Sherchan, Samendra P.; Gonsoroski, Elaina; Uejio, Christopher K.; Lichtveld, Maureen Y.

doi:10.1017/dmp.2021.367

Cited by 7 publications

(6 citation statements)

References 51 publications

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“…Previously, we used the vital statistics data and county level FEMA assistance levels as a proxy of hurricane related exposures to compare births outcomes in the year before and after Hurricane Michael in the same study area. We found that Hurricane Michael was associated with a higher risk of LBW and SGA in the year after Michael compared to the year before but using county level FEMA [43]. However, we failed to identify associations between the extent of residential building damage and the risk of adverse perinatal outcomes in the present study.…”

Section: Discussioncontrasting

confidence: 69%

Remotely sensed measures of Hurricane Michael damage and adverse perinatal outcomes and access to prenatal care services in the Florida panhandle

Gonsoroski

Uejio

et al. 2022

Environ Health

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Background Studies of effects of hurricanes on perinatal outcomes often rely on approximate measures of exposure. This study aims to use observed damage from aerial imagery to refine residential building damage estimates, evaluate the population changes post landfall, and assess the associations between the extent of residential building damage and adverse perinatal outcomes and access to prenatal care (PNC) services. Methods Vital statistics data from the Florida Department of Health’s Office of Vital Statistics were used to align maternal geocoded address data to high-resolution imagery (0.5-foot resolution, true color with red, blue, and green bands) aerial photographs. Machine learning (support vector machines) classified residential roof damage across the study area. Perinatal outcomes were compared with the presence or absence of damage to the mother’s home. Log-binomial regression models were used to compare the populations living in and outside of high-risk/damage areas, to assess the population changes after Hurricane Michael, and to estimate the associations between damage after Hurricane Michael and adverse perinatal outcomes/access to PNC services. A semi-parametric linear model was used to model time of first PNC visit and increase in damage. Results We included 8,965 women in analysis. Women with lower education and/or of Black or other non-White race/ethnicity were more likely to live in areas that would see high damage than other groups. Moreover, there was a greater proportion of births delivered by women living in the high-risk/damage area (> 25% damaged parcels after Michael) in the year before Michael than the year after Michael. Lastly, living in the area with relatively high damage increased the risk of having intermediate or inadequate PNC (adjusted Risk Ratio = 1.21, 95% CI: 1.03, 1.43), but not other adverse perinatal outcomes. Conclusions Aerially observed damage data enable us to evaluate the impact of natural disasters on perinatal outcomes and access to PNC services based on residential building damage immediately surrounding a household. The association between the extent of damage and adverse perinatal outcomes should be further investigated in future studies.

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Section: Discussioncontrasting

confidence: 69%

Remotely sensed measures of Hurricane Michael damage and adverse perinatal outcomes and access to prenatal care services in the Florida panhandle

Gonsoroski

Uejio

et al. 2022

Environ Health

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“…Cyclone-related preterm birth risks were reported in seven studies, 16 – 18 , 87 – 90 and two of them observed statistically significant higher risks among the women who experienced a hurricane during pregnancy. 18 , 89 However, a null association was found in the other four studies on a high-amplitude hurricane 16 , 87 , 88 or 58 tropical cyclones. 17 One cross-sectional study with 647,634 births in Queensland, Australia, examined the association of trimester-specific cyclone exposure with preterm birth and found that only tropical cyclone exposure in early pregnancy was associated with higher odds of preterm births.…”

Section: Resultsmentioning

confidence: 79%

“… 17 One cross-sectional study with 647,634 births in Queensland, Australia, examined the association of trimester-specific cyclone exposure with preterm birth and found that only tropical cyclone exposure in early pregnancy was associated with higher odds of preterm births. 90 Four 17 , 18 , 87 , 88 of these seven studies on preterm birth that reported relative change in the risk of preterm birth associated with cyclones (i.e., exposed vs. unexposed) were included in the meta-analysis, whereas the other three studies 16 , 89 , 90 were not included because one of them reported only the trimester-specific effect estimate, 90 one reported absolute change in the incidence rate, 89 and the remaining one used a continuous cyclone exposure level based on self-reported cyclone experience. 16 An overall statistically insignificant association [meta-

(95% CI: 0.91, 1.29); Figure 3 ] with high heterogeneity (

) and statistically insignificant asymmetry (Figure S4; Egger’s regression test,

) were found between cyclone exposures and preterm births.…”

Section: Resultsmentioning

confidence: 99%

Health Effects of Cyclones: A Systematic Review and Meta-Analysis of Epidemiological Studies

