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Obstetric Outcomes in U.S. Veterans: Emerging Knowledge, Considerations, and Gaps
Michele Hugin1,2, Jonathan G Shaw3,4
1Division of Gynecology, Department of Surgery, VA Palo Alto Health Care System, Palo Alto, California.
Seminars in Reproductive Medicine
|June 12, 2019
Summary
Pregnant women Veterans face higher risks for adverse birth outcomes, including preterm birth and preeclampsia. Their infants also show increased NICU admission rates, highlighting the need for specialized care coordination.
Area of Science:
- Reproductive Health
- Military Medicine
- Perinatal Outcomes
Background:
- Increased number of women serving in the military post-9/11.
- Growing population of reproductive-aged women Veterans exiting service.
- High burden of physical and mental health conditions, including trauma, among women Veterans.
Purpose of the Study:
- Review existing research on pregnancy and obstetric outcomes in women Veterans.
- Highlight unique perinatal concerns due to prevalent mental health conditions.
- Inform current research and programmatic efforts within the Department of Veterans Affairs (VA).
Main Methods:
- Review of limited but growing body of research.
- Analysis of contemporary large-scale birth data (California).
- Comparison of outcomes between Veterans utilizing VA healthcare and non-Veterans.
Main Results:
- Pregnant Veterans exhibit increased risk for preterm birth, preeclampsia, and gestational diabetes.
- Veterans using VA healthcare showed higher rates of preeclampsia and Cesarean delivery.
- Infants born to Veterans had a greater likelihood of requiring Neonatal Intensive Care Unit (NICU) care.
Conclusions:
- Unique health profiles of pregnant Veterans, including PTSD, are linked to adverse perinatal outcomes.
- Coordination of VA and non-VA care for Veteran mothers is crucial.
- Further research is needed to address upstream factors contributing to poorer outcomes.
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