Table 4.

Studies examining prenatal maternal stress due to disasters and child temperament

Reference	Sample Country	Methods	Prenatal stress Exposure Measure	Confoun ders	Outcome Measure	Outcome			Quality
						Negative affectivity	Surgency/Posi tive affectivity	Effortful control/ Regulation
Brand (2006)	*n = 98 USA	Prospective Cohort Study Exposed PTSD: n= 47 Not exposed to PTSD: n= 55	PCL (Blanchard et al., 1996) Pregnancy (Sept. 11, 2002) 9/11 World Trade Center One week postnatally Maternal salivary cortisol (morning and night)	Medical	IBQ (Rothbart, 1981) 9 months	PTSD and infant’s distress to novelty (r = 0.450, p < 0.01). Maternal morning cortisol and infant distress to novelty (r = −0.274, p < 0.05).			5
Buthmann (2019)	n = 380 USA	Prospective Cohort Study Prenatal: n= 169 Postnatal: n= 175 Preconception: n = 36	Storm32 (King & Laplante, 2005) Pregnancy (2nd trimester) Superstorm Sandy EPDS (Murray & Carothers, 1990) IES-R (Weiss & Marmar, 1996)	Medical Sociodemographic Behavior	IBQ-R (Gartstein & Rothbart, 2003) 6 months	ns Prenatal depression and infants’ negative affectivity (r = 0.18, p <0.01). Prenatal subjective distress and infant’s negative affectivity (r = 0.11, p < 0.05).	ns ns ns	ns Prenatal depression and infant’s regulation (r = −0.15, p < 0.01) ns	8
Diab (2018)	n = 511 Israel (Gaza)	Prospective Cohort Study	War trauma (Qouta et al., 2005) Pregnancy (2nd trimester) War of Gaza HTQ (Mollica et al., 1992) EPDS (Cox et al., 1987)	Medical Sociodemographic	IBQ-R (Gartstein & Rothbart, 2003) 4 months	ns ns ns	ns ns ns	ns ns ns	6
Isosävi (2017)	n = 511 Israel (Gaza)	Prospective Cohort Study	War trauma (Qouta et al., 2005) Pregnancy (2nd trimester) War of Gaza HTQ (Mollica et al., 1992) EPDS (Cox et al., 1987)	Medical Sociodemographic	IBQ-R (Gartstein & Rothbart, 2003) 4 months	ns (In mothers with low levels of war trauma, high childhood emotional abuse was associated with higher negative affectivity (β = −0.21, p = 0.002). ns (Prenatal hypervigilance and infant’s sadness (r = −0.10, p < 0.05) ns		ns ns ns	5
Laplante (2016)	n = 121 Canada	Retrospective Cohort Study/Cross-sectional	Storm32 (King & Laplante, 2005) Pregnancy Quebec Ice Storm IES-R (Weiss & Marmar, 1996)	Medical Sociodemographic Behavior	ICQ (Bates et al., 1979) 6 months	ns Prenatal subjective distress and infants’ difficulty/fussy (r = 0.24, p < 0.01).	ns ns	ns Prenatal subjective distress and infant’s needs attention (r = 0.31, p < 0.001).	5
McLean (2019)	n = 104 Australia	Prospective Cohort Study	QFOSS (Brock et al., 2014) Pregnancy Queensland floods IES-R (Weiss & Marmar, 1996) PDI (Brunet et al., 2001) EPDS (Cox et al., 1987) (6 months postpartum)	Medical Behavior	STST (Prior et al., 1989) 16 months	ns Maternal subjective distress and toddler’s negative reactivity (r = 0.23, p < 0.05). ns Perinatal depression at 6 months and toddler’s negative reactivity (r = 0.28, p < 0.05).		ns ns Peritraumatic distress and toddler’s persistence (r = −0.23, p < 0.05). ns	7
Nomura (2019)	n = 310 USA	Prospective Cohort Study Exposed: n=110 Not exposed: n=200 (pregnant before Sandy)	Pregnancy during Superstorm Sandy EPDS (Murray & Carothers, 1990)	Medical Sociodemographic Behavior	IBQ-R (Gartstein & Rothbart, 2003) 6 months	Infants exposed prenatally to Superstorm Sandy and to maternal depression had greater sadness (M = 3.74, p = 0.05) and greater distress (M = 4.50, p = 0.03) than those exposed to Superstorm Sandy (without depression). Prenatal depression and infant’s sadness (b = 0.05, p < 0.001) and distress (b = 0.25, p < 0.05) and less recovering from distress (b= −0.031, p < 0.01).	Infants exposed prenatally to Superstorm Sandy and to maternal depression had greater activity (M = 4.87, p = 0.02) and greater approach (M = 6.03, p = 0.05) than those exposed to Superstorm Sandy (without depression). Prenatal depression and infant’s less smiling and laughter (b = −0.043, p < 0.01) and less high pleasure seeking (b = −0.20, p = 0.05).	ns Prenatal depression and less infant’s soothability (b = −0.030, p < 0.01) and cuddliness (b= −0.034, p < 0.01).	7
