New studies have found that the mental development of children exposed to Superstorm Sandy in utero is associated with stress. This article originally appeared in Nexus Media News and The Guardian.
This article originally appeared in 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 dealt with previous disasters, including Hurricane Irene the year before, but this one felt different. He saw reports that Sandy would be worse than anything New Yorkers had seen before.
“What if I go into labor?” Sporer-Newman wondered. “I was like, [with] luckily for me, I’ll be at work in an ambulance standing in about 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 boy named Izzy. He weighed seven pounds six ounces and was jaundiced, but otherwise looked healthy. But when Sandy’s rain started to fall, Sporer-Newman and her baby faced challenges beyond their 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; neighborhoods are flooded; companies fail and workers lose their jobs.
But a study released this fall suggests there may be other, more insidious long-term impacts. Children who were exposed to Superstorm Sandy while in the womb have “substantially” higher risks of developing depression, anxiety and attention deficit disorder and disruptive behavior disorders, including ADHD.
The research, published in September in the Journal of Child Psychology and Psychiatry, surveyed 163 preschoolers 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 likelihood of being diagnosed with attention deficit disorder and disruptive behavior disorders. The study also found a sex difference in diagnosis between girls and boys. Girls were more at risk for anxiety and depression and boys were more at risk for ADHD. About 86 percent of study participants were from racial and ethnic minorities and low-income backgrounds.
Dr. Yoko Nomura, lead author of the study and a psychology professor at Queens College of the City University of New York, said she did not predict the magnitude or consistency of these findings. “Superstorm Sandy turned out to be a really bad, bad boy,” she said.
There has been much talk of how Sandy crippled New York City, killing at least 44 people and causing $19 billion in damage. Health workers in the city have been hit especially hard. Damage from the floods and storms caused the closure of six hospitals, with the evacuation of nearly 2,000 patients. The hospitals that remained open struggled to meet the needs of incoming patients.
Expectant parents were suddenly forced to change their birth plans. One study participant reported being stuck alone in an elevator; “[She was afraid she would] having a baby in an elevator without anyone’s help,” Nomura said.
When Sporer-Newman, who participated in the study, looks back on the birth of Superstorm Sandy and Izzy, “All I could think about was how stressed I was,” she said.
Although Izzy was born just days before the storm made landfall, the researchers included him in the group exposed with the children of mothers watching the storm news. He went into labor before the scheduled C-section and delivered without an epidural—there was no time for one, he said. “I don’t know if stress induced [labor] or… I had so many other things to do that I just wasn’t paying attention to my body,” Sporer-Newman said.
Sporer-Newman wanted to get home before the storm hit and left the hospital with her son against doctor’s advice. He said hospitals can be overwhelmed and he didn’t want to risk an evacuation. She felt 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 get Izzy to both checkups at seven days and then at 12-15 days due to the city shutdown after Sandy. Her pediatrician’s office was closed and, when it opened, was overcrowded 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 “failure to thrive,” meaning that he was below average weight and was not getting the nutrition he needed to grow. But hospital staff were unable to pinpoint exactly what was wrong. The baby cried and fussed a lot and, in retrospect, Sporer-Newman wonders if he was in pain. Eventually, his doctors and mother learned how to help Izzy gain and maintain enough weight to get him home.
Sporer-Newman said if he had taken Izzy to her first doctor visits, then her struggle with weight gain would have been noticed and treated sooner. Now, she wonders if the discomfort caused by the storm affected the medical care Izzy received. “He was born in a time of chaos. I’m not blaming anyone for missing things… but maybe he could 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’s are profound for pregnant people. “I don’t think people fully understood that it was possible for a hospital to shut down or not function,” she said. “And when you don’t feel safe, labor doesn’t work either.”
In the aftermath of Sandy, Shapiro helped organize a program that matched parents displaced by the hurricane with volunteer doulas who offered phone and email support through March 2013. “Doulas really make a big difference in terms of of emotional and physical support to parents in labor and new parents,” she said.
Participants in Nomura’s study pointed to a number of stressors surrounding Sandy, Nomura said. Food pantries flooded. Widespread power outages have impacted phone and internet services, making it difficult to stay in touch with friends and family. Some attendees welcomed extended family members whose homes were flooded or lost electricity; that meant spending hours in narrow corridors with several house guests.
“All of these things build up as a source of stress,” Nomura said.
One way stress is transmitted to the baby in utero is through the placenta, an organ that supplies nutrients and oxygen to a growing fetus, said Jia Liu, a neuroscientist and research professor in the Advanced Science Research Center at CUNY. Graduate Center. He worked with Nomura on a separate study, which used data from some of Nomura’s subjects, on how environmental stressors affect brain function. His goal was to identify cellular and molecular changes related to a child’s temperament early in life.
Nomura and a team of researchers collected placental tissues from all 33 participants who gave birth after the storm and followed up with their children from six to 12 months of age. The new parents were asked to fill out questionnaires to assess their child’s temperament. The study found a significant association between a child with 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, the genes that control how easily molecules (eg, toxins, metabolites) pass from mother to fetus across the placenta are decreasing in number. Both groups have a major impact on the neurodevelopment of the fetus.
And this affected the child’s behavior. Liu found that children whose mothers had been under a lot of stress from 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 this year by Frontiers in Genetics.
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 such relatively small studies.
“I think it’s a really good first step in getting other researchers to start looking at this more,” she said, adding that she wished she had learned more about the families’ experiences before Sandy that could have contributed to the findings, including the access to care or any other environmental justice issues in local communities that worsen public health.
As natural disaster events become more common, Sansom said he expects there will be ample opportunity to broaden this field of research. “I think this is something that will be of increasing concern in the years and decades to come,” she said.
Today Izzy Newman is 10 years old and in fifth grade. His mother describes him as active, empathetic and happy, but said he has trouble focusing and putting things out of place about him. Sporer-Newman recalled that a question in Nomura’s study asked parents if their child said please and thank you. “The answer is absolutely,” Sporer-Newman said. “And meanwhile he’s bouncing, like literally standing up saying, ‘thank you, thank you, thank you, thank you.'”
She said her personality is different from her other three boys. He will run a block ahead of the family on walks and they will walk behind, fighting to keep up with him.
Sporer-Newman said he plans to have Izzy tested for ADHD. Such a diagnosis could be an opportunity for early intervention, said Nomura, who led the study published in September. It would help him access certain accommodations, such as a quiet room without distractions to take tests, that could help him in school.
“In all his nervous movements, inability to sit still, brilliant mind. We love it. All of our children are different. We love each of them for who they are,” Sporer-Newman said.