Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Oct;23(10):792-800.
doi: 10.1089/jwh.2013.4681. Epub 2014 Aug 4.

Gestational diabetes and hypertensive disorders of pregnancy among women veterans deployed in service of operations in Afghanistan and Iraq

Jodie Katon  1 , Kristin Mattocks, Laurie Zephyrin, Gayle Reiber, Elizabeth M Yano, Lisa Callegari, Eleanor Bimla Schwarz, Joseph Goulet, Jonathan Shaw, Cynthia Brandt, Sally Haskell
Affiliations

Gestational diabetes and hypertensive disorders of pregnancy among women veterans deployed in service of operations in Afghanistan and Iraq

Jodie Katon et al. J Womens Health (Larchmt). 2014 Oct.

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 Disclaimer

Figures

<b>Fig. 1.</b>
Fig. 1.
Kaplan-Meier curves for use of VA services following delivery by presence of GDM and hypertensive disorders of pregnancy. GDM, gestational diabetes.
See this image and copyright information in PMC

Comment in

References

    1. Mattocks KM, Skanderson M, Goulet JL, et al. . Pregnancy and mental health among women veterans returning from Iraq and Afghanistan. J Womens Health (Larchmt) 2010;19:2159–2166 - PMC - PubMed
    1. Maguen S, Ren L, Bosch JO, Marmar CR, Seal KH. Gender differences in mental health diagnoses among Iraq and Afghanistan veterans enrolled in veterans affairs health care. Am J Public Health. 2010;100:2450–2456 - PMC - PubMed
    1. VA health care for women: Progress made in providing services to women veterans. Pub. No. GAO/HEHS-99-38. Washington, DC: U.S. General Accounting Office, 1999
    1. Veterans Health Administration. VHA handbook 1330.01: Health care services for women. Washington, DC: Department of Veterans Affairs, 2010
    1. Yano EM, Washington DL, Goldzweig C, Caffrey C, Turner C. The organization and delivery of women's health care in Department of Veterans Affairs Medical Center. Womens Health Issues 2003;13:55–61 - PubMed

Publication types

MeSH terms