title: Factors adversely affecting pregnancy outcome in the military.
abstract: This prospective study was undertaken to identify the significant risk factors associated with adverse pregnancy outcome in active-duty women. The deliveries of 300 consecutive pregnancies of active-duty women were assessed for maternal-fetal outcome. The risk factors evaluated were: marital status, parity, race, smoking and alcohol consumption while pregnant, maternal weight gain during pregnancy, maternal height, and educational level. Two-thirds of these women were junior enlisted personnel (rank E-4 or below) and worked under demanding job conditions over which they had little control. Increased age as a risk factor was associated with a significant increase in pregnancy-associated complications of cesarean birth, operative vaginal delivery, pregnancy-induced hypertension, preterm labor, maternal transport for fetal indications, intrauterine growth restriction, intrauterine fetal death, postpartum hemorrhage, placenta previa, and 5-minute Apgar scores < 7 (p = 0.039). In gravidas more than 65 inches in height with a weight gain more than 42 pounds, there was a significant increase in the complications of pregnancy (p = 0.022). Interactions of these risk factors yielded a significant age (p = 0.025), maternal height (p = 0.007), and height times weight gain interaction (p = 0.006) association with pregnancy complications. The risk factors of advancing maternal age and tall stature with a maternal weight gain of more than 42 pounds are associated with increased pregnancy complications of active-duty women.
authors.affiliation: Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216-4505, USA.
authors.forename: E F
authors.initials: EF
authors.lastname: Magann
authors.forename: M I
authors.initials: MI
authors.lastname: Winchester
authors.forename: D P
authors.initials: DP
authors.lastname: Carter
authors.forename: J N
authors.initials: JN
authors.lastname: Martin
authors.forename: J D
authors.initials: JD
authors.lastname: Bass
authors.forename: J C
authors.initials: JC
authors.lastname: Morrison
mesh_terms: D000328:Adult; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008423:Maternal Age; D008889:Military Personnel / Q000706:statistics & numerical data*; D009326:Naval Medicine; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D015430:Weight Gain