|
| |
Prevalence
of birth defects among infants of Gulf War veterans in Arkansas, Arizona,
California, Georgia, Hawaii, and Iowa
|
, 1989-1993  § |
|
Maria Rosario G. Araneta
1 *, Karen M. Schlangen 1,
Larry D. Edmonds 2, Daniel
A. Destiche 1, Ruth D.
Merz 3, Charlotte A. Hobbs
4, Timothy J. Flood 5,
John A. Harris 6, Diane
Krishnamurti 7, Gregory C.
Gray 1 |
|
1Department
of Defense Center for Deployment Health Research, Naval Health Research,
Center, San Diego, California
2Birth Defects and
Pediatric Genetics Branch, Centers for Disease Control and Prevention,
Atlanta, Georgia
3Hawaii Birth Defects
Program, Honolulu, Hawaii
4Arkansas Reproductive
Health Monitoring System, Little Rock, Arkansas
5Arizona Birth Defects
Monitoring Program, Phoenix, Arizona
6California Birth Defects
Monitoring Program, Emeryville, California
7Iowa Birth Defects
Registry, Iowa City, Iowa |
|
email: Maria Rosario G. Araneta (haraneta@ucsd.edu) |
*Correspondence to Maria
Rosario G. Araneta, University of California San Diego, Department of Family and
Preventive Medicine, 9500 Gilman Drive, 0607 Stein Clinical Research Building,
Rm.349, La Jolla, CA 92093-0607
This
article was prepared by a group consisting of both United States government
employees and non-United States government employees, and as such is subject to
17 U.S.C. Sec. 105.
This
article is a US government work and, as such, is in the public domain in the
United States of America.
§This study was conducted in accordance with the Department of the
Navy's Protection of Human Subjects guidelines. This represents report no. 01-25
supported by the Bureau of Medicine and Surgery Navy Medical Research, under DoD/HA
reimbursable-6423. The views expressed in this article are those of the authors
and do not reflect the official policy or position of the Department of the
Navy, the Department of Defense, or the U.S. Government. Approved for public
release; distribution unlimited.
|
aortic valve stenosis • birth defects • Gulf War
veterans • hypospadias • Persian Gulf War • renal agenesis or hypoplasia •
tricuspid valve insufficiency • tricuspid valve regurgitation |
|
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. Birth Defects Research (Part A)
67:246-260, 2003. Published 2003 Wiley-Liss, Inc. |
|
Good
Gov,