Effects of earthquake on perinatal outcomes: A Chilean register-based study

Yasna K Palmeiro-Silva, Pelusa Orellana, Pia Venegas, Lara Monteiro, Manuel Varas-Godoy, Errol Norwitz, Gregory Rice, Eduardo Osorio, Sebastián E Illanes, Yasna K Palmeiro-Silva, Pelusa Orellana, Pia Venegas, Lara Monteiro, Manuel Varas-Godoy, Errol Norwitz, Gregory Rice, Eduardo Osorio, Sebastián E Illanes

Abstract

Background: Natural disasters increase the level population stress, including pregnant women, who can experience prenatal maternal stress, affecting the fetus and triggering perinatal complications, such as low birth weight, smaller head circumference, etc. However, little is known about effects of earthquake on perinatal outcomes.

Objective: To evaluate the effect of earthquake occurred on February 27, 2010 and perinatal outcomes of Chilean pregnant women, and to examine these effects by timing of exposure during pregnancy and newborn gender.

Methods: A register-based study was performed using data collected from women who had a vaginal delivery in a large private health center in Santiago, Chile, during 2009 and 2010. The study population was categorized according to exposure to earthquake and timing during gestation. Primary perinatal outcomes were gestational age at birth, birth weight, length and head circumference. Analyses adjusted for gender, gestational age at exposure, parity, maternal age and income.

Results: A total of 1,966 eligible vaginal deliveries occurred during 2009 and 2,110 in 2010. Birth weight was not affected by the trimester of exposure; however, length, head circumference and gestational age at birth were significantly different according to trimester of exposure and gender of newborn. In multivariable analysis, newborns were shorter by 2 mm, 5 mm and 4.5 mm, if they were exposed during their first, second and third trimester, respectively. Furthermore, newborns had a smaller head circumference by 1.2 mm and 1.5 mm if they were exposed during first and second trimester of gestation.

Conclusion: In this cohort, exposure to the February 2010 earthquake resulted in earlier delivery and reduced length and head circumference in the offspring. This association varied according to trimester of exposure and fetal gender. Health workers should include exposed to high levels of stress associated with natural disasters when assessing pregnancy risk factors.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Flow diagram of selection of…
Fig 1. Flow diagram of selection of data.

