Pregnancy Outcomes Among U.S. Gulf War Veterans: A Population-Based Survey of 30,000 Veterans

Kang, Han; Magee, Carol; Mahan, Clare; Lee, Kyung; Murphy, Frances; Jackson, Leila; Matanoski, Genevieve

« Previous Next »Annals of Epidemiology
Volume 11, Issue 7 , Pages 504-511, October 2001

Pregnancy Outcomes Among U.S. Gulf War Veterans:

A Population-Based Survey of 30,000 Veterans

Han Kang, DrPH
- Environmental Epidemiology Service, Department of Veterans Affairs, Wasington, DC USA
- Address correspondences to: Address correspondence to: Dr. Han K. Kang, Environmental Epidemiology Service, Department of Veterans Affairs, 1120 20th Street, N.W. Suite 950, Washington, D.C. 20036
Carol Magee, PhD
- Environmental Epidemiology Service, Department of Veterans Affairs, Wasington, DC USA
Clare Mahan, PhD
- Environmental Epidemiology Service, Department of Veterans Affairs, Wasington, DC USA
Kyung Lee, PhD
- Food and Drug Administration, Department of Health and Human Services, Washington, DC USA
Frances Murphy, MD, MPH
- Office of the Under Secretary for Health, Department of Veterans Affairs, Wasington, DC USA
Leila Jackson, MPH
- Environmental Epidemiology Service, Department of Veterans Affairs, Wasington, DC USA
Genevieve Matanoski, MD, DrPH
- School of Hygiene and Public Health, The Johns Hopkins University, Baltimore, MD USA

Received 4 October 2000; received in revised form 23 March 2001; accepted 11 April 2001.

Abstract

PURPOSE: We evaluated an association between veterans' Gulf War service and reported adverse pregnancy outcomes.

METHODS: We conducted a health survey in which selected reproductive outcomes of a population-based sample of 15,000 Gulf War veterans representing four military branches and three unit components (active, reserve, and National Guard) were compared to those of 15,000 non-Gulf veteran controls.

RESULTS: Male Gulf veterans, compared with their non-Gulf veteran controls, reported a significantly higher rate of miscarriage (odds ratio [OR] = 1.62; 95% confidence interval [CI] = 1.32–1.99). Female Gulf veterans also reported more miscarriages than their respective controls, although their excess was not statistically significant (OR= 1.35; CI = 0.97–1.89). Both men and women deployed to the Gulf theater reported significant excesses of birth defects among their liveborn infants. These excess rates also extended to the subset of “moderate to severe” birth defects [males: OR= 1.78 (CI = 1.19–2.66); females: OR = 2.80 (CI = 1.26–6.25)]. No statistically significant differences by deployment status were found among men or women for stillbirths, pre-term deliveries or infant mortality.

CONCLUSION: The risk of veterans reporting birth defects among their children was significantly associated with veteran's military service in the Gulf War. This observation needs to be confirmed by a review of medical records to rule out possible reporting bias.

Keywords: Gulf War, Birth Defects, Spontaneous Abortions