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Effects of Hurricane Michael on Access to Care for Pregnant Women and Associated Pregnancy Outcomes

Background: Disasters are associated with worse perinatal outcomes, perhaps due to inadequate prenatal care (PNC). Methods: Using 2017–2019 Florida vital statistics, we compared PNC use before and after Hurricane Michael. We categorized counties as most affected (Area A) or less affected (Area B and...

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Autores principales: Pan, Ke, Beitsch, Leslie, Gonsoroski, Elaina, Sherchan, Samendra P., Uejio, Christopher K., Lichtveld, Maureen Y., Harville, Emily W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7825524/
https://www.ncbi.nlm.nih.gov/pubmed/33419129
http://dx.doi.org/10.3390/ijerph18020390
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author Pan, Ke
Beitsch, Leslie
Gonsoroski, Elaina
Sherchan, Samendra P.
Uejio, Christopher K.
Lichtveld, Maureen Y.
Harville, Emily W.
author_facet Pan, Ke
Beitsch, Leslie
Gonsoroski, Elaina
Sherchan, Samendra P.
Uejio, Christopher K.
Lichtveld, Maureen Y.
Harville, Emily W.
author_sort Pan, Ke
collection PubMed
description Background: Disasters are associated with worse perinatal outcomes, perhaps due to inadequate prenatal care (PNC). Methods: Using 2017–2019 Florida vital statistics, we compared PNC use before and after Hurricane Michael. We categorized counties as most affected (Area A) or less affected (Area B and C). We examined whether Michael’s effects on perinatal outcomes varied by maternity care availability and used the Baron and Kenny method to assess whether delayed PNC initiation mediated perinatal outcomes. Log-binomial regression and semi-parametric linear regression were used, controlling for maternal and ZIP code tabulation area characteristics. Results: Compared to the one-year period pre-Michael, the week of the first PNC was later in all areas in the one-year period post-Michael, with the largest change in Area A (adjusted difference 0.112, 95% CI: 0.055–0.169), where women were less likely to receive PNC overall (aRR = 0.994, 95% CI = 0.990–0.998) and more likely to have inadequate PNC (aRR = 1.193, 95% CI = 1.127–1.264). Michael’s effects on perinatal outcomes did not vary significantly by maternity care availability within Area A. Delayed PNC initiation appeared to mediate an increased risk in small for gestational age (SGA) births after Michael. Conclusion: Women in Area A initiated PNC later and had a higher likelihood of inadequate PNC. Delayed PNC initiation may partially explain increased risk of SGA.
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spelling pubmed-78255242021-01-24 Effects of Hurricane Michael on Access to Care for Pregnant Women and Associated Pregnancy Outcomes Pan, Ke Beitsch, Leslie Gonsoroski, Elaina Sherchan, Samendra P. Uejio, Christopher K. Lichtveld, Maureen Y. Harville, Emily W. Int J Environ Res Public Health Article Background: Disasters are associated with worse perinatal outcomes, perhaps due to inadequate prenatal care (PNC). Methods: Using 2017–2019 Florida vital statistics, we compared PNC use before and after Hurricane Michael. We categorized counties as most affected (Area A) or less affected (Area B and C). We examined whether Michael’s effects on perinatal outcomes varied by maternity care availability and used the Baron and Kenny method to assess whether delayed PNC initiation mediated perinatal outcomes. Log-binomial regression and semi-parametric linear regression were used, controlling for maternal and ZIP code tabulation area characteristics. Results: Compared to the one-year period pre-Michael, the week of the first PNC was later in all areas in the one-year period post-Michael, with the largest change in Area A (adjusted difference 0.112, 95% CI: 0.055–0.169), where women were less likely to receive PNC overall (aRR = 0.994, 95% CI = 0.990–0.998) and more likely to have inadequate PNC (aRR = 1.193, 95% CI = 1.127–1.264). Michael’s effects on perinatal outcomes did not vary significantly by maternity care availability within Area A. Delayed PNC initiation appeared to mediate an increased risk in small for gestational age (SGA) births after Michael. Conclusion: Women in Area A initiated PNC later and had a higher likelihood of inadequate PNC. Delayed PNC initiation may partially explain increased risk of SGA. MDPI 2021-01-06 2021-01 /pmc/articles/PMC7825524/ /pubmed/33419129 http://dx.doi.org/10.3390/ijerph18020390 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pan, Ke
Beitsch, Leslie
Gonsoroski, Elaina
Sherchan, Samendra P.
Uejio, Christopher K.
Lichtveld, Maureen Y.
Harville, Emily W.
Effects of Hurricane Michael on Access to Care for Pregnant Women and Associated Pregnancy Outcomes
title Effects of Hurricane Michael on Access to Care for Pregnant Women and Associated Pregnancy Outcomes
title_full Effects of Hurricane Michael on Access to Care for Pregnant Women and Associated Pregnancy Outcomes
title_fullStr Effects of Hurricane Michael on Access to Care for Pregnant Women and Associated Pregnancy Outcomes
title_full_unstemmed Effects of Hurricane Michael on Access to Care for Pregnant Women and Associated Pregnancy Outcomes
title_short Effects of Hurricane Michael on Access to Care for Pregnant Women and Associated Pregnancy Outcomes
title_sort effects of hurricane michael on access to care for pregnant women and associated pregnancy outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7825524/
https://www.ncbi.nlm.nih.gov/pubmed/33419129
http://dx.doi.org/10.3390/ijerph18020390
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