Major flood related strains and pregnancy outcomes

Objective: To assess the impact of experiencing a major flood during pregnancy on fetal growth and length of gestation, and to consider how flood-related strains might contribute to these effects. Method: The Red River Pregnancy Project was a prospective study carried out for 3 months immediately after the historic 2009 crest of the Red River in Fargo, North Dakota. Pregnant community residents who were at least 18 years old with a singleton, intrauterine pregnancy participated in the study (N = 169). Analyses examined if birth weight and length of gestation were associated with residential distance from flooding and gestational age at time of the flood crest. Results: For pregnancies earlier in gestation during the crest (-1 SD = 12 weeks), birth weight decreased as distance from flooding decreased (-42.29 g/mi, p < .01). For pregnancies later in gestation at crest (+1 SD = 26 weeks), distance was not associated with birth weight (p > .10). Biparietal growth trajectories showed a decrease in growth after the crest of the flood but only for women early in pregnancy. However, various measures of flood related and general stress or strain did not explain these effects. Length of gestation was not associated with distance from or the timing of the flood. Conclusions: Pregnant women in the first trimester who experience a major flood near their homes are at risk of having lower birth weight neonates due to a reduction in fetal growth. The mechanisms of this effect deserve further attention in rapidly mounted investigations after disaster.