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Objectives. To review the trends in pregnancy outcomes after Hurricane Katrina and assess effects of the disaster on research and public health related to pregnant women. Methods. We reexamined the 2004–2006 vital statistics data from Alabama, Louisiana, and Mississippi, assessing what the risk of adverse pregnancy outcomes in the population would have been under varying risk scenarios. Results. We saw a reduction in number of births as well as in low birth weight and preterm birth. If the number of births had stayed constant and the relative higher risk in the "missing" births had been between 17% and 100%, the storm would have been associated with an increased risk instead of a decrease. Because the relative decline in births was larger in Black women, the higher risk in the "missing" births required to create a significant increase associated with the storm was generally not as great as for White women. Conclusions. Higher exposure to Katrina may have produced a reduction in births among high-risk women in the region rather than increasing adverse outcomes among those who did give birth. [ABSTRACT FROM AUTHOR]

Introduction Researchers in perinatal health, as well as other areas, may be interested in linking existing datasets to vital records data when the existence or timing of births is unknown. Methods 5914 women who participated in the Bogalusa Heart Study (1973-2009), a long-running study of cardiovascular health in childhood, adolescence, and adulthood, were linked to vital statistics birth data from Louisiana, Mississippi, and Texas (1982-2010). Deterministic and probabilistic linkages based on social security number, race, maternal date of birth, first name, last name, and Soundex codes for name were conducted. Characteristics of the linked and unlinked women were compared using t-tests, Chi square tests, and multiple regression with adjustment for age and year of examinations. Results The Louisiana linkage linked 4876 births for 2770 women; Mississippi linked 791 births to 487 women; Texas linked 223 births to 153 women; After removal of duplicates and implausible dates, this left a total of 5922 births to 3260 women. This represents a successful linkage of 55% of all women ever seen in the larger study, and an estimated 65% of all women expected to have given birth. Those linked had more study visits, were more likely to be black, and had statistically lower BMIs than unlinked participants. Discussion Linking unrelated study data to vital records data was feasible to a degree. The linked group had a somewhat more favorable health profile and was less mobile than the overall study population. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) has been associated with stress, but few studies have examined the effect of natural disaster on IPV. In this study, the authors examine the relationship between experience of Hurricane Katrina and reported relationship aggression and violence in a cohort of 123 postpartum women. Hurricane experience is measured using a series of questions about damage, injury, and danger during the storm; IPV was measured using the Conflict Tactics Scale (CTS-2). Multiple log-poisson regression was used to calculate relative risks (RRs), adjusted for potential confounders. Most participants report that they and their partners had explained themselves to each other, showed each other respect, and also insulted, swore, or shouted during conflicts with each other. A few participants report physical violence, sexual force, or destroying property, though in each case at least 5% endorse that it had happened at least once in the last 6 months. Another few report that they and their partners had carried out these actions. Experiencing damage due to the storm is associated with increased likelihood of most conflict tactics. Strong RRs are seen for the relationship between damage due to the storm and aggression or violence, especially being insulted, sworn, shouted, or yelled at (adjusted relative risk [aRR] = 1.23, 95% CI = 1.02-1.48); pushed, shoved, or slapped (aRR = 5.28, 95% CI = 1.93-14.45); or being punched, kicked, or beat up (aRR = 8.25, 95% CI = 1.68-40.47). Results suggest that certain experiences of the hurricane are associated with an increased likelihood of violent methods of conflict resolution. Relief and medical workers may need to be aware of the possibility of increased IPV after disaster.

We review the literature on the effects of Hurricane Katrina on perinatal health, and providing data from our own research on pregnant and postpartum women. After Katrina, obstetric, prenatal, and neonatal care was compromised in the short term, but increases in adverse birth outcomes such as preterm birth, low birthweight, and maternal complications were mostly limited to highly exposed women. Both pregnant and postpartum women had rates of post-traumatic stress disorder similar to, or lower than, others exposed to Katrina, and rates of depression similar to other pregnant and postpartum populations. Health behaviors, such as smoking and breastfeeding, may have been somewhat negatively affected by the disaster, whereas effects on nutrition were likely associated with limited time, money, and food choices, and indicated by both weight gain and loss. We conclude that, with a few specific exceptions, postdisaster concerns and health outcomes for pregnant and postpartum women were similar to those of other people exposed to Hurricane Katrina. In such situations, disaster planners and researchers should focus on providing care and support for the normal concerns of the peripartum period, such as breastfeeding, depression, and smoking cessation. Contraception needs to be available for those who do not want to become pregnant. Although additional physical and mental health care needs to be provided for the most severely exposed women and their babies, many women are capable of surviving and thriving in postdisaster environments.