References

    1. Moehle J, Riddell R, Boroschek R. The Mw 8.8 Chile Earthquake of February 27, 2010. 2010. Available from
    1. Harville E, Xiong X, Buekens P. Disasters and perinatal health: a systematic review. Obstet Gynecol Surv. 2010;65: 713–728. doi:
    1. Oyarzo C, Bertoglia P, Avendaño R, Bacigalupo F, Escudero A, Acurio J, et al. Adverse perinatal outcomes after the February 27th 2010 Chilean earthquake. J Matern Fetal Neonatal Med. 2012;25: 1868–1873. doi:
    1. King S, Dancause K, Turcotte-Tremblay A, Veru F, Laplante D. Using Natural Disasters to Study the effects of prenatal Maternal Stress on Child Health and Development. Birth Defects Res. 2012;96: 273–288.
    1. Liu S, Han J, Xiao D, Ma C, Chen B. A report on the reproductive health of women after the massive 2008 Wenchuan earthquake. Int J Gynaecol Obstet. 2010;108: 161–164. doi:
    1. Tan CE, Li HJ, Zhang XG, Zhang H, Han PY, An Q, et al. The impact of the Wenchuan earthquake on birth outcomes. PLoS One. 2009;4: e8200 doi:
    1. Lau Y, Yin L, Wang Y. Severe antenatal depressive symptoms before and after the 2008 Wenchuan earthquake in Chengdu, China. J Obstet Gynecol Neonatal Nurs. 2011;40: 62–74. doi:
    1. Chang HL, Chang TC, Lin TY, Kuo SS. Psychiatric morbidity and pregnancy outcome in a disaster area of Taiwan 921 earthquake. Psychiatry Clin Neurosci. 2002;56: 139–144. doi:
    1. Torche F. The effect of maternal stress on birth outcomes: exploiting a natural experiment. Demography. 2011; 48:1473–1491. doi:
    1. Kramer MS, Lydon J, Seguin L, Goulet L, Kahn SR, McNamara H, et al. Stress pathways to spontaneous preterm birth: the role of stressors, psychological distress and stress hormones. Am J Epidemiol. 2009;169: 1319–1326. doi:
    1. King S, Barr RG, Brunet A, Saucier JF, Meaney M, Woo S, et al. The ice storm: an opportunity to study the effects of prenatal stress on the baby and the mother. Sante Ment Que. 2000;25: 163–185.
    1. Suzuki K, Yamagata Z, Kawado M, Hashimoto S. Effects of the Great East Japan Earthquake on Secondary Sex Ratio and Perinatal Outcomes. J Epidemiol. 2016; 26: 76–83. doi:
    1. Perera F, Herbstman J. Prenatal environmental exposures, epigenetics, and disease. Reprod Toxicol. 2011;31: 363–373. doi:
    1. Billack B, Serio R, Silva I, Kinsley CH. Epigenetic changes brought about perinatal stressors: a brief review of the literature. J Pharmacol Toxicol Methods. 2012;66: 221–231. doi:
    1. Charil A, Laplante DP, Vaillancourt C, King S. Prenatal stress and brain development. Brain Res Rev. 2010;65: 56–79. doi:
    1. Barker DJ. The developmental origins of adult disease. J Am Coll Nutr. 2004;23: 588S–595S.
    1. Eriksson JG. Early growth and adult health outcomes-lessons learned from the Helsinki Birth Cohort Study. Matern Child Nutr. 2005;1: 149–154. doi:
    1. Xiong X, Harville EW, Mattison D, Elkind-Hirsch K, Pridijian G, Buekens P. Exposure to Hurricane Katrina, post-traumatic stress disorder and birth outcomes. Am J Med Sci 2008;336: 111–115. doi:
    1. Seckl J, Holmes MC. Mechanism of disease: glucocorticoids, their placental metabolism and fetal programming of adult pathobiology. Nat Clin Pract Endocrinol Metab 2007;3: 479–488. doi:
    1. Franzek EJ, Sprangers N, Janssens AC, Van Duijn CM, Van De Wetering BJ. Prenatal exposure to the 1944–1945 Dutch "hunger winter" and addiction later life. Addiction. 2008;103: 433–438. doi:
    1. Malaspina D, Corcoran C, Kleinhaus KR, Perrin MC, Fenning S, Nahon D, et al. Acute maternal stress in pregnancy and schizophrenia in offspring: a cohort prospective study. BMC Psychiatry. 2008;8: 71 doi:
    1. SEREMI de Desarrollo Social Metropolitana. Indicadores comunales Encuesta CASEN 2013 –Región Metropolitana de Santiago; 2014. Available from:
    1. Mancuso RA, Schetter CD, Rini CM, Roesch SC, Hobel CJ. Maternal prenatal anxiety and corticotropin-releasing hormone associated with timing of delivery. Psychosom Med 2004;66: 762–769. doi:
    1. Tegethoff M, Greene N, Olsen J, Meyer AH, Meinlschmidt G. Maternal psychosocial adversity during pregnancy is associated with length of gestation and offspring size at birth: evidence from a population-based cohort study. Psychosom Med 2010;72: 419–426. doi:
