Association between maternal traumatic stress related to Great East Japan Earthquake and behavioral problems in...

: Women who experienced the Great East Japan Earthquake (GEJE) and subsequently became pregnant may have children who are more likely to exhibit emotional and behavioral problems. However, few longitudinal studies have investigated the developmental outcomes among children born to mothers who experienced natural disasters before pregnancy and continued to experience stress symptoms thereafter.

: This study aimed to examine the association between maternal traumatic stress related to the GEJE and behavioral problems in their children.

: A total of 21,656 mother-child pairs were included in the analysis; 52.0% of the offspring were male. Maternal traumatic stress symptoms related to the GEJE were assessed using items evaluating recollection, emotional distress, somatic reactions, and avoidance behaviors (Cronbach α=0.681). Child behavioral outcomes at 2 and 3 years of age were assessed using the Child Behavior Checklist for Ages 1½-5 (CBCL/1½-5). Missing data were addressed by multiple imputation, and a multivariable logistic regression was performed with adjustment for maternal psychological distress, social isolation, sleep problems, parity, breastfeeding, disaster-related exposure, parental history of mental illness, and socioeconomic characteristics. Covariate selection was guided by a directed acyclic graph.

: Compared with mothers who reported no traumatic stress symptoms, those reporting one or 2 symptoms had a higher odds of their children exhibiting internalizing (odds ratio [OR], 1.34; 95% confidence interval [CI], 1.06-1.69), externalizing (OR, 1.29; 95% CI, 1.07-1.55) and total problems (OR, 1.38; 95% CI, 1.11-1.72) at age 2 and internalizing (OR, 1.38; 95% CI, 1.13-1.69), externalizing (OR, 1.21; 95% CI, 1.01-1.45) and total problems (OR, 1.37; 95% CI, 1.10-1.71) at age 3. Mothers reporting 3 or 4 symptoms showed stronger associations, a pattern consistent with a dose-response relationship supported by a formal test for trends for most outcomes. These findings were consistent with those of sensitivity analyses using continuous CBCL scores.

: These findings suggest that maternal mental health support beyond pregnancy may be important for women of reproductive age in disaster-affected areas and could help inform preventive strategies addressing the intergenerational effects of trauma following largescale disasters such as the GEJE.