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This cross\u2010sectional study evaluated the long\u2010term 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\u2013child dyads. Mothers reported prenatal hurricane\u2010related 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\u2010to\u2010severe stress (66.1%) were prevalent 12\u201354 months postpartum. Linear regression models showed that property damage\/loss predicted depressive,\n                    <jats:italic>B<\/jats:italic>\n                    \u00a0=\u00a00.290,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.007, and PTSD symptoms,\n                    <jats:italic>B<\/jats:italic>\n                    \u00a0=\u00a00.893,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.001, and injury predicted higher depressive,\n                    <jats:italic>B<\/jats:italic>\n                    \u00a0=\u00a00.546,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.039, and PTSD symptoms,\n                    <jats:italic>B<\/jats:italic>\n                    \u00a0=\u00a01.979,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.003. Prehurricane depression also predicted higher depressive,\n                    <jats:italic>B<\/jats:italic>\n                    \u00a0=\u00a01.927,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.035, and PTSD symptoms,\n                    <jats:italic>B<\/jats:italic>\n                    \u00a0=\u00a04.628,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.046, whereas total trauma count was associated with PTSD symptoms,\n                    <jats:italic>B<\/jats:italic>\n                    \u00a0=\u00a01.905,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.003, and perceived stress,\n                    <jats:italic>B<\/jats:italic>\n                    \u00a0=\u00a00.803,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.007. Mothers interviewed closer to the hurricane were more likely to report PTSD symptoms,\n                    <jats:italic>B<\/jats:italic>\n                    \u00a0=\u00a05.001,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.021. Married,\n                    <jats:italic>B<\/jats:italic>\n                    \u00a0=\u00a0\u221210.706,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.038, and cohabitating women,\n                    <jats:italic>B<\/jats:italic>\n                    \u00a0=\u00a0\u221210.948,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.035, reported lower perceived stress. Hurricane\u2010related experiences during pregnancy can have negative long\u2010term 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.\n                  <\/jats:p>","DOI":"10.1002\/jts.70025","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T04:24:41Z","timestamp":1763958281000},"page":"119-130","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010term negative mental health outcomes in mothers exposed to Hurricane Maria in Puerto Rico during the pre\u2010 and perinatal periods"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1650-9998","authenticated-orcid":false,"given":"Nayra del C.","family":"Rodr\u00edguez\u2010Soto","sequence":"first","affiliation":[{"name":"Department of Psychiatry, School of Medicine University of Puerto Rico  San Juan Puerto Rico USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frances","family":"Fuster","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, School of Medicine University of Puerto Rico  San Juan Puerto Rico USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8854-3998","authenticated-orcid":false,"given":"Polaris","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, School of Medicine University of Puerto Rico  San Juan Puerto Rico USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3773-7028","authenticated-orcid":false,"given":"Sona","family":"Rivas\u2010Tumanyan","sequence":"additional","affiliation":[{"name":"School of Dental Medicine University of Puerto Rico  San Juan Puerto Rico USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7744-3550","authenticated-orcid":false,"given":"Maribel","family":"Campos","sequence":"additional","affiliation":[{"name":"School of Dental Medicine University of Puerto Rico  San Juan Puerto Rico USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8819-1643","authenticated-orcid":false,"given":"Carmen J.","family":"Bux\u00f3","sequence":"additional","affiliation":[{"name":"School of Dental Medicine University of Puerto Rico  San Juan Puerto Rico USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2198-1376","authenticated-orcid":false,"given":"Evangelia","family":"Morou\u2010Bermudez","sequence":"additional","affiliation":[{"name":"School of Dental Medicine University of Puerto Rico  San Juan Puerto Rico USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7011-2751","authenticated-orcid":false,"given":"Karen G.","family":"Martinez\u2010Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, School of Medicine University of Puerto Rico  San Juan Puerto Rico USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,23]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"19","volume-title":"Psychiatry in the aftermath of disaster","author":"Alexander D. 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