Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2020

01-12-2020 | Premature Birth | Research article

Maternal exposure to Wenchuan earthquake and prolonged risk of offspring birth outcomes: a natural experiment study

Authors: Qiguo Lian, Jiaying Ni, Jun Zhang, Julian Little, Shan Luo, Lin Zhang

Published in: BMC Pregnancy and Childbirth | Issue 1/2020

Login to get access

Abstract

Background

The prolonged effects of disasters on reproductive outcomes among the survivors are less studied, and the findings are inconsistent. We examined the associations of maternal exposure to the 2008 Wenchuan earthquake years before conception with adverse birth outcomes.

Methods

We included 73,493 women who delivered in 96 hospitals in 24 provinces and autonomous regions from the 2015/16 China Labor and Delivery Survey. We weighted the multivariable logistic models based on the combination of coarsened exact matching (CEM) weight and survey weight, and performed sex-stratified analysis to test whether associations of maternal earthquake exposure with adverse birth outcomes (Stillbirth, preterm birth [PTB], low birthweight [LBW], and small for gestational age [SGA]) varied by sex.

Results

The bivariate models showed that the weighted incidence of each adverse birth outcome was higher in exposed group than unexposed group: stillbirth (2.00% vs. 1.33%), PTB (14.14% vs. 7.32%), LBW (10.82% vs. 5.76%), and SGA (11.32% vs. 9.52%). The multivariable models showed maternal earthquake exposure was only associated significantly with a higher risk of PTB in offspring among all births (adjusted risk ratio [aRR](95%CI):1.25(1.06–1.48), P = 0.010). The sex-stratified analysis showed the association was significant among male births (aRR (95%CI): 1.40(1.12–1.75),P = 0.002),but unsignificant among female births. The sensitivity analysis reported similar findings.

