When the storm hit and the toll of its devastation became clear, Nomura realized she was uniquely placed to investigate a more specific question: how would the stress of the natural disaster not only affect the pregnant women, but also their children who were exposed to it. while in the womb?
The latest data from Nomura’s “Stress in Pregnancy” study, co-authored by Jeffrey Newcorn, professor of psychiatry and pediatrics and director of the ADHD and learning disabilities division at the Icahn School of Medicine at Mount Sinai, l left them stunned, Nomura said.
The study, published in the Journal of Child Psychology and Psychiatry, found that children exposed to Sandy, a superstorm, while in utero had significantly increased risks of depression, anxiety, attention and disruptive behavior disorders. Symptoms of these disorders first appeared when the children were preschoolers.
The study found that specific behavioral patterns varied by gender, with girls more likely to suffer from anxiety and depression, while attention deficit and disruptive behaviors were more common among boys.
Among the most striking results: girls who were exposed to Sandy in utero experienced a 20-fold increase in generalized anxiety disorder and a 30-fold increase in depressive disorder, compared to girls who were not exposed to storm. Among boys who were in utero during Sandy, researchers found they were at a 60 times higher risk of developing ADHD, a 20 times higher risk of developing conduct disorder, and a 15 times higher risk of developing oppositional defiant disorder.
“We know for sure that in utero exposure to stress during pregnancy affects the development of mental health in the child,” Nomura said. “We know that the perinatal period is a very vulnerable period. What we didn’t know, however, was the magnitude of this impact, and I was genuinely surprised that our sample had such a high prevalence of these disorders. I didn’t expect it to be so clear. »
The implications of the study, the researchers noted, are particularly significant in a world increasingly altered by climate change, with the effects of natural disasters disproportionately affecting already vulnerable and marginalized communities of color.
The study followed 163 preschoolers from various racial and economic backgrounds, 40.5% of whom were exposed to Sandy in utero and 59.5% were not, either having already been born before the storm, be designed after his passage. The research team conducted interviews with the children’s parents and monitored the children’s health to track normal and abnormal development, Nomura said.
The mothers involved in the study were affected by the storm in multiple ways, Nomura explained: One told her she had been stuck in an elevator for hours, unable to get help. assistance. Others found themselves without running water or access to diapers or formula for their children. Some have lost their jobs, their means of transport or their homes. These stresses aren’t unusual following a natural disaster, Nomura said, “but the difference is that these people are pregnant, so whatever stress they’re facing goes straight through the placenta.” Many of these women, Nomura noted, had symptoms of post-traumatic stress disorder as a result of their experiences.
The study represents a new addition to the substantial body of research surrounding the impact of maternal prenatal stress on fetal brain development, said Jill Goldstein, professor of psychiatry and medicine at Harvard Medical School and founder and executive director of the Center. innovation on sex differences. in medicine at Massachusetts General Hospital, in an email to the Washington Post.
“The study by Nomura and colleagues reports another example of how environmental events, when extreme and sustained, have a substantial impact on population health and, for pregnant women, can impact on fetal development,” Goldstein said. “Depending on the timing of exposure, this can impact the male and female brain differently… The authors use a natural experiment in a new way to study [Sandy] and its impact on offspring psychiatric outcomes which differs by sex.
The study, Goldstein said, underscores the fact that “maternal health in pregnancy critically leads to population health — a theme that is very relevant during these current political storms around women’s health.” .
Previous studies have shown that high levels of stress during pregnancy are linked to outcomes such as low birth weight, premature birth, and high risk for a host of physiological, psychological, and behavioral disorders.
Newcorn noted that the new data “extends the work that’s been done in this area, it goes a bit deeper in terms of psychiatric disorders,” he said. “And of course that puts it in relation to the major environmental stress of a natural disaster.”
The team hopes to continue their work, he added, and follow the children as they grow older.
“We need to know what will happen to these children when they reach adolescence,” Nomura said. “We are going to have to follow these children to see how the manifestation of these disorders is going to present itself.”
Newcorn said it’s also important to explore exactly how maternal stress drives these outcomes for children to help mitigate the risk. Although there is clearly a relationship between the environmental and genetic factors at play, he said, there are still many unanswered questions.
“We would especially like to be able to do more research to find out why this actually happened,” he said. “What are the exact mechanisms that caused this? »
Having a better understanding of this will be key to helping society navigate a rapidly changing environment, he notes, where exposure to natural disasters during pregnancy is often impossible to avoid. In the meantime, say the researchers, parents, educators and pediatricians should be aware that children who have been exposed to the stress of a natural disaster while in utero are at increased risk for psychiatric disorders, even when very youth.
“There is a general myth that makes people believe that children don’t have psychiatric disorders at a very early age, but that’s not true,” Nomura said. “Everyone knows that early intervention is the most effective, but you can’t have early intervention without having an actual diagnosis.”
Ultimately, she says, she wants their work to help prepare future generations to better navigate a changing world.
“Due to global warming, natural disasters will continue to occur with greater frequency and magnitude,” she said. She hopes their research will “help guide what’s going to happen, so that we can come up with better planning, better response, better infrastructure.” People won’t stop getting pregnant just because natural disasters keep happening, so we need to find a way to make it easier for society to have better functioning children in the future.
