Gestational diabetes and hypertensive disorders of pregnancy among women veterans deployed in service of operations in Afghanistan and Iraq
- PMID: 25090022
- PMCID: PMC4195229
- DOI: 10.1089/jwh.2013.4681
Gestational diabetes and hypertensive disorders of pregnancy among women veterans deployed in service of operations in Afghanistan and Iraq
Abstract
Objective: To determine the prevalence of gestational diabetes (GDM) and hypertensive disorders of pregnancy (HDP) among women Veterans using Department of Veterans Affairs (VA) maternity benefits previously deployed in service of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND), and whether pregnancy complications were associated with VA use following delivery.
Methods: We identified the study population through linkage with the Department of Defense roster and VA administrative and clinical data. GDM and HDP were identified by International Classification of Diseases, Ninth Revision codes in VA inpatient or outpatient files. Similarly, we constructed a nationally representative sample of deliveries from the Nationwide Inpatient Sample. We calculated standardized incidence ratios (SIR) adjusted for age and year of delivery to compare rates of GDM and HDP. Proportional hazards regression was used to determine whether pregnancy complications were associated with use of VA following delivery.
Results: Between 2001 and 2010, 2,288 women OEF/OIF/OND Veterans used VA maternity benefits; 5.2% had GDM and 9.6% had HDP. Compared with women delivering in the United States, women OEF/OIF/OND Veterans using VA maternity benefits had higher risk of developing GDM (SIR: 1.40; 95% confidence interval [CI] 1.16, 1.68) and HDP (SIR: 1.32; 95% CI 1.15, 1.51). Among women OEF/OIF/OND Veterans using VA maternity benefits, GDM (HR 1.01, 95% CI 0.83, 1.24) and HDP (HR 1.07, 95% CI 0.92, 1.25) were not associated with use of VA following delivery.
Conclusions: Non-VA providers should be aware of their patients' Veteran status and the associated elevated risk for pregnancy complications. Within VA, focused efforts to optimize Veterans' preconception and postpartum health are needed.
Figures
Comment in
-
Care coordination: an imperative for VA obstetric care.J Womens Health (Larchmt). 2014 Oct;23(10):783-4. doi: 10.1089/jwh.2014.1513. J Womens Health (Larchmt). 2014. PMID: 25321312 No abstract available.
Similar articles
-
Brief report: Comparison of methods to identify Iraq and Afghanistan war veterans using Department of Veterans Affairs administrative data.J Rehabil Res Dev. 2010;47(8):815-21. doi: 10.1682/jrrd.2009.08.0115. J Rehabil Res Dev. 2010. PMID: 21110254
-
Race/ethnicity and gender differences in mental health diagnoses among Iraq and Afghanistan veterans.Psychiatry Res. 2015 Oct 30;229(3):724-31. doi: 10.1016/j.psychres.2015.08.013. Epub 2015 Aug 10. Psychiatry Res. 2015. PMID: 26282226
-
Bringing the war back home: mental health disorders among 103,788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities.Arch Intern Med. 2007 Mar 12;167(5):476-82. doi: 10.1001/archinte.167.5.476. Arch Intern Med. 2007. PMID: 17353495
-
The prevalence of posttraumatic stress disorder in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans: a meta-analysis.J Anxiety Disord. 2015 Apr;31:98-107. doi: 10.1016/j.janxdis.2015.02.003. Epub 2015 Feb 19. J Anxiety Disord. 2015. PMID: 25768399 Review.
-
Access to VA services for returning veterans with PTSD.Mil Med. 2012 Jul;177(7):814-22. doi: 10.7205/milmed-d-12-00009. Mil Med. 2012. PMID: 22808888 Review.
Cited by
-
Improving the Maternity Care Safety Net: Establishing Maternal Mortality Surveillance for Non-Obstetric Providers and Institutions.Int J Environ Res Public Health. 2023 Dec 27;21(1):37. doi: 10.3390/ijerph21010037. Int J Environ Res Public Health. 2023. PMID: 38248502 Free PMC article.
-
Development of the Ready to Care Survey for VA Women's Health Primary Care Provider.J Gen Intern Med. 2024 May;39(6):1010-1014. doi: 10.1007/s11606-023-08467-y. Epub 2023 Nov 9. J Gen Intern Med. 2024. PMID: 37946022
-
The impact of military sexual trauma and warfare exposure on women veterans' perinatal outcomes.Psychol Trauma. 2022 Jul;14(5):730-737. doi: 10.1037/tra0001095. Epub 2021 Aug 19. Psychol Trauma. 2022. PMID: 34410813 Free PMC article.
-
Veteran-Reported Receipt of Prepregnancy Care: Data from the Examining Contraceptive Use and Unmet Need (ECUUN) Study.Matern Child Health J. 2021 Aug;25(8):1254-1264. doi: 10.1007/s10995-021-03131-5. Epub 2021 Apr 30. Matern Child Health J. 2021. PMID: 33929654 Free PMC article.
-
The Impact of Posttraumatic Stress Disorder and Moral Injury on Women Veterans' Perinatal Outcomes Following Separation From Military Service.J Trauma Stress. 2020 Jun;33(3):248-256. doi: 10.1002/jts.22509. Epub 2020 Apr 15. J Trauma Stress. 2020. PMID: 32291816 Free PMC article.
References
-
- VA health care for women: Progress made in providing services to women veterans. Pub. No. GAO/HEHS-99-38. Washington, DC: U.S. General Accounting Office, 1999
-
- Veterans Health Administration. VHA handbook 1330.01: Health care services for women. Washington, DC: Department of Veterans Affairs, 2010
-
- Yano EM, Washington DL, Goldzweig C, Caffrey C, Turner C. The organization and delivery of women's health care in Department of Veterans Affairs Medical Center. Womens Health Issues 2003;13:55–61 - PubMed
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