Pehme (2018)	n = 95 USA	Prospective Cohort Study Exposed: n=43 Not exposed: n=52 (44 gave birth before Sandy and 8 became pregnant after Sandy)	Pregnancy during Superstorm Sandy (2nd trimester) EPDS (Cox et al., 1987) (6 months postpartum)	Medical Sociodemographic Behavior	IBQ-R (Gartstein & Rothbart, 2003) 12 months	ns	Infants whose mothers were exposed (M = 5.59) compared to those who were not exposed in utero to Sandy (M = 6.12) had lower Smiling/Laughter scores, t(93) = 2.96, p = 0.004. ns	ns	4
Simcock (2017)	*n = 121 Australia	Prospective Cohort Study Exposed: n= 38 Not exposed: n= 88 (not pregnant during floods)	QFOSS (Brock et al., 2014): 7 months after disaster Queensland floods PDI (Brunet et al., 2001) IES-R (Weiss & Marmar, 1996) 12 months after floods	Medical Sociodemographic Behavior	STSI (Sanson et al., 1987) 6 months	ns ns Maternal subjective distress and higher irritability (r = 0.27, p < 0.01).	ns Peritraumatic distress and higher activity-reactivity (r = 0.21, p < 0.01). ns	ns ns ns	6
Tees (2010)	*n = 288 USA	Prospective Cohort Study Prenatal (exposed): n=68 Preconception (not exposed): n= 216	EDS (Norris et al., 1999) Pregnancy Hurricane Katrina: 2 months postpartum PTSD Checklist (DeSalvo et al., 2007) EPDS (Cox et al., 1987)	Medical Sociodemographic Behavior	EITQ (Medoff-Cooper et al., 1993) 2 months TTS (Fullard et al., 1984) 12 months	Flooding in the house and 3 difficult temperament among those pregnant during the storm (OR = 11.25). Perinatal PTSD increased odds of difficult temperament at 12 months (OR = 2.27). Perinatal depression increased odds of difficult temperament at 12 months (OR = 3.16).			7
Vänskä (2019)	n = 502 Israel (Gaza)	Prospective Cohort Study	HTQ (Mollica et al., 1992) Pregnancy (1st trimester) 2014 War of Gaza	Medical	IBQ-R (Gartstein & Rothbart, 2003) 6–7 months	ns	ns	ns	5
Zhang (2018)	n = 318 USA	Prospective Cohort Study Exposed: n=183 Not exposed: n=135 (pregnant before or after Sandy)	Pregnancy during Superstorm Sandy (2nd trimester)	Medical Sociodemographic Behavior	IBQ-R (Gartstein & Rothbart, 2003) 6 months 12 months ECBQ (Putnam et al., 2006) 18 months 24 months	At 6 months, children exposed to Sandy in-utero were rated higher on Fearfulness, and Perceptual Sensitivity as compared to no-exposed. Fearfulness decreased overtime.	At 6 months, children exposed to Sandy in-utero were rated higher on High-Intensity Pleasure, and Approach as compared to no-exposed. Approach and High-Intensity Pleasure decreased overtime.	At 6 months, children exposed to Sandy in-utero were rated lower on Cuddliness and Duration of Orientation as compared to no-exposed.	8

Notes:

^*It is not clear from which groups participants were excluded. Questionnaires’ abbreviations. Depression: EPDS: Edinburgh Postnatal Depression Scale; PTE: Objective hardship: EDS: Exposure to Disaster Scale, QFOSS: Queensland flood objective stress scale, Storm32: Objective stress due to a storm; Subjective distress: IES-R: Impact of Event Scale-Revised; Peritraumatic Distress: PDI: Peritraumatic Distress Inventory; PTSD: PCL: PTSD checklist; Temperament: CITS: Carey Infant Temperament Scale, ECBQ: Early Childhood Behavior Questionnaire, EITQ: Early Infancy Temperament Questionnaire, IBQ: Infant Behavior Questionnaire, IBQ-R: Infant Behavior Questionnaire-Revised, ICQ: Infant Characteristics Questionnaire, STS: Short Temperament Scale, STSI: Short Temperament Scale for Infants, STST: Short Temperament Scale for Toddlers, TTS: Toddler Temperament Scale; Trauma: HTQ: Harvard Trauma Questionnaire.