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

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

Research output: Contribution to journalArticle

19 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)792-800
Number of pages9
JournalJournal of women's health (2002)
Volume23
Issue number10
DOIs
StatePublished - Oct 1 2014
Externally publishedYes

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Afghanistan
Iraq
2003-2011 Iraq War
Gestational Diabetes
Veterans
Pregnancy
Afghan Campaign 2001-
Pregnancy Complications
Confidence Intervals
Inpatients
Incidence
International Classification of Diseases

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Gestational diabetes and hypertensive disorders of pregnancy among women veterans deployed in service of operations in Afghanistan and Iraq. / Katon, Jodie; Mattocks, Kristin; Zephyrin, Laurie; Reiber, Gayle; Yano, Elizabeth M.; Callegari, Lisa; Schwarz, Eleanor; Goulet, Joseph; Shaw, Jonathan; Brandt, Cynthia; Haskell, Sally.

In: Journal of women's health (2002), Vol. 23, No. 10, 01.10.2014, p. 792-800.

Research output: Contribution to journalArticle

Katon, J, Mattocks, K, Zephyrin, L, Reiber, G, Yano, EM, Callegari, L, Schwarz, E, Goulet, J, Shaw, J, Brandt, C & Haskell, S 2014, 'Gestational diabetes and hypertensive disorders of pregnancy among women veterans deployed in service of operations in Afghanistan and Iraq', Journal of women's health (2002), vol. 23, no. 10, pp. 792-800. https://doi.org/10.1089/jwh.2013.4681
Katon, Jodie ; Mattocks, Kristin ; Zephyrin, Laurie ; Reiber, Gayle ; Yano, Elizabeth M. ; Callegari, Lisa ; Schwarz, Eleanor ; Goulet, Joseph ; Shaw, Jonathan ; Brandt, Cynthia ; Haskell, Sally. / Gestational diabetes and hypertensive disorders of pregnancy among women veterans deployed in service of operations in Afghanistan and Iraq. In: Journal of women's health (2002). 2014 ; Vol. 23, No. 10. pp. 792-800.
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title = "Gestational diabetes and hypertensive disorders of pregnancy among women veterans deployed in service of operations in Afghanistan and Iraq",
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.",
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T1 - Gestational diabetes and hypertensive disorders of pregnancy among women veterans deployed in service of operations in Afghanistan and Iraq

AU - Katon, Jodie

AU - Mattocks, Kristin

AU - Zephyrin, Laurie

AU - Reiber, Gayle

AU - Yano, Elizabeth M.

AU - Callegari, Lisa

AU - Schwarz, Eleanor

AU - Goulet, Joseph

AU - Shaw, Jonathan

AU - Brandt, Cynthia

AU - Haskell, Sally

PY - 2014/10/1

Y1 - 2014/10/1

N2 - 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.

AB - 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.

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