New studies have found that the mental development of children exposed to Superstorm Sandy in utero is associated with stress. This article originally appeared on Nexus Media News and The Guardian.
Flickr/New York Governor’s Office
Destruction from Hurricane Sandy in Queens, November 6, 2012.
This article originally appeared on Nexus Media News and the guardian.
When Superstorm Sandy hit in October 2012, Celia Sporer-Newman was about eight months pregnant and working full-time as a paramedic in Queens, New York.
Sporer-Newman had worked on previous disasters, including Hurricane Irene the year before, but this felt different. He saw news reports that Sandy was going to be worse than anything New Yorkers had ever seen.
“What if I go into labor?” Sporer-Newman wondered. “I was like, [with] My luck, I’ll be at work in an ambulance standing in, like, 12 feet of water.”
Four days before Superstorm Sandy made landfall and about three weeks before her due date, Sporer-Newman gave birth to a baby boy named Izzy. He weighed seven pounds six ounces and was jaundiced, but otherwise appeared healthy. But as Sandy’s rain began to fall, Sporer-Newman and her baby would face challenges beyond her expectations.
In the United States, hurricanes are increasing in frequency and intensity due to the climate crisis. Disasters cause obvious problems: people’s homes are damaged or destroyed; the neighborhoods are flooded; businesses fail and workers lose their jobs.
but a study released this fall suggests there could be other, more insidious long-term impacts. Children who were exposed to Superstorm Sandy while in utero have “substantially” higher risks of developing depression, anxiety and attention deficit disorders, and disruptive behavior disorders, including ADHD.
The research, published in September in the Journal of Child Psychology and Psychiatry, surveyed 163 preschool-age children and found that those exposed to Sandy in utero were more than twice as likely to be diagnosed with anxiety disorders and nearly four times as likely to be diagnosed with attention deficit and disruptive behavior disorders. The study also found a sex difference in diagnosis between girls and boys. Girls were at higher risk for anxiety and depression, and boys were at higher risk for ADHD. About 86 percent of the study participants were from racial and ethnic minorities and low income.
Dr. Yoko Nomura, lead author of the study and a professor of psychology at Queens College of the City University of New York, said she did not anticipate the magnitude or consistency of these findings. “Superstorm Sandy turned out to be really, really bad,” she said.
Much has been said about how Sandy brought New York City to a standstill, resulting in at least 44 deaths and causing $19 billion in damage. Health care providers in the city were especially hard hit. Flood and storm damage caused the closure of six hospitals, leading to the evacuation of nearly 2,000 patients. Hospitals that remained open struggled to meet the needs of incoming patients.
Suddenly, expecting parents were forced to change their birth plans. One study participant reported getting stuck alone in an elevator; “[She was afraid she would] have a baby in the elevator without anyone’s help,” Nomura said.
When Sporer-Newman, who participated in the study, thinks about the birth of Superstorm Sandy and Izzy, “all I could think about was how stressed I was,” she said.
Although Izzy was born a few days before the storm made landfall, the researchers included him in the exposed group with children of mothers who watched the news about the storm. He went into labor before the scheduled C-section and gave birth without an epidural; there was no time for one, he said. “I don’t know if the stress induced [labor] or…I had so many other things to do that I just wasn’t paying attention to my own body,” Sporer-Newman said.
Sporer-Newman wanted to get home before the storm hit and left the hospital with her son against medical advice. She said hospitals can be overwhelmed and she didn’t want to risk an evacuation. She felt that her chances of staying safe were better at home and, as a medical professional, she was able to monitor herself and her baby. She was unable to take Izzy to her two checkups at seven days and then at 12 or 15 days due to gridlock in the city after Sandy. Her pediatrician’s office was closed and, when she opened, she was packed with patients.
At Izzy’s month-long visit, the doctor said she wasn’t gaining weight. He was taken to the emergency room, where he remained hospitalized for 10 days. He was diagnosed with ‘stunting’, meaning his weight was below average and he wasn’t getting the nutrition he needed to grow. But hospital staff couldn’t pinpoint exactly what was wrong. The baby cried and fussed a lot, and in retrospect, Sporer-Newman wonders if he was in pain. Over time, doctors and his mother learned ways to help Izzy gain and maintain enough weight so she could go home.
