Bushfires and Mothers’ Mental Health in Pregnancy and Recent Post-Partum
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Bushfire and Smoke Exposures
2.3. COVID-19 Exposure
2.4. Pregnancy
2.5. Mental Health and Wellbeing Measures
2.6. Covariates
2.7. Statistical Analysis
3. Results
3.1. Mental Health
3.2. Bushfire and Smoke Exposure
3.3. COVID-19 Exposure
3.4. Bushfire and Smoke Exposure and Mental Health
3.5. COVID-19 and Mental Health
3.6. Sensitivity Analyses
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Survey Questions | ||
---|---|---|
Broad Bushfire Exposure | Acute Bushfire Exposure | “Were you evacuated from your home or workplace because of the threat of fire?” |
“Were you personally involved in fighting bushfires threatening your own home or neighbourhood?” | ||
“Were your own home, possessions or workplace damaged or destroyed?” | ||
“Was your partner/spouse personally involved in fighting bushfires?” | ||
“Did you suffer any injury due to the fires?” | ||
“Did any relative or friend die or suffer injury due to the fires?” | ||
“Did you own any animal that suffered as a result of the fires?” | ||
“Did you feel very frightened or upset during the period of the fires?” | ||
“Apart from defending your own home and neighbourhood, did you do any work involving the bushfires and/or their effects? (e.g., fighting fires, keeping order, dealing with health effects, restoring power, caring for victims)”. | ||
“Were buildings in your suburb or area damaged or destroyed by fire?”, | ||
“Did any relative or friend have their home, possessions or workplace damaged or destroyed?” | ||
“Did you suffer significant financial loss due to the fires?” | ||
“Did the bushfires impact on your health care appointments?” | ||
“Did the bushfires impact on your access to medications/other health care supplies/baby care supplies?” | ||
Smoke Exposure | During the period of 1st December 2019 to 14th of February 2020 what do you consider your bushfire smoke exposure was?” | |
Broad COVID-19 Exposure | Acute COVID-19 Exposure | “I have been diagnosed positive for COVID-19” |
“I have a family member who has been diagnosed positive by a laboratory test” | ||
“I was directed by the health department to self-isolate” | ||
“I have a family member who is currently or has been required to self-isolate” | ||
“I have been tested for COVID-19—awaiting result” | ||
“I have been tested for COVID-19—negative result” | ||
“I have voluntarily self-isolated (current or previous)” | ||
“I have been a contact of someone who has been diagnosed positive by a laboratory test” | ||
“I know someone who has been or is currently required to self-isolate” |
Preconception (n = 66) | Pregnant (n = 636) | New Baby (n = 217) | Total (n = 919) | p Value | |
---|---|---|---|---|---|
Age (years) | 0.009 | ||||
Mean (SD) | 31.74 (4.63) | 31.80 (4.42) | 32.84 (4.30) | 32.04 (4.43) | |
Tertiary education | 50 (75.8%) | 472 (74.2%) | 164 (75.6%) | 686 (74.6%) | 0.903 |
Middle/high income | 62 (93.9%) | 611 (96.1%) | 213 (98.2%) | 886 (96.4%) | 0.193 |
Parity | 0.916 | ||||
Median (IQR) | 1 (1) | 1 (1) | 1 (1) | 1 (1) | |
Prior depression | 22 (33.3%) | 108 (17.0%) | 30 (13.8%) | 160 (17.4%) | 0.001 |
Prior anxiety | 28 (42.4%) | 220 (34.6%) | 66 (30.4%) | 314 (34.2%) | 0.182 |
Wellbeing (WHO-5) | 0.667 | ||||
Mean (SD) | 48.55 (19.51) | 50.29 (20.26) | 49.16 (20.77) | 49.90 (20.31) | |
DASS depression score | 0.295 | ||||
Mean (SD) | 2.35 (3.08) | 2.89 (3.36) | 3.09 (3.59) | 2.90 (3.40) | |
DASS anxiety score | 0.628 | ||||
Mean (SD) | 2.59 (2.95) | 2.24 (2.71) | 2.32 (3.12) | 2.29 (2.83) | |
DASS stress score | 0.488 | ||||
Mean (SD) | 5.45 (3.90) | 5.61 (4.16) | 5.97 (4.32) | 5.69 (4.18) | |
DASS total score | 0.621 | ||||
Mean (SD) | 10.39 (8.97) | 10.75 (9.16) | 11.39 (9.77) | 10.87 (9.29) | |
Acute bushfire exposure | 0.782 | ||||
Mean (SD) | 1.06 (0.93) | 1.15 (1.11) | 1.12 (0.95) | 1.13 (1.06) | |
Broad bushfire exposure | 0.655 | ||||
Mean (SD) | 1.97 (1.99) | 2.21 (2.21) | 2.24 (1.96) | 2.20 (2.14) | |
Smoke exposure | 0.667 | ||||
Not/mildly exposed | 5 (7.6%) | 44 (6.9%) | 13 (6.0%) | 62 (6.7%) | |
