title: Impact of Hurricane Exposure on Reproductive Health Outcomes, Florida, 2004.
abstract: Prenatal hurricane exposure may be an increasingly important contributor to poor reproductive health outcomes. In the current literature, mixed associations have been suggested between hurricane exposure and reproductive health outcomes. This may be due, in part, to residual confounding. We assessed the association between hurricane exposure and reproductive health outcomes by using a difference-in-difference analysis technique to control for confounding in a cohort of Florida pregnancies.
  
  
  
  We implemented a difference-in-difference analysis to evaluate hurricane weather and reproductive health outcomes including low birth weight, fetal death, and birth rate. The study population for analysis included all Florida pregnancies conceived before or during the 2003 and 2004 hurricane season. Reproductive health data were extracted from vital statistics records from the Florida Department of Health. In 2004, 4 hurricanes (Charley, Frances, Ivan, and Jeanne) made landfall in rapid succession; whereas in 2003, no hurricanes made landfall in Florida.
  
  
  
  Overall models using the difference-in-difference analysis showed no association between exposure to hurricane weather and reproductive health.
  
  
  
  The inconsistency of the literature on hurricane exposure and reproductive health may be in part due to biases inherent in pre-post or regression-based county-level comparisons. We found no associations between hurricane exposure and reproductive health. (Disaster Med Public Health Preparedness. 2017;11:407-411).
authors.affiliation: 1Department of Epidemiology,UNC Chapel Hill,Chapel Hill,North Carolina.
authors.forename: Shannon C
authors.initials: SC
authors.lastname: Grabich
authors.affiliation: 1Department of Epidemiology,UNC Chapel Hill,Chapel Hill,North Carolina.
authors.forename: Whitney R
authors.initials: WR
authors.lastname: Robinson
authors.affiliation: 2Department of Geography,UNC Chapel Hill,Chapel Hill,North Carolina.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Konrad
authors.affiliation: 1Department of Epidemiology,UNC Chapel Hill,Chapel Hill,North Carolina.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Horney
mesh_terms: D055867:Cyclonic Storms / Q000706:statistics & numerical data*; D064891:Disaster Victims / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D046689:Fetal Mortality; D005431:Florida / Q000453:epidemiology; D006801:Humans; D060728:Reproductive Health / Q000706:statistics & numerical data / Q000639:trends*
keywords: disasters; epidemiologic methods; hurricane; public health; vital statistics