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

Abstract

Anecdotal reports by veterans of the Persian Gulf War of 1990 have included concern over negative reproductive outcomes, including spontaneous abortions and birth defects. Two previous birth records studies failed to findevidence of an increased risk of defects, but a large population-based study of Gulf War veterans in the United Kingdom did suggest more miscarriages than in a control population. The present health survey examined reproductive outcomes in 15,000 Gulf War veterans and a comparable number of non-Gulf War veterans. The final study group, representing a 70% rate of response to a 16-page health survey, included 11,44] Gulf War veterans and 9476 control subjects. Nearly 30% of survey participants (6043) had index pregnancies. Male Gulf veterans reported more miscarriages and stillbirths than male non-Gulf War veterans, but the difference was statistically significant only for miscarriages. Female Gulf War veterans reported the same effects, but neither was significant. Live-born infants of male Gulf War veterans reportedly had likely birth defects nearly twice as often as control infants (adjusted odds ratio [OR], 1.94; 95% confidence interval [CI], 1.37-2.74), Female Gulf War veterans were nearly 3-fold likelier than control subjects to have a child with a likely birth defect (adjusted OR, 2.97; 95% CI, 1.47-5.99). Adjusted ORs for moderate to severe birth defects were 1.78 for males and 2.80 for females. A small excess of chromosomal defects was reported by Gulf War veterans. This large-scale population-based survey suggests that both male and female Gulf War veterans report significantly higher rates of birth defects in their live-born infants than do military control subjects. In addition, male Gulf War veterans reported significantly more miscarriages.