| Association between maternal traumatic stress related to Great East Japan Earthquake and behavioral problems in offspring |
Shun Tanabe1, Masatsugu Orui2,3,4 
, Chikana Kawaguchi5,6
, Genki Shinoda3,4, Aoi Noda3,4,7
, Mami Ishikuro3,4
, Taku Obara3,4,7
, Shinichi Kuriyama2,3,4
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1School of Medicine, Tohoku University, Sendai, Japan
2International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
3Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
4Graduate School of Medicine, Tohoku University, Sendai, Japan
5Osaka Regional Center for Japan Environment and Children's Study (JECS), The University of Osaka, Suita, Japan
6Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, The University of Osaka, Suita, Japan
7Tohoku University Hospital, Tohoku University, Sendai, Japan |
Correspondence:
Masatsugu Orui, Email: masatsugu.orui.e5@tohoku.ac.jp
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Received: 8 April 2026 • Revised: 2 August 2026 • Accepted: 8 August 2026 |
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| Abstract |
Background
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.
Purpose
This study aimed to examine the association between maternal traumatic stress related to the GEJE and behavioral problems in their children.
Methods
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.
Results
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.
Conclusion
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. |
| Key Words:
Disasters, Traumatic stress disorders, Maternal Health, Neurodevelopmental disorders, Child Behavior Checklist |
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