Effects of Hurricane Katrina on Postpartum Mental Health

描述(申请人提供)：卡特里娜飓风被描述为该国历史上最严重的灾难或一系列灾难。自然灾害可能会导致长期的精神病态。新妈妈患抑郁症和焦虑症的风险已经很高，也有可能患上与灾难相关的精神疾病。焦虑或抑郁的母亲可能无法最好地照顾自己和她们的婴儿。怀孕期间的压力也可能直接影响儿童的发育；压力会导致糖皮质激素的释放，这可能决定胎儿HPA轴的设定点和/或改变大脑发育。此前还没有专门针对灾难发生后产后心理健康的研究。我们将测试的具体假设是：1)经历过更严重飓风的女性比几乎没有直接经历过飓风的女性患产后精神病理的风险更大。2)飓风经历的影响将受到女性获得的社会支持、她的基线资源水平和她的宗教信仰的影响。3)与没有经历过飓风的女性相比，经历过飓风的女性产后吸烟的可能性更大，母乳喂养的可能性更小。4)严重暴露在飓风中或抑郁的女性皮质醇水平较高，而患有创伤后应激障碍的女性皮质醇水平较低。我们建议招募250名在怀孕期间经历过广泛飓风的妇女(125名现在住在巴吞鲁日的疏散人员和125名住在新奥尔良的妇女)，并招募125名巴吞鲁日居民作为对照组。我们将在产后2个月、6个月和12个月采访这些母亲，包括飓风期间的经历；抑郁、焦虑和创伤后应激障碍；健康行为；社会支持；弹性；宗教信仰；以及婴儿气质。皮质醇将在75名女性中进行测试。通过纵向设计，我们将建立灾难体验、母亲心理健康和健康行为因素之间的相关性和因果关系。我们的目的是记录一场重大自然灾害对人口的影响；确定飓风经历的特征，以改善灾害后的妇幼健康；检查受灾害影响的健康行为，以便进行预防和干预；并探索怀孕期间和怀孕后应激的影响。

DESCRIPTION (provided by applicant): Hurricane Katrina has been described as "the worst catastrophe, or set of catastrophes" in the country's history. Natural disasters can lead to long-lasting psychopathology. New mothers are already at high risk for depression and anxiety, and also are potentially at high risk for disaster-related mental illness. Mothers who are anxious or depressed may be unable to care for themselves and their infants optimally. Child development may also be directly affected by stress during pregnancy; stress causes the release of glucocorticoids, which may determine the setpoint of the fetus' HPA axis and/or alter brain development. No previous research has specifically targeted postpartum mental health in the aftermath of a disaster. The specific hypotheses we will test are 1) women who had more severe experiences of the hurricane will be at greater risk for postpartum psychopathology than women with little direct experience of the hurricane. 2) The effect of hurricane experience will be moderated by the social support a woman receives, her baseline level of resources, and her religious faith. 3) Women who had a more severe experience of the hurricane will be more likely to smoke postpartum and less likely to breastfeed than women who did not. 4) Women who were severely exposed to the hurricane or are depressed will have higher cortisol levels, while women with PTSD will have lower cortisol levels. We propose to recruit 250 women who experienced the hurricane extensively during their pregnancies (125 evacuees now living in Baton Rouge and 125 women in New Orleans) and a comparison group of 125 Baton Rouge residents. We will interview the mothers at 2, 6, and 12 months postpartum, including information about experience during the hurricane; depression, anxiety, and post- traumatic stress disorder; health behaviors; social support; resilience; religiosity; and infant temperament. Cortisol will be measured in a subset of 75 women. With the longitudinal design, we will establish correlations and causality among the factors of disaster experience, maternal mental health, and health behavior. Our purpose is to document the effects of a major natural disaster on a population; to identify characteristics of the hurricane experience that could be modified to improve maternal and child health after disasters; to examine health behaviors affected by disaster, to allow for prevention and intervention; and to explore the effects of stress during and after pregnancy.