Deployment and Adverse Pregnancy Outcomes: Primary Findings and Methodological Considerations
| Autor: | Jodie G. Katon, Mubashra Raza, Shannon K. Barth, Gayle Reiber, Aaron I. Schneiderman, Yasmin Cypel, Elizabeth M. Yano, Laurie C. Zephyrin |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
medicine.medical_specialty Warfare Epidemiology Cohort Studies 03 medical and health sciences 0302 clinical medicine Pregnancy parasitic diseases medicine Odds Ratio Prevalence Humans 030212 general & internal medicine Generalized estimating equation Retrospective Studies 030219 obstetrics & reproductive medicine Obstetrics business.industry Public health Public Health Environmental and Occupational Health Pregnancy Outcome Obstetrics and Gynecology Retrospective cohort study Odds ratio Middle Aged Confidence interval United States Pregnancy Complications Low birth weight Military Personnel Software deployment Pediatrics Perinatology and Child Health Premature Birth Female medicine.symptom Live birth business |
| Zdroj: | Maternal and child health journal. 21(2) |
| ISSN: | 1573-6628 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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