Moderately exposed | 18 (27.3%) | 199 (31.3%) | 58 (26.7%) | 275 (29.9%) | |
Severely exposed | 43 (65.2%) | 393 (61.8%) | 146 (67.3%) | 582 (63.3%) | |
Acute COVID exposure | 0.214 | ||||
Mean (SD) | 0.33 (0.57) | 0.22 (0.47) | 0.22 (0.45) | 0.23 (0.47) | |
Broad COVID exposure | 0.139 | ||||
Mean (SD) | 1.38 (1.30) | 1.11 (1.11) | 1.21 (1.12) | 1.15 (1.13) |
Study | Population | Depression | Dep SD | Anxiety | Anx SD | Stress | Str SD | Total Score | SD |
---|---|---|---|---|---|---|---|---|---|
MC2020 | Preconception/pregnant/ post-partum women | 2.9 | 3.4 | 2.3 | 2.8 | 5.7 | 4.2 | 10.9 | 9.3 |
Bryson et al. | Pregnant women | 2.9 | 3.3 | 3.4 | 3.3 | 5.4 | 4.0 | 11.7 | 9.4 |
Crawford et al. | Adult Australian population | 2.6 | 3.9 | 1.7 | 2.8 | 4.0 | 4.2 | 8.3 | 9.8 |
WHO-5 | Depression | Anxiety | Stress | |||||
---|---|---|---|---|---|---|---|---|
Intercept | 54.722 *** | 54.691 *** | 5.131 *** | 5.105 *** | 6.588 *** | 6.487 *** | 7.350 *** | 7.276 *** |
p < 0.001 | p < 0.001 | p < 0.00001 | p < 0.00001 | p < 0.001 | p < 0.001 | p < 0.001 | p < 0.001 | |
Age, yrs | −0.033 | −0.039 | −0.094 *** | −0.092 *** | −0.140 *** | −0.137 *** | −0.103 ** | −0.100 ** |
p = 0.841 | p = 0.816 | p = 0.001 | p = 0.001 | p < 0.001 | p < 0.001 | p = 0.003 | p = 0.003 | |
Parity, number | −1.599 | −1.541 | 0.439 ** | 0.423 ** | 0.535 *** | 0.516 *** | 0.615 *** | 0.588 *** |
p = 0.062 | p = 0.073 | p = 0.002 | p = 0.003 | p = 0.00001 | p = 0.00001 | p = 0.0004 | p = 0.001 | |
Tertiary education (yes) | 1.605 | 1.507 | −0.684 ** | −0.656 * | −0.901 *** | −0.869 *** | −0.824 * | −0.777 * |
p = 0.331 | p = 0.363 | p = 0.012 | p = 0.016 | p = 0.00004 | p = 0.0001 | p = 0.013 | p = 0.020 | |
Pregnancy phase (pregnant) | 1.889 | 1.952 | 0.515 | 0.499 | −0.368 | −0.383 | 0.105 | 0.079 |
p = 0.470 | p = 0.456 | p = 0.229 | p = 0.243 | p = 0.287 | p = 0.266 | p = 0.842 | p = 0.880 | |
Pregnancy phase (new baby) | 0.774 | 0.919 | 0.837 | 0.803 | −0.124 | −0.152 | 0.602 | 0.549 |
p = 0.786 | p = 0.747 | p = 0.072 | p = 0.085 | p = 0.741 | p = 0.686 | p = 0.291 | p = 0.335 | |
Bushfire exposure (acute) | −1.826 ** | 0.390 *** | 0.214 * | 0.565 *** | ||||
p = 0.006 | p = 0.0003 | p = 0.013 | p = 0.00002 | |||||
Bushfire exposure (broad) | −0.902 ** | 0.203 *** | 0.138 ** | 0.304 *** | ||||
p = 0.006 | p = 0.0002 | p = 0.002 | p = 0.00001 | |||||
Smoke exposure (moderate) | −2.552 | −2.528 | −0.171 | −0.181 | 0.479 | 0.459 | 0.888 | 0.867 |
p = 0.371 | p = 0.375 | p = 0.714 | p = 0.697 | p = 0.204 | p = 0.222 | p = 0.120 | p = 0.128 | |
Smoke exposure (severe) | −3.898 | −3.793 | 0.035 | 0.002 | 0.592 | 0.545 | 1.078 * | 1.018 |
p = 0.152 | p = 0.165 | p = 0.938 | p = 0.998 | p = 0.100 | p = 0.130 | p = 0.048 | p = 0.062 | |
Observations | 919 | 919 | 919 | 919 | 919 | 919 | 919 | 919 |
Log Likelihood | −4061.52 | −4061.64 | −2396.80 | −2396.29 | −2201.50 | −2199.47 | −2583.26 | −2581.78 |
Akaike Inf. Crit. | 8141.04 | 8141.28 | 4811.60 | 4810.58 | 4421.00 | 4416.93 | 5184.52 | 5181.57 |
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Cherbuin, N.; Bansal, A.; Dahlstrom, J.E.; Carlisle, H.; Broom, M.; Nanan, R.; Sutherland, S.; Vardoulakis, S.; Phillips, C.B.; Peek, M.J.; et al. Bushfires and Mothers’ Mental Health in Pregnancy and Recent Post-Partum. Int. J. Environ. Res. Public Health 2024, 21, 7. https://doi.org/10.3390/ijerph21010007
Cherbuin N, Bansal A, Dahlstrom JE, Carlisle H, Broom M, Nanan R, Sutherland S, Vardoulakis S, Phillips CB, Peek MJ, et al. Bushfires and Mothers’ Mental Health in Pregnancy and Recent Post-Partum. International Journal of Environmental Research and Public Health. 2024; 21(1):7. https://doi.org/10.3390/ijerph21010007
Chicago/Turabian StyleCherbuin, Nicolas, Amita Bansal, Jane E. Dahlstrom, Hazel Carlisle, Margaret Broom, Ralph Nanan, Stewart Sutherland, Sotiris Vardoulakis, Christine B. Phillips, Michael J. Peek, and et al. 2024. "Bushfires and Mothers’ Mental Health in Pregnancy and Recent Post-Partum" International Journal of Environmental Research and Public Health 21, no. 1: 7. https://doi.org/10.3390/ijerph21010007