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美国历史上“最严重的灾难，或一系列灾难”。自然灾害会导致长期的精神病理。新妈妈们已经处于抑郁和焦虑的高风险中，也有可能处于与灾难相关的精神疾病的高风险中。焦虑或抑郁的母亲可能无法以最佳方式照顾自己和婴儿。怀孕期间的压力也可能直接影响儿童的发育；压力导致糖皮质激素的释放，这可能决定胎儿HPA轴的设定值和/或改变大脑发育。之前没有研究专门针对灾难后的产后心理健康。我们将测试的具体假设是：1)经历过飓风更严重的女性比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)飓风经历的影响将被女性获得的社会支持、她的基线资源水平和她的宗教信仰所缓和。经历过更严重飓风的妇女比没有经历过飓风的妇女更有可能在产后吸烟，更不可能进行母乳喂养。4)遭受飓风重创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。我们打算招募250名在怀孕期间经历过飓风的妇女（125名现在住在巴吞鲁日的撤离者和125名住在新奥尔良的妇女）和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;弹性;宗教信仰;还有婴儿的气质。将在75名女性中测量皮质醇。通过纵向设计，我们将建立灾害经历、产妇心理健康和健康行为因素之间的相关性和因果关系。我们的目的是记录重大自然灾害对人口的影响；查明飓风经历的特点，以便在灾后改善产妇和儿童的健康；审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压力的影响。

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.