Table 1.
Studies of the World Trace Center disaster of September 11h, 2001 and other terrorist attacks
| Study | disaster | outcome | definition of exposure | sample size | Results (exposed vs. unexposed) | Notes on timing |
|---|---|---|---|---|---|---|
| Berkowitz, 2003a (45) | WTC (United States) | GA IUGR LOW BIRTH WEIGHT PTB |
Proximity to WTC | 187 exposed, 2367 controls | GA: 39.1 vs 39.0, p=0.55 BW: 3203 vs 3267, p=0.14 PTB: 9.9% vs. 9.2%, p=0.76 LOW BIRTH WEIGHT: 8.2% vs 6.8%, p=.47 IUGR: 8.2% vs. 3.8%; OR 2.2, 1.3-3.71; aOR1.9, 1.05-3.71 |
no difference by trimester or time of recruitment |
| Brand, 2006 (55) | WTC (United States) | maternal report of infant distress, response to novelty | 98 | women with post traumatic stress disorder rated infants as more distress, less likely novelty; no difference in other temperament traits | 9 months old infant | |
| Camacho, 2008 (57) | terrorist attacks (Colombia) | BW | location of residence | 781000 | 8.7 g reduction for living in area with landmine explosions | strongest in first trimester |
| El-Sayed, 2008 (52) | WTC (United States) | VERY low birth weight LOW BIRTH WEIGHT PTB |
timing | 3133 Arab, 126251 non-Arab | VERY low birth weight aOR: 0.49, 0.31-0.76 LOW BIRTH WEIGHT aOR: 0.97, 0.78-1.06 PTB aOR: 0.78, 0.98?-0.90 |
|
| Endara, 2009 (50) | WTC (United States) | birth defects PTB SGA Infant growth deficiency (infant health registry) |
timing of birth | 164743 infants born to active-duty military families; compared to 2000 and 2002 babies | Birth defects: aOR 1.01, 0.93-1.09 PTB: aOR 1.02, 0.98-1.06 SGA: aOR 1.00, 0.92-1.09 Growth: aOR 1.00, 0.95-1.06 |
Estimated date of delivery June 12, 2000-September 11, 2001 |
| Engel, 2005a (39) | WTC (United States) | GA BW HC |
post traumatic stress disorder/depression | 52 women enrolled while pregnant, 5 zones | post traumatic stress disorder and depression associated with longer gestations post traumatic stress disorder assoc with smaller HC week after 9/11- more births <2000 g, fewer births 2000-2500 g |
|
| Eskenazi, 2007 (53) | WTC (United States) | VERY low birth weight MLOW BIRTH WEIGHT LOW BIRTH WEIGHT VPTB MPTB PTB |
timing of birth | 1,660,401 New York State women (birth certificate data) | VERY low birth weight: aOR 1.44, MLOW BIRTH WEIGHT: aOR 1.67 BW 2000-2500 g: aOR 0.83 VERY low birth weight: in Dec and Jan - aOR 1.36, 1.28 MPTB in first 8 weeks after disaster in NYC: aOR 0.87 MPTB in first 4 weeks after disaster in upstate, aOR 0.89 |
months after 9/11 |
| Lauderdale, 2006 (51) | WTC (United States) | LOW BIRTH WEIGHT VERY low birth weight PTB |
timing and Arabic last name | 15064 Arab named, 1532311 non-Arab named | LOW BIRTH WEIGHT: aOR 1.34, 1.04-1.73 VERY low birth weight, PTB: no association |
Six months after vs. six months before |
| Lederman, 2004b (48) | WTC (United States) | BW HC BL |
live or work within 2 miles of WTC | 300 fullterm, nonsmokers | BW: adjusted 149g less HC: adjusted -0.29, p=0.15 BL; adjusted -0.82 cm less PI: no difference GA: 2-4 days less; -1.22, p=0.18 after adjustment |
|
| PI | ||||||
| SGA | SGA: no difference | |||||
| 329 | ||||||
| Lederman, 2008b (49) | WTC (United States) | BW BL HC GA (all full-term) Bayley scales |
mercury exposure; mercury level not associated with proximity to WTC | 136-151 infants | no associations | 12 and 24 months |
| Lewis, 2005c (38) | WTC (United States) | mother/infant bonding alcohol use (Alcohol Use Disorders and Associated Disabilities Interview Schedule) Depression (CES-D) |
explain how affected by terrorism subjective effect of attacks |
99 pregnant women | drug users more likely to say disaster affected ability to bond no other main effects No association with alcohol use CES-D scale: 15.1 +/-9.7 (elevated) exposure to attacks associated with depressive symptoms |
2-9 months after WTC |
| Lewis, 2008c (100) | WTC (United States) | Depression (CES-D) effect of terrorism | timing and self-report within 9 months of 9/11 |
99 pregnant women | more trauma predicted subjective effect history of domestic violence/abuse predicts response to event |
|
| Maric, 2009 (58) | bombing (Serbia) | BW GA BL HC Pre-eclampsia Birth defects |
timing (registry data) | 1198 exposed, 2617 control | BW: 86 g lighter, 95% CI 67-104 GA, BL: no difference HC: 0.6 cm larger in exposed, p<0.01 Pre-eclampsia: aOR 0.60 (0.41-0.86) Birth defects: aOR 3.3 (0.9-11.7) |
|
| Perera, 2005b (46) | WTC (United States) | BW HC PI SGA GA |
polycyclic aromatic hydrocarbons Benzo(a)-pyrene DNA adducts (inversely correlated with distance from WTC) | 170 women, 203 infants | no independent effects interactive effect on birthweight with tobacco smoke: 276-g reduction in BW 1.3 cm reduction in HC no interaction effects on PI, small for gestational age, GA |
|
| Rich-Edwards, 2005 (47) | WTC (United States) | GA PTB |
Timing | 606 exposed, 1184 matched controls | GA: 0.13 (-0.05, 0.3) weeks longer in exposed PTB: OR 0.60, 0.36-0.98 |
|
| Santos-Leal, 2006 (59) | Madrid train bombing (Spain) | PROM | 18 in weeks after bombing, vs. average of 9 | |||
| Smits, 2006 (54) | WTC (The Netherlands) | BW GA |
timing | 1885 year after, 1258 year before | 48 g (95% CI 14-83) lower in exposed 0.7 days, p=0.07 |
no variation by trimester |
| Yehuda, 2005a (56) | WTC (United States) | cortisol levels | post traumatic stress disorder after WTC | 38 | lower cortisol in both mother and baby if mother had post traumatic stress disorder | most likely if mother developed post traumatic stress disorder in 3rd trimester |
GA, gestational age; BW, birthweight; low birth weight, low birthweight (<2500 g unless otherwise specified); PTB, preterm birth (<37 weeks’ gestation unless otherwise specified); IUGR, intrauterine growth restriction; small for gestational age, small-for-gestational-age; post traumatic stress disorder, post-traumatic stress disorder; OR, odds ratio; aOR, adjusted odds ratio; very low birth weight, very low birthweight (<1500 g unless otherwise specified); VPTB, very preterm birth; WTC, World Trade Center disaster of September 11th; PROM, premature rupture of membranes; NS, non-statistically significant; HC, head circumference; BL, birth length; PI, ponderal index; SAb, spontaneous abortion; MLOW BIRTH WEIGHT, moderately low birthweight, 1500-1999g; MPTB, 33-36 weeks
Studies marked with the same superscript letter are different analyses of the same sample