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Gestational Diabetes and Hypertensive Disorders of Pregnancy Among Women Veterans Deployed in Service of Operations in Afghanistan and Iraq
Quantitative Health Sciences Publications and Presentations
  • Jodie Katon, University of Washington - Seattle Campus
  • Kristin M. Mattocks, University of Massachusetts Medical School
  • Laurie Zephyrin, Department of Veterans Affairs
  • Gayle E. Reiber, University of Washington
  • Elizabeth M. Yano, University of California - Los Angeles
  • Lisa Callegari, University of Washington
  • Eleanor Bimla Schwarz, University of Pittsburgh - Main Campus
  • Joseph L. Goulet, Yale University
  • Jonathan Shaw, Stanford University
  • Cynthia A. Brandt, Yale University
  • Sally G. Haskell, Yale University
UMMS Affiliation
Department of Quantitative Health Sciences
Publication Date
8-4-2014
Document Type
Article
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.
PubMed ID
25090022
Comments

Citation: Katon J, Mattocks K, Zephyrin L, Reiber G, Yano EM, Callegari L, Schwarz EB, Goulet J, Shaw J, Brandt C, Haskell S. Gestational Diabetes and Hypertensive Disorders of Pregnancy Among Women Veterans Deployed in Service of Operations in Afghanistan and Iraq. J Womens Health (Larchmt). 2014 Aug 4. DOI: 10.1089/jwh.2013.4681

Related Resources
Link to article in PubMed
Citation Information
Jodie Katon, Kristin M. Mattocks, Laurie Zephyrin, Gayle E. Reiber, et al.. "Gestational Diabetes and Hypertensive Disorders of Pregnancy Among Women Veterans Deployed in Service of Operations in Afghanistan and Iraq" (2014) ISSN: 1931-843X
Available at: http://works.bepress.com/kristin_mattocks/39/