Long‐term negative mental health outcomes in mothers exposed to Hurricane Maria in Puerto Rico during the pre‐ and perinatal periods

In September 2017, Category 4 Hurricane Maria devastated Puerto Rico (PR). This cross‐sectional study evaluated the long‐term mental health outcomes among women who were pregnant during or became pregnant shortly after (i.e., within 3 months) hurricane exposure. The HELiOS Study cohort recruited 187 mother–child dyads. Mothers reported prenatal hurricane‐related experiences (threat, injury, property loss) and completed assessments of posttraumatic stress disorder (PTSD), perceived stress, and depressive symptoms. Maternal probable depression (19.5%), probable PTSD (21.4%), and moderate‐to‐severe stress (66.1%) were prevalent 12–54 months postpartum. Linear regression models showed that property damage/loss predicted depressive, B = 0.290, p = .007, and PTSD symptoms, B = 0.893, p = .001, and injury predicted higher depressive, B = 0.546, p = .039, and PTSD symptoms, B = 1.979, p = .003. Prehurricane depression also predicted higher depressive, B = 1.927, p = .035, and PTSD symptoms, B = 4.628, p = .046, whereas total trauma count was associated with PTSD symptoms, B = 1.905, p = .003, and perceived stress, B = 0.803, p = .007. Mothers interviewed closer to the hurricane were more likely to report PTSD symptoms, B = 5.001, p = .021. Married, B = −10.706, p = .038, and cohabitating women, B = −10.948, p = .035, reported lower perceived stress. Hurricane‐related experiences during pregnancy can have negative long‐term effects on maternal mental health. Single mothers and pregnant women with a history of trauma exposure and/or depression may have a heightened risk of adverse postdisaster mental health outcomes.