Effects of Hurricane Katrina on Postpartum Mental Health

描述（由申请人提供）：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”。自然灾害可能导致长期的精神病理学。新妈妈已经处于抑郁和焦虑的高风险之中，而且也可能处于与灾害有关的精神疾病的高风险之中。焦虑或抑郁的母亲可能无法最佳地照顾自己和婴儿。怀孕期间的压力也可能直接影响儿童发育;压力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。以前没有研究专门针对灾难后的产后心理健康。我们将检验的具体假设是：1）经历过更严重飓风的妇女比没有直接经历过飓风的妇女患产后精神病理学的风险更大。2)飓风经历的影响将受到妇女获得的社会支持、她的基线资源水平和她的宗教信仰的缓和。3)经历过更严重飓风的妇女产后吸烟的可能性更大，母乳喂养的可能性也比没有经历过飓风的妇女小。4)严重暴露于飓风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。我们计划招募250名在怀孕期间经历过飓风的妇女（125名撤离者现在住在巴吞鲁日，125名妇女住在新奥尔良）和125名巴吞鲁日居民作为对照组。我们将在产后2、6和12个月采访这些母亲，包括飓风期间的经历信息;抑郁、焦虑和创伤后应激障碍;健康行为;社会支持;复原力;宗教信仰;和婴儿气质。皮质醇将在75名女性的子集中进行测量。本研究采用纵向设计，探讨灾害经验、产妇心理健康、健康行为三因子间的相关性与因果关系。我们的目的是记录重大自然灾害对人口的影响;确定飓风经历的特征，这些特征可以在灾害发生后进行修改以改善孕产妇和儿童健康;检查受灾害影响的健康行为，以进行预防和干预;并探索怀孕期间和之后的压力影响。

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.