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Post-Disaster Reproductive Health Outcomes

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Abstract

We examined methodological issues in studies of disaster-related effects on reproductive health outcomes and fertility among women of reproductive age and infants in the United States (US). We conducted a systematic literature review of 1,635 articles and reports published in peer-reviewed journals or by the government from January 1981 through December 2010. We classified the studies using three exposure types: (1) physical exposure to toxicants; (2) psychological trauma; and (3) general exposure to disaster. Fifteen articles met our inclusion criteria concerning research focus and design. Overall studies pertained to eight different disasters, with most (n = 6) focused on the World Trade Center attack. Only one study examined pregnancy loss, i.e., occurrence of spontaneous abortions post-disaster. Most studies focused on associations between disaster and adverse birth outcomes, but two studies pertained only to post-disaster fertility while another two examined it in addition to adverse birth outcomes. In most studies disaster-affected populations were assumed to have experienced psychological trauma, but exposure to trauma was measured in only four studies. Furthermore, effects of both physical exposure to toxicants and psychological trauma on disaster-affected populations were examined in only one study. Effects on birth outcomes were not consistently demonstrated, and study methodologies varied widely. Even so, these studies suggest an association between disasters and reproductive health and highlight the need for further studies to clarify associations. We postulate that post-disaster surveillance among pregnant women could improve our understanding of effects of disaster on the reproductive health of US pregnant women.

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Acknowledgments

We would like to thank Barbara Landreth, CDC Librarian, and Leslie Harrison, MPH, Tonya Stancil, PhD, and Brian Morrow, MA, of the PRAMS team for their assistance with this paper. This publication was supported by funds made available from the Centers for Disease Control and Prevention, Office for Public Health Preparedness and Response.

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Authors and Affiliations

  1. Division of Reproductive Health/NCCDPHP, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS-K22, Atlanta, GA, 30341, USA

    Marianne E. Zotti, Amy M. Williams, McKaylee Robertson & Jason Hsia

  2. Center for Public Health Preparedness, University of North Carolina (UNC), Chapel Hill, NC, USA

    Jennifer Horney

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  1. Marianne E. Zotti
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  2. Amy M. Williams
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  3. McKaylee Robertson
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Correspondence to Marianne E. Zotti.

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The findings and conclusions are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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Zotti, M.E., Williams, A.M., Robertson, M. et al. Post-Disaster Reproductive Health Outcomes. Matern Child Health J 17, 783–796 (2013). https://doi.org/10.1007/s10995-012-1068-x

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