The effects of the World Trade Center disaster on pregnant women and their offspring

This dissertation draws on data from a cohort study evaluating the effects of environmental toxicants following September 11, 2001 on birth and developmental outcomes on newborns. Three hundred and twenty-nine women, recruited at three lower Manhattan hospitals following delivery, were enrolled in the study between December 2001 and June 2002, and followed up at 12 months.; The first research aim was to evaluate total maternal weight gain, and pattern of gain, over the course of pregnancy following exposure to the WTC disaster. Different measures of exposure to the WTC included biomarkers, geographic location and women's perception of air quality. These measures were not highly correlated with one another, possibly because each captures a different dimension of exposure to the WTC. Furthermore, neither perception of air quality in the four weeks following September 11, nor PAH-DNA biomarkers measured in maternal and cord blood, was associated with either total weight gain or pattern of gain. However, women residing within 2 miles of the WTC site had a total weight gain approximately 3 pounds lower than those who were not in the two-mile zone at all during those weeks (after controlling for covariates).; Evaluation of the effects of prenatal maternal distress on birth and postnatal growth outcomes was the second study aim. Birth weight and infant weight at 12 months were reduced as satisfaction with living conditions was reported to be higher. The presence of material hardships in the year prior to delivery was associated with a significant increase in infant weight at the 12-month visit of approximately 2 pounds after controlling for covariates. A reduction in head circumference of about 0.4 cm (after controlling for covariates) was evident at birth among infants whose mothers reported higher satisfaction levels with living conditions. These results appear to be contradictory to existing literature, and may be explained in part, by the unmeasured confounders, including the effects of acute stress directly resulting from the WTC event.; Finally, the study of the combined effects of maternal weight gain during pregnancy and prenatal distress on birth and growth outcomes was the third study aim. When examining the interaction between the measures of maternal psychological status and total weight gain on the combined effects on birth and infant outcomes, increased material hardship and increased total weight gain were significant predictors of greater values of birth length and infant weight at 12 month visit. However, this may not truly reflect the combined effect of the exposure measures, but rather may be the result of sample bias and differences between groups.; Based on these results, it is unlikely that exposure to the WTC disaster had a direct effect on maternal weight gain, and thus exposure did not act through maternal weight gain to influence birth weight, length and head circumference. However, measures of prenatal maternal distress were found to influence birth outcomes. The lack of association between maternal weight gain and psychological factors with mental and motor neurodevelopment may be the result of postnatal influences or the effects of toxicants released from the WTC site that have not yet resulted in any adverse outcomes. Many of these toxicants may take several years to result in a measurable deficit in the infant. (Abstract shortened by UMI.)...