Living near big flood can mean smaller baby, NDSU study shows

FARGO-Carlye Gast was nine months pregnant during the record-breaking flood here in 2009.

Roads were closed, hospitals were evacuated and the north Fargo resident didn't know whether to leave or stay.

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It was stressful a time for Gast, who was worried the National Guard, which had been deployed to help with flood fighting efforts, would have to take her by humvee to a hospital. Instead, Gast chose to stay and gave birth a few days after the crest to Harry, a healthy 9-pound, 7-ounce son.
"I was conflicted about staying put, or driving to another community," she said. "Holding tight was the right choice."

Though the impact wasn't seen in mothers-to-be as far along as Gast, expecting a baby while living near a dangerous flood can affect a newborn's birth weight, according to a North Dakota State University study of the 2009 Red River flood published last month. And it was only the proximity to the flood that mattered, not the personal involvement in the flood fight.

The research team led by psychology professor Clayton Hilmert found pregnant women in their first or early second trimester who were near flooding areas had generally smaller babies regardless of their role in preparing for the the 2009 Red River flood, the Fargo area's worst in recorded history.

"You might have smaller babies if you're close to a flood," he said of the study's findings, "but the only way to avoid this is to get away."

Hilmert said the exact reason for the smaller birth weights isn't clear and needs further study.

The researchers interviewed more than 150 pregnant women and examined other data, like ultrasound images.

They found that women early in pregnancy gave birth to babies about 1½ ounces heavier for each mile they were away from the flood, a number Hilmert said is significant for newborns.

Hilmert said researchers initially expected to find that women who were stressed due to helping prepare for the flood would give birth to smaller babies. But whether pregnant women helped prepare, like filling and stacking sandbags, had no impact on the birth weight of their baby. Only their distance to the major flooding impacted the weight.

Other studies have echoed Hilmert's findings. A 2008 Tulane University study found pregnant women who experienced distress due to Hurricane Katrina were more likely to manifest depression, PTSD, early deliveries and smaller babies, and a 2010 Centers for Disease Control and Prevention study of the 1997 Red River flood found that many medical conditions were more prevalent in pregnant women after flooding.

"Meditating, not being physically active, none of that is going to matter," Hilmert said. "The only thing we know is women who were farther away had bigger babies."

Hilmert said there's something special about floods compared to other disasters regarding how they can lead to problems with pregnancy, and the study's suggestions need further study.

He said the expectation of a stress is often worse than the stress itself. Warnings for the 2009 flood started in early March, about 20 days before the river crested. Other disasters like earthquakes typically don't have long periods of anticipation that can cause stress, he said.

"We knew it was coming, so the stress begins and lasts for three weeks and whatever damage is done," he said.

Siri Fiebiger, who now works in Minneapolis and helped work on the study while she was working at Essentia Health in Fargo, said floods are unique events.

"People who are under stress typically don't have a single event like this," she said. "It typically continues throughout the pregnancy. What's unique is that it's a single, relatively short event."

Fiebiger said she was surprised that babies in the earlier trimesters were more affected, because fetuses develop most later.

Peter Van Eerden, a maternal-fetal medicine specialist at Sanford Health in Fargo, said there are biological reasons for why a woman might deliver earlier than expected. He said a hormone released when people are stressed can prompt an early delivery.

But studying stress can be hard because keeping variables constant is difficult, van Eerden said.

It's important for pregnant women to manage stress as best they can to ensure a healthy baby, health providers say.

Trishia Powell, a licensed independent clinical social worker at Sanford, said when pregnant women are stressed, it's important to know what triggers it and to develop ways to relax.

"Everyone has stress, and some is normal," Powell said, but when it gets bad enough to impact someone's health, it could be time to get in touch with a medical professional.