Study

Design

Population

Outcomes

Results

Adjustments

Comments

Doyle et al., 2004 (Update)

Retrospective cohort

All UK GWVs and randomly selected cohort of NDVs. responding to postal questionnaire; conceptions from postdeployment (for NDVs—conceived after 1/1/1991) through 11/8/1997 GWV fathers (n = 16,442) NDV fathers (n = 11,517) GWV mothers (n = 484) NDV mothers (n = 377)

Fetal death: early and late miscarriage, stillbirth; congenital malformations excluding minor abnormalities among live births; self-report with clinical confirmation attempted for fetal deaths and live births with reported abnormalities

Adjusted ORs: GWVs vs NDVs father: all miscarriages 2829/15,539 vs 1525/10,988 (OR 1.4, 95% CI 1.3-1.5); any congenital malformation, 686/13,191 vs 342/9758 (OR 1.5, 95% CI 1.3-1.7); other malformations of digestive system, 69/13,191 vs 31/9758 (OR 1.6, 95% CI 1.0-2.5); genital system, 45/13,191 vs 19/9758 (OR 1.8, 95% CI 1.0-3.0); urinary system, 103/13,191 vs 48/9758 (OR 1.6, 95% CI 1.1-2.3); musculoskeletal system, 194/13,191 vs 78/9758 (OR 1.8, 95% CI 1.4-2.4); other nonchromosomal malformations, 45/13,191 vs 19/9758 (OR 1.7, 95% CI 1.0-3.0); cranial neural crest, 184/13,191 vs 101/9758 (OR 1.3, 95% CI 1.0-1.7); metabolic and single gene defects, 22/13,191 vs 8/9758 (OR 2.0, 95% CI 0.9-4.8); mothers: no significant associations

Stratum matched on branch of service, sex, age, serving status, rank; ORs adjusted by year of pregnancy end, paternal/maternal pregnancy order, maternal age, service, rank, previous fetal death, multiplicity

Response rates: GWVs: men 53%, women 72%; NDVs: men 42%, women 60% Limitations: poor response rates among men and response rates lower in NDVs, low numbers of miscarriages in NDVs. compared with NIFS population could mean participation and reporting bias; multiple comparisons Strengths: medical confirmation for some cases; fetal deaths as well as live births; external comparison groups to evaluate possible biases

 

 

External comparison populations: (1) NIFS; (2) annual registered stillbirths in England and Wales, 1991-1998

 

 

Adverse pregnancy outcomes

Araneta et al., 2004 (Vol. 4)

Retrospective cohort

Deployed women admitted to military hospitals for pregnancy-related

Self-reported stillbirths, spontaneous abortions, ectopic

Adjusted RRs: mothers: GWV vs NDV postwar conceptions:

Age, race, education, marital status, branch of service, military rank, parity, history

Overall response rate: 50% Limitations: low response rate; no



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