Deployment and Adverse Pregnancy Outcomes: Primary Findings and Methodological Considerations

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• 作者：Jodie Katon ; Yasmin Cypel ; Mubashra Raza…
• 关键词：Deployment ; Preterm birth ; Low birth weight ; Women Veterans ; OEF/OIF
• 刊名：Maternal and Child Health Journal
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：21
• 期：2
• 页码：376-386
• 全文大小：
• 刊物主题：Public Health; Sociology, general; Population Economics; Pediatrics; Gynecology; Maternal and Child Health;
• 出版者：Springer US
• ISSN：1573-6628
• 卷排序：21

文摘

Objective To characterize the pregnancy outcomes of women Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans including prevalence of preterm delivery, low birth weight, and macrosomia, and to highlight methodological limitations that can impact findings. Methods A retrospective cohort study was conducted starting in 2014 analyzing data from the 2009 to 2011 National Health Study for a New Generation of US Veterans, which sampled Veterans deployed and not deployed to OIF/OEF. All pregnancies resulting in a live birth were included, and categorized as occurring among non-deployers, before deployment, during deployment, or after deployment. Outcomes included preterm birth, low birth weight, and macrosomia. The association of deployment with selected outcomes was estimated using separate general estimating equations to account for lack of outcome independence among women contributing multiple pregnancies. Adjustment variables included maternal age at outcome, and race/ethnicity. Results There were 2276 live births (191 preterm births, 153 low birth weight infants, and 272 macrosomic infants). Compared with pregnancies before deployment, pregnancies among non-deployers and those after deployment appeared to have greater risk of preterm birth [non-deployers: odds ratio (OR) = 2.16, 95 % confidence interval (CI) 1.25, 3.72; after deployment: OR = 1.90, 95 % CI 0.90, 4.02]. A similar pattern was observed for low birth weight. No association of deployment with macrosomia was detected. Discussion Compared with non-deployers, those who eventually deploy appear to have better pregnancy outcomes prior to deployment, but this advantage is no longer apparent after deployment. Non-deployers may not be an appropriate reference group to study the putative health impacts of deployment on pregnancy outcomes.