Conclusions

The 2008 Wenchuan earthquake exposure has a long-term effect on PTB. Maternal acute exposure to disasters could be a major monitor for long-term reproductive outcomes. More attention should be paid to the underlining reasons for disaster-related adverse birth outcomes.
Appendix
Available only for authorised users
Literature
1.
2.
Mahumud RA, Sultana M, Sarker AR. Distribution and determinants of low birth weight in developing countries. J Prev Med Public Health. 2017;50(1):18–28.PubMedCrossRef
3.
Klepac P, Locatelli I, Korosec S, Kunzli N, Kukec A. Ambient air pollution and pregnancy outcomes: a comprehensive review and identification of environmental public health challenges. Environ Res. 2018;167:144–59.PubMedCrossRef
4.
Kim D, Saada A. The social determinants of infant mortality and birth outcomes in Western developed nations: a cross-country systematic review. Int J Environ Res Public Health. 2013;10(6):2296–335.PubMedPubMedCentralCrossRef
5.
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(2):139–44.PubMedCrossRef
6.
Lipkind HS, Curry AE, Huynh M, Thorpe LE, Matte T. Birth outcomes among offspring of women exposed to the September 11, 2001, terrorist attacks. Obstet Gynecol. 2010;116(4):917–25.PubMedCrossRef
7.
Palmeiro-Silva YK, Orellana P, Venegas P, Monteiro L, Varas-Godoy M, Norwitz E, Rice G, Osorio E, Illanes SE. Effects of earthquake on perinatal outcomes: a Chilean register-based study. PLoS One. 2018;13(2):e0191340.PubMedPubMedCentralCrossRef
8.
9.
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(2):558–67.PubMedCrossRef
10.
Maslow CB, Caramanica K, Li J, Stellman SD, Brackbill RM. Reproductive outcomes following maternal exposure to the events of September 11, 2001, at the world trade center, in New York City. Am J Public Health. 2016;106(10):1796–803.PubMedPubMedCentralCrossRef
11.
Leppold C, Nomura S, Sawano T, Ozaki A, Tsubokura M, Hill S, Kanazawa Y, Anbe H. Birth outcomes after the Fukushima Daiichi nuclear power plant disaster: a long-term retrospective study. Int J Environ Res Public Health. 2017;14(5):542.PubMedCentralCrossRef
12.
Fan F, Zhou Y, Mo L, Zhang W, Xie J, Liu X, Group tWS. Cohort profile: the Wenchuan earthquake adolescent health cohort study. Int J Epidemiol. 2016;46(1):27–8.
13.
Lian Q, Zuo X, Mao Y, Zhang Y, Luo S, Zhang S, Lou C, Tu X, Zhou W. The impact of the Wenchuan earthquake on early puberty: a natural experiment. PeerJ. 2018;6:e5085.PubMedPubMedCentralCrossRef
14.
Wainstock T, Shoham-Vardi I, Glasser S, Anteby E, Lerner-Geva L. Fetal sex modifies effects of prenatal stress exposure and adverse birth outcomes. Stress. 2015;18(1):49–56.PubMedCrossRef
15.
Chen C, Zhang JW, Xia HW, Zhang HX, Betran AP, Zhang L, Hua XL, Feng LP, Chen D, Sun K, et al. Preterm birth in China between 2015 and 2016. Am J Public Health. 2019;109(11):1597–604.PubMedCrossRefPubMedCentral
16.
Craig P, Cooper C, Gunnell D, Haw S, Lawson K, Macintyre S, Ogilvie D, Petticrew M, Reeves B, Sutton M, et al. Using natural experiments to evaluate population health interventions: new Medical Research Council guidance. J Epidemiol Community Health. 2012;66(12):1182–6.PubMedCrossRef
17.
Craig P, Katikireddi SV, Leyland A, Popham F. Natural experiments: An overview of methods, approaches, and contributions to public health intervention research. Annu Rev Public Health. 2017;38:39–56.PubMedPubMedCentralCrossRef
18.
19.
WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157–63.CrossRef
20.
Blackwell M, Iacus S, King G, Porro G. cem: coarsened exact matching in Stata. Stata J. 2009;9(4):524–46.CrossRef
21.
Norton EC, Miller MM, Kleinman LC. Computing adjusted risk ratios and risk differences in Stata. Stata J. 2013;13(3):492–509.CrossRef
22.
Heino A, Gissler M, Hindori-Mohangoo AD, Blondel B, Klungsøyr K, Verdenik I, Mierzejewska E, Velebil P, Sól Ólafsdóttir H, Macfarlane A, et al. Variations in multiple birth rates and impact on perinatal outcomes in Europe. PLoS One. 2016;11(3):e0149252.PubMedPubMedCentralCrossRef
23.
Russo FM, Pozzi E, Pelizzoni F, Todyrenchuk L, Bernasconi DP, Cozzolino S, Vergani P. Stillbirths in singletons, dichorionic and monochorionic twins: a comparison of risks and causes. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):131–6.PubMedCrossRef
24.
Oyarzo C, Bertoglia P, Avendano R, Bacigalupo F, Escudero A, Acurio J, Escudero C. Adverse perinatal outcomes after the February 27th 2010 Chilean earthquake. J Matern Fetal Neonatal Med. 2012;25(10):1868–73.PubMedCrossRef
25.
Fujimori K, Kyozuka H, Yasuda S, Goto A, Yasumura S, Ota M, Ohtsuru A, Nomura Y, Hata K, Suzuki K, et al. Pregnancy and birth survey after the great East Japan earthquake and Fukushima Daiichi nuclear power plant accident in Fukushima prefecture. Fukushima J Med Sci. 2014;60(1):75–81.PubMedCrossRef
26.
Yasuda S, Kyozuka H, Nomura Y, Fujimori K, Goto A, Yasumura S, Hata K, Ohira T, Abe M. Influence of the great East Japan earthquake and the Fukushima Daiichi nuclear disaster on the birth weight of newborns in Fukushima prefecture: Fukushima health management survey. J Matern Fetal Neonatal Med. 2017;30(24):2900–4.PubMedCrossRef
27.
Harville EW, Tran T, Xiong X, Buekens P. Population changes, racial/ethnic disparities, and birth outcomes in Louisiana after hurricane Katrina. Disaster Med Public Health Prep. 2010;4(Suppl 1):S39–45.PubMedCrossRef
28.
Hamilton BE, Sutton PD, Mathews TJ, Martin JA, Ventura SJ. The effect of hurricane Katrina: births in the U.S. Gulf Coast region, before and after the storm. Natl Vital Stat Rep. 2009;58(2):1–28 32.PubMed
29.
Walsh K, McCormack CA, Webster R, Pinto A, Lee S, Feng T, Krakovsky HS, O'Grady SM, Tycko B, Champagne FA, et al. Maternal prenatal stress phenotypes associate with fetal neurodevelopment and birth outcomes. Proc Natl Acad Sci U S A. 2019;116(48):23996–4005.PubMedPubMedCentralCrossRef
30.
Clifton VL. Review: sex and the human placenta: mediating differential strategies of fetal growth and survival. Placenta. 2010;31(Suppl):S33–9.PubMedCrossRef
31.
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(12):813–20.PubMedCrossRef
32.
Williams TC, Drake AJ. Preterm birth in evolutionary context: a predictive adaptive response? Philos Trans R Soc Lond Ser B Biol Sci. 2019;374(1770):20180121.CrossRef
33.
Pike IL. Maternal stress and fetal responses: evolutionary perspectives on preterm delivery. Am J Hum Biol. 2005;17(1):55–65.PubMedCrossRef
34.
Levi R, Lundberg U, Hanson U, Frankenhacuser M. Anxiety during pregnancy after the Chernobyl accident as related to obstetric outcome. J Psychosom Obstet Gynecol. 1989;10(3):221–30.CrossRef
35.
Zhang L-P, Zhao Q, Luo Z-C, Lei Y-X, Wang Y, Wang P-X. Prevalence and risk factors of posttraumatic stress disorder among survivors five years after the “Wenchuan” earthquake in China. Health Qual Life Outcomes. 2015;13:75.PubMedPubMedCentralCrossRef
36.
Krontira AC, Cruceanu C, Binder EB. Glucocorticoids as mediators of adverse outcomes of prenatal stress. Trends Neurosci. 2020;43(6):394–405.PubMedCrossRef
37.
National Health and Family Planning Commission of the People's Republic of China: China Health and Family Planning Statistical Yearbook. In., vol. 978–7–5679-0643-3; 2016.
Metadata
Title
Maternal exposure to Wenchuan earthquake and prolonged risk of offspring birth outcomes: a natural experiment study
Authors
Qiguo Lian
Jiaying Ni
Jun Zhang
Julian Little
Shan Luo
Lin Zhang
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Premature Birth
Published in
BMC Pregnancy and Childbirth / Issue 1/2020
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-020-03206-1

Other articles of this Issue 1/2020

BMC Pregnancy and Childbirth 1/2020 Go to the issue

Research article

Determinants of uptake of first dose of intermittent preventive treatment among pregnant women in a secondary health Centre in Maiduguri, Nigeria

Research article

Exploring the reasons why women prefer to give birth at home in rural northern Ghana: a qualitative study

Research article

The risk of eating disorder relapse during pregnancy and after delivery and postpartum depression among women recovered from eating disorders

Research article

Pregnancy outcomes in asylum seekers in the North of the Netherlands: a retrospective documentary analysis

Research article

Health care professionals’ adherence to partograph use in Ethiopia: analysis of 2016 national emergency obstetric and newborn care survey

Research article

Delays in obstetric care increase the risk of neonatal near-miss morbidity events and death: a case-control study