Project 1: DWHD, Lifetime Adversity and Reproductive-Aged Women

该提案审查的教区经历了“五年内的五次灾难”——卡特里娜飓风、丽塔飓风、古斯塔夫飓风、艾克飓风和DWH飓风。育龄妇女的身心健康不仅本身很重要，而且对后代的健康也很重要。以往对环境灾害的研究大多表明，虽然环境灾害的物理影响通常是主要关注的来源，但这些灾害的心理影响可能更为显著。妇女容易受到灾后精神病理的影响，孕妇和母亲可能尤其容易受到影响。在怀孕期间经历压力、患有抑郁症或其他精神健康问题的妇女，出现低出生体重（LBW）和早产（PTB）等不良妊娠结局的风险也会增加。此外，一些环境污染物，如铅和空气污染，与不良妊娠结局有关。虽然有人提出，社会和环境逆境的影响可能是累积的，并使健康差距永久化，但这种情况很少

The parishes examined by this proposal have seen "five disasters in five years" - Hurricanes Katrina, Rita, Gustav, Ike, and the DWH disaster. The mental and physical health of women of reproductive age is important not only in itself, but for the health of future generations. Previous studies of environmental disasters largely indicate that although the physical effects of environmental disasters are usually the major source of concern, psychological effects of these disasters can be more significant. Women are vulnerable to post-disaster psychopathology, and pregnant women and mothers may be particularly vulnerable. Women who experience stress during their pregnancy and who have depression or other mental health problems are also at increased risk for adverse pregnancy outcomes like low birthweight (LBW) and preterm birth (PTB). In addition, some environmental contaminants, such as lead and air pollution, have been associated with adverse pregnancy outcomes. While it has been proposed that the effects of social and environmental adversity are likely to be cumulative and perpetuate health disparities, this has been little studied. We propose to compare mental and physical health outcomes in women exposed in varying degrees to the DWH disaster. 250 pregnant and non-pregnant women each, from two affected communities, will be recruited over two years, and will be questioned about their experience of the oil spill. Hurricane Katrina, and other adversities. They will also provide blood samples to determine lead and mercury levels. Air pollution data will be collected from monitoring data. Depression and anxiety levels, as well as reproductive choices, will be examined in these women. An additional 1000 pregnant women will be recruited over four years to allow us to examine the effects of the disasters and environmental exposures on birth outcomes. Our specific aims are 1) To determine the effect of the DWH disaster on the mental health of women of reproductive age; 2) To determine the effect of the DWH disaster on reproductive outcomes (reproductive choices, fertility, LBW, PTB); 3) To determine the effect of lifetime social adversity on reproductive outcomes, and 4) To determine how social and environmental adversity interact to affect reproductive outcomes. The proposed research will be innovative in bringing together the research on disaster psychology with stress and pregnancy, examining the role of lifetime social adversities on reproductive outcomes, and examining the interaction between social adversity and environmental contamination.