The Effect of Spousal Military Deployment during Pregnancy on Birth Outcomes: A Systematic Review

Abstract

Abstract Background Stress experienced during pregnancy is associated with adverse birth outcomes including pre-term delivery and low birth weight. Pregnant spouses and partners of deployed military personnel can experience heightened stress due to several factors associated with the military lifestyle which may increase the risk of pre-term delivery and low birth weight. This systematic review aims to establish the potential effect of spousal deployment on birth outcomes in a population who have increased psychosocial risks for birth complications. Methods A systematic review following the PRISMA guidelines was conducted of English language literature to assess the effect of deployment on the birth outcomes (pre-term delivery <37 weeks; low birth weight < 2500g) of babies born to partners of serving military personnel who were deployed at the time of delivery. Comparison was made to pregnant women whose military partners were not deployed at the time of delivery. EMBASE, Medline, Global Health, Web of Science and PubMed databases were searched for relevant articles using a keyword Boolean search strategy. A quality review and risk of bias was conducted on each of the three included studies. Results Three cohort or cross-sectional studies fulfilled the eligibility criteria. Each study was conducted in the US military, involved a total of 11,028 participants and were published between 2005 and 2016. Evidence suggests that spousal deployment may be a risk factor for pre-term delivery. No association between spousal deployment and low birth weight was found. Conclusions Pregnant partners or spouses of deployed military personnel may be at increased risk of pre-term delivery. There is a paucity of rigorous research in this area and more research is required to help inform healthcare professionals of the needs of this cohort of women and whether tailored public health interventions are required to reduce the risk of adverse birth outcomes in this population. Key messages Pregnant partners or spouses of deployed military personnel may be at increased risk of pre-term delivery due to psychosocial factors associated with the military lifestyle. Stress is a risk factor for birth complications. More research involving military spouses is required to understand the antenatal needs of this population.