title: Spousal Military Deployment During Pregnancy and Adverse Birth Outcomes.
abstract: Pregnant women with a military-deployed spouse have increased risk of depression and self-reported stress. In nonmilitary populations, depression and stress during pregnancy are associated with adverse birth outcomes. This study assesses the association between a spouse's military deployment and adverse birth outcomes. We conducted a retrospective cohort study at a large military medicine center in the Northwest and evaluated records of singleton deliveries to dependent Army spouses from September 2001 to September 2011. We used logistic regression to estimate relative risks and 95% confidence intervals (CI) of the associations between deployment and low birth weight (<2,500 g), preterm delivery (<37 weeks), small for gestational age (SGA, <10 percentile for gestational age), and cesarean delivery. We identified 10,536 births; 1,364 (12.9%) spouses were deployed at delivery. No associations were observed in the overall population. Among women with two or more children, we observed an 81% increased risk of SGA (95% CI 1.18-2.79). Women 30 to 34 years old had an 82% (95% CI 1.06-3.14) increased risk of low birth weight and an 84% increased risk of SGA (95% CI 1.13-2.98). Deployment's effects vary by maternal age and the number of children in the household. These findings may inform programs and practitioners to best serve women with military-deployed spouses.
authors.affiliation: Wyoming Department of Health, 1600 Yellowstone Road, Suite 420, Cheyenne, WY 82001.
authors.forename: Amy
authors.initials: A
authors.lastname: Spieker
authors.affiliation: Harborview Injury Prevention and Research Center, 401 Broadway, 4th Floor, Seattle, WA 98104.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Schiff
authors.affiliation: University of Washington, Leadership Education in Neurodevelopmental and Related Disabilities Program, P. O. Box 357920, Seattle, WA 98195.
authors.forename: Beth E
authors.initials: BE
authors.lastname: Davis
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008016:Life Change Events; D016015:Logistic Models; D066067:Military Family / Q000706:statistics & numerical data; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth; D012189:Retrospective Studies; D012307:Risk Factors; D018454:Spouses; D055815:Young Adult