Huang,

Gao,

et al. 2023

Environ Health Perspect

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Background: More intense cyclones are expected in the future as a result of climate change. A comprehensive review is urgently needed to summarize and update the evidence on the health effects of cyclones. Objectives: We aimed to provide a systematic review with meta-analysis of current evidence on the risks of all reported health outcomes related to cyclones and to identify research gaps and make recommendations for further research. Methods: We systematically searched five electronic databases (MEDLINE, Embase, PubMed, Scopus, and Web of Science) for relevant studies in English published before 21 December 2022. Following the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines, we developed inclusion criteria, screened the literature, and included epidemiological studies with a quantitative risk assessment of any mortality or morbidity-related outcomes associated with cyclone exposures. We extracted key data and assessed study quality for these studies and applied meta-analyses to quantify the overall effect estimate and the heterogeneity of comparable studies. Results: In total, 71 studies from eight countries (the United States, China, India, Japan, the Philippines, South Korea, Australia, Brazil), mostly the United States, were included in the review. These studies investigated the all-cause and cause-specific mortality, as well as morbidity related to injury, cardiovascular diseases (CVDs), respiratory diseases, infectious diseases, mental disorders, adverse birth outcomes, cancer, diabetes, and other outcomes (e.g., suicide rates, gender-based violence). Studies mostly included only one high-amplitude cyclone (cyclones with a Saffir–Simpson category of 4 or 5, i.e., Hurricanes Katrina or Sandy) and focused on mental disorders morbidity and all-cause mortality and hospitalizations. Consistently elevated risks of overall mental health morbidity, post-traumatic stress disorder (PTSD), as well as all-cause mortality or hospitalizations, were found to be associated with cyclones. However, the results for other outcomes were generally mixed or limited. A statistically significant overall relative risk of 1.09 [95% confidence interval (CI): 1.04, 1.13], 1.18 (95% CI: 1.12, 1.25), 1.15 (95% CI: 1.13, 1.18), 1.26 (95% CI: 1.05, 1.50) was observed for all-cause mortality, all-cause hospitalizations, respiratory disease, and chronic obstructive pulmonary disease hospitalizations, respectively, after cyclone exposures, whereas no statistically significant risks were identified for diabetes mortality, heart disease mortality, and preterm birth. High between-study heterogeneity was observed. Conclusions: There is generally consistent evidence supporting the notion that high-amplitude cyclones could significantly increase risks of mental disorders, especially for PTSD, as well as mortality and hospitalizations, but the evidence for other health outcomes, s...

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“… 4 , 5 In the United States, 60.2 million people live in hurricane-prone areas, 6 and damages due to hurricanes have risen considerably over the last century, mainly due to increases in population and wealth in hurricane-affected areas. 7 , 8 Prior studies suggest exposure to a hurricane during pregnancy may be associated with an increased risk of adverse birth outcomes, 9 including preterm birth, 10 , 11 fetal distress, 12 low birth weight, 11 , 13 and small for gestational age birth. 13 Leading explanations include stress 14 and limited access to prenatal care.…”

Section: Introductionmentioning

confidence: 99%

“… 7 , 8 Prior studies suggest exposure to a hurricane during pregnancy may be associated with an increased risk of adverse birth outcomes, 9 including preterm birth, 10 , 11 fetal distress, 12 low birth weight, 11 , 13 and small for gestational age birth. 13 Leading explanations include stress 14 and limited access to prenatal care. 15 However, the evidence is not consistent, with some studies reporting a null or protective effect for preterm birth and low birth weight.…”

Section: Introductionmentioning

confidence: 99%

Hurricane Harvey and the risk of spontaneous preterm and early-term birth

Liu,

Berberian,

Wang

et al. 2024

Environmental Epidemiology

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Background: Hurricane Harvey made landfall in August 2017 and resulted in catastrophic flooding in Houston, Texas. Prior studies of hurricanes and preterm birth have found conflicting results. We tested the hypotheses that exposure to Hurricane Harvey was associated with a higher risk of spontaneous pre- and early-term birth and assessed vulnerable subpopulations. Methods: We conducted a retrospective study of singleton births using administrative birth records in the nine-county greater Houston area from 2015 to 2019. We estimated the likelihood of pre- and early-term births using logistic regression, comparing births occurring during or within 1, 2, or 4 weeks of Hurricane Harvey to unexposed reference periods encompassing the same dates 2 years prior and after. Stratified models assessed effect modification by degree of flooding, birth parent age, high- vs. low-risk pregnancy, race/ethnicity, and prenatal care. Results: Among 15,564 births, we found no association between exposure to Hurricane Harvey and spontaneous preterm birth within 1 week adjusted (odds ratio [OR], 1.06; 95% confidence interval [CI] = 0.91, 1.25) but a 14% higher odds of spontaneous early-term birth (OR, 1.14; 95% CI = 1.04, 1.25). The odds of early-term birth were even higher in neighborhoods with severe flooding (OR, 1.21; 95% CI = 1.05, 1.38), segregated neighborhoods (OR, 1.23; 95% CI = 1.03, 1.47), and among foreign-born Hispanics (OR, 1.21; 95% CI = 1.04, 1.53) and pregnant people receiving no prenatal care (OR, 1.37; 95% CI = 1.03, 1.82). Effect estimates were attenuated or null when considering 2-week or 4-week lags to define exposure. Conclusions: Hurricane Harvey was associated with higher odds of spontaneous early-term birth up to 1 week later, especially among socially marginalized populations.

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Hurricane Michael and Adverse Birth Outcomes in the Florida Panhandle: Analysis of Vital Statistics Data

Cited by 7 publications

References 51 publications

Remotely sensed measures of Hurricane Michael damage and adverse perinatal outcomes and access to prenatal care services in the Florida panhandle

Remotely sensed measures of Hurricane Michael damage and adverse perinatal outcomes and access to prenatal care services in the Florida panhandle

Health Effects of Cyclones: A Systematic Review and Meta-Analysis of Epidemiological Studies

Hurricane Harvey and the risk of spontaneous preterm and early-term birth

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