TY - JOUR
T1 - Prevalence of birth defects among infants of Gulf War veterans in Arkansas, Arizona, California, Georgia, Hawaii, and Iowa, 1989-1993
AU - Araneta, Maria Rosario G.
AU - Schlangen, Karen M.
AU - Edmonds, Larry D.
AU - Destiche, Daniel A.
AU - Merz, Ruth D.
AU - Hobbs, Charlotte A.
AU - Flood, Timothy J.
AU - Harris, John A.
AU - Krishnamurti, Diane
AU - Gray, Gregory C.
PY - 2003/4/1
Y1 - 2003/4/1
N2 - BACKGROUND: Epidemiologic studies of birth defects among infants of Gulf War veterans (GWV) have been limited to military hospitals, anomalies diagnosed among newborns, or self-reported data. This study was conducted to measure the prevalence of birth defects among infants of GWVs and nondeployed veterans (NDV) in states that conducted active case ascertainment of birth defects between 1989-93. METHODS: Military records of 684,645 GWVs and 1,587,102 NDVs were electronically linked with 2,314,908 birth certificates from Arizona, Hawaii, Iowa, and selected counties of Arkansas, California, and Georgia; 11,961 GWV infants and 33,052 NDV infants were identified. Of these, 450 infants had mothers who served in the Gulf War, and 3966 had NDV mothers. RESULTS: Infants conceived postwar to male GWVs had significantly higher prevalence of tricuspid valve insufficiency (relative risk [RR], 2.7; 95% confidence interval [CI], 1.1-6.6; p = 0.039) and aortic valve stenosis (RR, 6.0; 95% CI, 1.2-31.0; p = 0.026) compared to infants conceived postwar to NDV males. Among infants of male GWVs, aortic valve stenosis (RR, 16.3; 95% CI, 0.09-294; p = 0.011) and renal agenesis or hypoplasia (RR, 16.3; 95% CI, 0.09-294; p = 0.011) were significantly higher among infants conceived postwar than prewar. Hypospadias was significantly higher among infant sons conceived postwar to GWV women compared to NDV women (RR, 6.3; 95% CI, 1.5-26.3; p = 0.015). CONCLUSION: We observed a higher prevalence of tricuspid valve insufficiency, aortic valve stenosis, and renal agenesis or hypoplasia among infants conceived postwar to GWV men, and a higher prevalence of hypospadias among infants conceived postwar to female GWVs. We did not have the ability to determine if the excess was caused by inherited or environmental factors, or was due to chance because of myriad reasons, including multiple comparisons. Although the statistical power was sufficient to compare the combined birth defects prevalence, larger sample sizes were needed for less frequent individual component defects.
AB - BACKGROUND: Epidemiologic studies of birth defects among infants of Gulf War veterans (GWV) have been limited to military hospitals, anomalies diagnosed among newborns, or self-reported data. This study was conducted to measure the prevalence of birth defects among infants of GWVs and nondeployed veterans (NDV) in states that conducted active case ascertainment of birth defects between 1989-93. METHODS: Military records of 684,645 GWVs and 1,587,102 NDVs were electronically linked with 2,314,908 birth certificates from Arizona, Hawaii, Iowa, and selected counties of Arkansas, California, and Georgia; 11,961 GWV infants and 33,052 NDV infants were identified. Of these, 450 infants had mothers who served in the Gulf War, and 3966 had NDV mothers. RESULTS: Infants conceived postwar to male GWVs had significantly higher prevalence of tricuspid valve insufficiency (relative risk [RR], 2.7; 95% confidence interval [CI], 1.1-6.6; p = 0.039) and aortic valve stenosis (RR, 6.0; 95% CI, 1.2-31.0; p = 0.026) compared to infants conceived postwar to NDV males. Among infants of male GWVs, aortic valve stenosis (RR, 16.3; 95% CI, 0.09-294; p = 0.011) and renal agenesis or hypoplasia (RR, 16.3; 95% CI, 0.09-294; p = 0.011) were significantly higher among infants conceived postwar than prewar. Hypospadias was significantly higher among infant sons conceived postwar to GWV women compared to NDV women (RR, 6.3; 95% CI, 1.5-26.3; p = 0.015). CONCLUSION: We observed a higher prevalence of tricuspid valve insufficiency, aortic valve stenosis, and renal agenesis or hypoplasia among infants conceived postwar to GWV men, and a higher prevalence of hypospadias among infants conceived postwar to female GWVs. We did not have the ability to determine if the excess was caused by inherited or environmental factors, or was due to chance because of myriad reasons, including multiple comparisons. Although the statistical power was sufficient to compare the combined birth defects prevalence, larger sample sizes were needed for less frequent individual component defects.
KW - Aortic valve stenosis
KW - Birth defects
KW - Gulf War veterans
KW - Hypospadias
KW - Persian Gulf War
KW - Renal agenesis or hypoplasia
KW - Tricuspid valve insufficiency
KW - Tricuspid valve regurgitation
UR - http://www.scopus.com/inward/record.url?scp=10744221448&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=10744221448&partnerID=8YFLogxK
U2 - 10.1002/bdra.10033
DO - 10.1002/bdra.10033
M3 - Article
C2 - 12854660
AN - SCOPUS:10744221448
SN - 1542-0752
VL - 67
SP - 246
EP - 260
JO - Birth Defects Research Part A - Clinical and Molecular Teratology
JF - Birth Defects Research Part A - Clinical and Molecular Teratology
IS - 4
ER -