Deployment and Preterm Birth Among US Army Soldiers

Area of Science:

• Military medicine
• Reproductive health
• Perinatal epidemiology

Background:

• Increasing integration of women into combat roles necessitates understanding deployment's impact on reproductive outcomes.
• Limited research exists on deployment-related risks for preterm birth in servicewomen, particularly recent cohorts.

Purpose of the Study:

• To investigate the association between military deployment and spontaneous preterm birth (SPB) in US Army soldiers.
• To examine the impact of prior deployment, recency of deployment, and posttraumatic stress disorder on SPB risk.

Main Methods:

• Utilized linked medical and administrative data from the Stanford Military Data Repository (2011-2014).
• Analyzed data for US Army soldiers with deliveries, adjusting for sociodemographic, military-service, and health factors.
• Employed multivariable discrete-time logistic regression models to estimate associations.

Main Results:

• Of 12,877 deliveries, 6.1% resulted in SPB.
• Deliveries within 6 months of return from deployment showed a doubled SPB prevalence (11.7%).
• Delivering within 6 months of deployment was strongly associated with SPB (aOR=2.1, 95% CI: 1.5, 2.9); PTSD and multiple deployments were not significant factors.

Conclusions:

• Timing of pregnancy relative to military deployment is a novel risk factor for spontaneous preterm birth.
• Servicewomen delivering shortly after deployment face a significantly elevated SPB risk.
• Enhanced focus on predeployment reproductive counseling and contraception access for servicewomen is crucial.