    1. Torche F, Kleinhaus K. Prenatal stress, gestational age and secondary sex ratio: the sex-specific effects of exposure to a natural disaster in early pregnancy. Hum Reprod 2012;27: 558–512 doi:
    1. Dayan J, Creveuil C, Marks MN, Conroy S, Herlicovierz M, Dreyfus M, et al. Prenatal depression, prenatal anxiety and spontaneous preterm birth: a prospective cohort study among women with early and regular care. Psychosom Med 2006;68: 938–946. doi:
    1. Lou HC, Hansen D, Nordentoft M, Pryds O, Jensen F, Nim J, et al. Prenatal stressors of human life affect fetal brain development. Dev Med Child Neurol. 1994;36: 826–832.
    1. Dancause KN, Laplante DP, Oremus C, Fraser S, Brunet A, King S. Disaster-related prenatal maternal stress influences birth outcomes: Project Ice Storm. Early Hum Dev. 2011;87: 813–820 doi:
    1. Harville E, Do M. Reproductive and birth outcomes in Haiti before and after the 2010 earthquake. Disaster Med Public Health Prep. 2016;10: 59–66. doi:
    1. Sandman CA, Wadhwa PD, Dunkel-Schetter C, Chicz-DeMet A, Belman J, Porto M, et al. Psychobiological influences of stress and HPA regulation on the human fetus and infant birth outcomes. Ann N Y Acad Sci. 1994;739: 198–210.
    1. Nieuwenhuizen AG, Rutters F. The hypothalamic-pituitary-adrenal-axis in the regulation of energy balance. Physiol Behav. 2008;94: 169–177. doi:
    1. Hobel CJ, Goldstein A, Barrett ES. Psychosocial stress and pregnancy outcome. Clin Obstet Gynecol. 2008;51: 333–348. doi:
    1. Hobel C. Stress and preterm birth. Clin Obstet Gynecol. 2004;47: 856–880.
    1. O'Donnel KJ, Bugge A, Freeman L, Khalife N, O'Connor TG, Glover V. Maternal anxiety and downregulation of placental 11B-HSD2. Psychoneuroendocrinology. 2012;37: 818–826. doi:
    1. Lazinski MJ, Shea AK, Steiner M. Effects of maternal prenatal stress on offspring development: a commentary. Arch Womens Ment Health. 2008;11: 363–375. doi:
    1. Börzsönyi B, Demendi C, Pajor A, Rigó J Jr, Marosi K, Agota A, et al. Gene expression patterns of the 11β-hydroxysteroid dehydrogenase 2 enzyme in human placenta from intrauterine growth restriction: The role of impaired feto-maternal glucocorticoid metabolism. Eur J Obstetrics Gynecol Reprod Biol. 2012;161: 12–17.
    1. Demendi C, Börzsönyi B, Pajor A, Rigó J Jr, Nagy ZB, Szentpéteri I, et al. Abnormal fetomaternal glucocorticoid metabolism in the background of premature delivery: placental expression patterns of the 11β-hydroxysteroid dehydrogenase 2 gene. Eur J Obstet Gynecol Reprod Biol. 2012;165: 210–214. doi:
    1. Kajantie E, Dunkel L, Turpeinen U, Stenman UH, Andersson S. Placental 11β-HSD2 activity, early postnatal clinical course and adrenal function in extremely low birth weight infants. Pediatr Res. 2006;59: 575–578. doi:
    1. Cao-Lei L, Laplante D, King S. Prenatal maternal stress and epigenetic: Review of the human research. Curr Mol Bio Rep. 2016;2: 16–25.
    1. Salaria S, Chana G, Caldara F, Feltrin E, Altieri M, Faggioni F, et al. Microarray analysis of cultured human brain aggregates following cortisol exposure: implications for cellular functions relevant to mood disorders. Neurobiol Dis. 2006:23; 630–636. doi:
    1. Wang R, An C, Wang J, Wang Y, Song M, Li N, et al. Earthquake experience at different trimesters during pregnancy is associated with leukocyte telomere length and long-term health in adulthood. Front Psychiatry. 2017;8: 1–7. doi:
    1. Lui S, Huang X, Chen L, Tang H, Zhang T, Li X, et al. High-field MRI reveals an acute impact on brain function in survivors of the magnitude 8.0 earthquake in China. PNAS. 2009;106: 15412–15417. doi:
    1. Cai D, Zhu Z, Sun H, Qi Y, Xing L, Zhao X, et al. Maternal PTSD following exposure to the Wenchuan earthquake is associated with impaired mental development of children. PLoS One. 2017;12: e0168747 doi:
    1. Departamento de Estadísticas e Información en Salud Indicadores Básicos en Salud, Chile; 2013. 2013. Available from: .

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