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Gulf War and Health: Volume 8: Update of Health Effects of Serving in the Gulf War (2010)

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. "4 HEALTH OUTCOMES." Gulf War and Health: Volume 8: Update of Health Effects of Serving in the Gulf War. Washington, DC: The National Academies Press, 2010.

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Gulf War and Health, Volume 8: Update of Health Effects of Serving in the Gulf War

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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