Fener Kalamış Cad. Belvü Apt. No: 75
K: 1 D:2 Kadıköy / İstanbul / Türkiye
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Background: Many studies involving human subjects have shown that exposure to negative factors during pregnancy can have both short – and long-term effects. This study aims to examine the effects on the mental health of the adolescent children of mothers exposed to prenatal maternal stress during earthquakes.  
Methods: The sample consisted of 407 adolescents aged 17 years at the time the study was conducted, as well as their mothers, who were pregnant during the earthquake of August 17, 1999 in Turkey. The mothers’ mental state were evaluated using the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI) and the Traumatic Stress Symptom Checklist (TSSC). The evaluations of the mental status of the mother following earthquake exposure in pregnancy were conducted retrospectively using self-reported depression, anxiety and trauma scales. The mothers were asked to fill out the BDI and BAI questionnaires based on their mental state in the week following the earthquake, while for the TSSC they were asked to select the statements that best described their status in the 6 months following the earthquake. The adolescents’ current depression, anxiety and Attention Deficit Hyperactivity Disorder (ADHD) symptoms were evaluated with the BDI, BAI and the Wender Utah Rating Scale. Given the contribution of stressful events to their current mental status and to the long-term effects of perinatal stress, the Traumatic Experiences List (TEL) was also administered. The presence of depression, anxiety and ADHD among adolescents and the link to the mother’s mental status, and the factors predicting depression, anxiety and ADHD were analyzed.  
Results: The adolescents whose mothers had mental complaints during pregnancy were found to have significantly higher levels of depression and mental complaints than those whose mothers had no mental complaints in their case histories (p<0.05). The adolescents whose mothers had depression, anxiety and PTSD (past and present) were found to score significantly higher in the presence of ADHD (p<0.05). In univariate logistic regression analyses, the mothers’ mental complaints during pregnancy in the post- earthquake period, and the presence of depression, anxiety and PTSD in mothers were found to be significant predictors of depression, anxiety and ADHD among adolescents (p<0.05). Multivariate logistic regression analyses identified the presence of anxiety in mothers during pregnancy as a significant predictor of depression and anxiety among adolescents, while the presence of PTSD in mothers during pregnancy was a significant predictor of ADHD among adolescents (p<0.05).  
Conclusions: The results suggest that disaster-related objective and subjective prenatal maternal stresses are a potential pathway through which the adolescent depression, anxiety and ADHD symptomatologies may be impacted. It is important for health care professionals to identify the mental state and potential stressful life-events of the mother during pregnancy, especially when there has been exposure to a significant external trauma, as the first step toward tailored interventions.  

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