Sporer-Newman said that if she had taken Izzy to her first doctor visits, her struggle to gain weight would have been noticed and treated sooner. Now, he wonders if concern about the storm affected Izzy’s medical care. “He was born in a time of chaos. He didn’t blame anyone for missing things… but maybe he would have had a little more attention,” he said.
Jada Shapiro has been a doula for over 20 years in New York City. She said the emotional toll and uncertainty that comes with traumatic events like Sandy runs deep for pregnant women. “I don’t think people fully understood that it was possible for a hospital to close or not function,” she said. “And when you don’t feel safe, labor doesn’t work as well.”
After Sandy, Shapiro helped organize a program that matched parents displaced by the hurricane with volunteers. doulas who offered phone and email support until March 2013. “Doulas really make a world of difference in terms of providing emotional and physical support to working parents and new parents,” she said.
Participants in Nomura’s study pointed to a number of stressors surrounding Sandy, Nomura said. Food pantries were flooded. Widespread power outages affected telephone and internet services, making it difficult to stay in touch with friends and family. Some participants hosted extended family members whose homes were flooded or lost power; that meant spending hours in narrow hallways with various house guests.
“All of those things add up as a source of stress,” Nomura said.
One way that stress is transmitted to the child in the womb is through the placenta, an organ that provides nutrients and oxygen to the growing fetus, said Jia Liu, a neuroscientist and research professor at the Center for Advanced Scientific Research at the Graduate Center from CUNY. She worked with Nomura on a separate study, using data from some of Nomura’s subjects, on how environmental stressors affect brain function. Her goal was to identify the cellular and molecular changes that are related to a baby’s temperament early in life.
Nomura and a team of researchers collected placental tissues from 33 participants who gave birth after the storm and followed their children from six to 12 months of age. New parents were asked to complete questionnaires to assess their baby’s temperament. The study found a significant association between a baby having a temperament described as “slow to warm up” with high levels of stress during pregnancy.
Liu said the researchers identified changes in two specific groups of genes expressed in the placenta. First, genes that regulate inflammation increased in number, which the researchers believe was a response to stress in the womb. And second, genes that control how easily molecules (eg, toxins, metabolites) pass from mother to fetus across the placenta have decreased in number. Both groups have a prominent impact on the neurodevelopment of the fetus.
And that affected child behavior. Liu found that babies whose mothers had been highly stressed by the storm were, on average, less active and had a harder time adjusting to new people and environments. The results of that study were published by the Frontiers in Genetics this year.
Both studies are in line with existing research examining the impact of stress on the health of pregnant people and their children, said Garett Sansom, an environmental epidemiologist at Texas A&M University. But he cautioned against drawing too many conclusions from relatively small studies.
“I think it’s a very good first step to ask other researchers to start looking at this further,” he said, adding that he would have liked to know more about the families’ experiences before Sandy that might have contributed to the results. including access to care or any other environmental justice issues in local communities that worsen public health.
As natural disasters become more common, Sansom said he hopes there will be a great opportunity to expand this field of research. “I think this is something that will be of increasing concern in the coming years and decades,” he said.
Today, Izzy Newman is 10 years old and in fifth grade. His mother describes him as active, empathetic and happy, but she said she has trouble concentrating and losing his belongings. Sporer-Newman recalled a question in Nomura’s study asking parents if his child said please and thank you. “The answer is absolutely,” Sporer-Newman said. “And meanwhile, he’s bouncing around, like literally standing up and saying, ‘thank you, thank you, thank you, thank you.'”
She said that her personality is different from her other three children. She will run a block ahead of the family on walks and they will walk behind her, struggling to keep up.
Sporer-Newman said she plans to test Izzy for ADHD. Such a diagnosis could be an opportunity for early intervention, said Nomura, who led the study published in September. He would help him access certain accommodations, like a quiet room with no distractions for taking tests, that could help him in school.
“In all his nervous movements, inability to sit still, brilliant mind. We love it. All our children are different. We love each one for who they are,” Sporer-Newman said.
