Hurricane Katrina experience and the risk of post-traumatic stress disorder and depression among pregnant women


  • Emily W. Harville, PhD
  • Donald R. Mattison, MD
  • Karen Elkind-Hirsch, PhD
  • Gabriella Pridjian, MD
  • Pierre Buekens, MD, PhD



depression, disaster, Hurricane Katrina, post-traumatic stress disorder, pregnancy


Objective: Little is known about the effects of disaster exposure and intensity on the development of mental disorders among pregnant women. The aim of this study was to examine the effect of exposure to Hurricane Katrina on mental health in pregnant women.
Design: Prospective cohort epidemiological study.
Setting: Tertiary hospitals in New Orleans and Baton Rouge, USA.
Participants: Women who were pregnant during Hurricane Katrina or became pregnant immediately after the hurricane.
Main outcome measures: Post-traumatic stress disorder (PTSD) and depression.
Results: The frequency of PTSD was higher in women with high hurricane exposure (13.8 percent) than women without high hurricane exposure (1.3 percent), with an adjusted odds ratio (aOR) of 16.8 (95% confidence interval: 2.6-106.6) after adjustment for maternal race, age, education, smoking and alcohol use, family income, parity, and other confounders. The frequency of depression was higher in women with high hurricane exposure (32.3 percent) than women without high hurricane exposure (12.3 percent), with an aOR of 3.3 (1.6-7.1). Moreover, the risk of PTSD and depression increased with an increasing number of severe experiences of the hurricane.
Conclusions: Pregnant women who had severe hurricane experiences were at a significantly increased risk for PTSD and depression. This information should be useful for screening pregnant women who are at higher risk of developing mental disorders after disaster.

Author Biographies

Emily W. Harville, PhD

Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.

Donald R. Mattison, MD

National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.

Karen Elkind-Hirsch, PhD

Woman’s Health Research Institute, Woman’s Hospital, Baton Rouge, Louisiana.

Gabriella Pridjian, MD

Department of Obstetrics and Gynecology, Tulane University School of Medicine, New Orleans, Louisiana.

Pierre Buekens, MD, PhD

Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.


Buekens P, Xiong X, Harville E: Hurricanes and pregnancy. Birth. 2006; 33: 91-93.

Travis J: Hurricane Katrina. Scientists’ fears come true as hurricane floods New Orleans. Science. 2005; 309: 1656-1659.

Wilson JF: Health and the environment after Hurricane Katrina. Ann Intern Med. 2006; 144: 153-156.

Waelde LC, Koopman C: Symptoms of acute stress disorder and posttraumatic stress disorder following exposure to disastrous flooding. J Trauma Dissoc. 2001; 2: 37-52.

Ahern M, Kovats RS,Wilkinson P, et al.: Global health impacts of floods: Epidemiologic evidence. Epidemiol Rev. 2005; 27: 36-46.

Galea S, Nandi A, Vlahov D: The epidemiology of post-traumatic stress disorder after disasters. Epidemiol Rev. 2005; 27: 78-91.

Bromet E, Dew MA: Review of psychiatric epidemiologic research on disasters. Epidemiol Rev. 1995; 17: 113-119.

Briere J, Elliott D: Prevalence, characteristics, and long-term sequelae of natural disaster exposure in the general population. J Trauma Stress. 2000; 13: 661-679.

Armenian HK, Morikawa M, Melkonian AK, et al.: Loss as a determinant of PTSD in a cohort of adult survivors of the 1988 earthquake in Armenia: Implications for policy. Acta Psychiatr Scand. 2000; 102: 58-64.

Cordero JF: The epidemiology of disasters and adverse reproductive outcomes: Lessons learned. Environ Health Perspect. 1993; 101 (Suppl 2): 131-136.

Xiong X, Harville EW, Mattison DR, et al.: Exposure to Hurricane Katrina, post-traumatic stress disorder and birth outcomes. Am J Med Sci. 2008; 336: 111-115.

Norris FH, Perilla JL, Riad JK, et al.: Stability and change in stress, resources, and psychological morbidity: Who suffers and who recovers: Findings from Hurricane Andrew. Anxiety Stress Coping. 1999; 12: 363-396.

Norris FH, Friedman MJ, Watson PJ, et al.: 60,000 disaster victims speak. I. An empirical review of the empirical literature, 1981-2001. Psychiatry. 2002; 65: 207-239.

Weathers FW, Ruscio AM,Keane TM: Psychometric properties of nine scoring rules for the clinician-administered posttraumatic stress disorder scale. Psychol Assess. 1999; 11: 124-133.

Norris FH, Hamblen JL: Standardized self-report measures of civilian trauma and PTSD. In Wilson JP,Keane TM (eds.): Assessing Psychological Trauma and PTSD. New York: Guildford Press, 2004: 63-102.

Cox JL, Holden JM, Sagovsky R: Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987; 150: 782-786.

Cox JL, Chapman G, Murray D, et al.:Validation of the Edinburgh Postnatal Depression Scale (EPDS) in non-postnatal women. J Affect Disord. 1996; 39: 185-189.

Murray D, Cox JL: Screening for depression during pregnancy with the Edinburgh Depression Scale. J Reprod Infant Psychol. 1990; 8: 99-107.

Dayan J, Creveuil C, Herlicoviez M, et al.: Role of anxiety and depression in the onset of spontaneous preterm labor. Am J Epidemiol. 2002; 155: 293-301.

Voelker R: Katrina’s impact on mental health likely to last years. JAMA. 2005; 294: 1599-1600.

Rubonis AV, Bickman L: Psychological impairment in the wake of disaster: The disaster-psychopathology relationship. Psychol Bull. 1991; 109: 384-399.

Bennett HA, Einarson A, Taddio A, et al.: Prevalence of depression during pregnancy: Systematic review. Obstet Gynecol. 2004; 103: 698-709.

Kessler RC, Galea S, Gruber MJ, et al.: Trends in mental illness and suicidality after Hurricane Katrina. Mol Psychiatry. 2008; 13: 374-384.

DeSalvo KB, Hyre AD, Ompad DC, et al.: Symptoms of posttraumatic stress disorder in a New Orleans workforce following Hurricane Katrina. J Urban Health. 2007; 84: 142-152.

Buekens P, Miller CA: Pre-natal care in occupied Belgium during the Second World War. Eur J Public Health. 1996; 6: 105-108.

Harville EW, Xiong X, Buekens P, et al.: Resilience after Hurricane Katrina among pregnant and postpartum women.Women’s Health Issues. 2010; 20: 20-27.

Norris FH, Kaniasty K: Received and perceived social support in times of stress: A test of the social support deterioration deterrence model. J Pers Soc Psychol. 1996; 71: 498-511.

Wang X, Gao L, Zhang H, et al.: Post-earthquake quality of life and psychological well-being: Longitudinal evaluation in a rural community sample in northern China. Psychiatry Clin Neurosci. 2000; 54: 427-433.

Joseph S, Yule W,Williams R, et al.: Crisis support in the aftermath of disaster: A longitudinal perspective. Br J Clin Psychol. 1993; 32 (Part 2): 177-185.




How to Cite

Harville, PhD, E. W., D. R. Mattison, MD, K. Elkind-Hirsch, PhD, G. Pridjian, MD, and P. Buekens, MD, PhD. “Hurricane Katrina Experience and the Risk of Post-Traumatic Stress Disorder and Depression Among Pregnant Women”. American Journal of Disaster Medicine, vol. 5, no. 3, May 2010, pp. 181-7, doi:10.5055/ajdm.2010.0022.