https://aub.ie/MilitaryREACH-Lutgendorf2021

Lutgendorf, M. A., Abramovitz, L. M., Bukowinski, A. T., Gumbs, G. R., Conlin, A. M. S., & Hall, C. (2022). Pregnancy and posttraumatic stress disorder: Associations with infant outcomes and prenatal care utilization. The Journal of Maternal-Fetal & Neonatal Medicine, 35(25), 9053-9060. https://doi.org/10.1080/14767058.2021.2013796

This study examined if posttraumatic stress disorder (PTSD) influenced prenatal care utilization or negative infant outcomes (i.e., preterm birth, small size for gestational age, major birth defects) among 103,221 active-duty Servicewomen giving birth to one child. Servicewomen diagnosed with PTSD were compared to those without. Several maternal factors (e.g., maternal age at birth, medications, presence of other mental health disorders) and military factors (e.g., rank, number of deployments) were also considered. In both the PTSD and non-PTSD groups, Servicewomen were highly likely to seek prenatal care in their first trimester. Additionally, no differences between groups on infant outcomes were identified, indicating that PTSD diagnosis was not a risk factor for negative infant outcomes.

https://doi.org/10.1080/14767058.2021.2013796

Children
Mental health
Physical health

Army
Navy
Air Force
Marine Corps
Coast Guard
Multiple branches

Active Duty

Active duty service member

Adolescence (13 - 17 yrs)
Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)

Quantitative Study
Longitudinal Study

Lutgendorf, Monica A., Abramovitz, Lisa M., Bukowinski, Anna T., Gumbs, Gia R., Conlin, Ava Marie S., Hall, Clinton

Background Posttraumatic stress disorder (PTSD) affects 3.6–9.7% of women, and has been associated with adverse outcomes in pregnancy; however, associations with prenatal care (PNC) utilization are not clear.Objective To evaluate associations of PTSD in pregnancy with PNC utilization and adverse infant outcomes in an active-duty military population (a population with universal health insurance).Methods This was a retrospective cohort study of pregnant active-duty service members in Department of Defense Birth and Infant Health Research program data from 2007 to 2014. Administrative medical encounter data were used to define PTSD cases and outcomes of interest. Descriptive statistics and multivariable log-binomial regression compared PNC utilization and adverse infant outcomes (preterm birth, small for gestational age [SGA], major birth defects) among service members with current PTSD (defined as PTSD in the year prior to pregnancy or during pregnancy) to those without current PTSD.Results Of the 103,221 singleton live births identified, 1657 (1.6%) were born to active-duty service members diagnosed with current PTSD. Service members with PTSD were more likely to initiate PNC in the first trimester (93.5% vs. 90.2%) and score adequate plus on the Adequacy of Prenatal Care Utilization Index (63.2% vs. 40.0%) compared to service members without PTSD. PTSD case status was not associated with preterm birth, SGA, or major birth defects, regardless of the adjustment set used (fully adjusted RR 0.96, 95% CI 0.82–1.13; RR 1.08, 95% CI 0.79–1.48; and RR 1.03, 95% CI 0.79–1.34, respectively).Conclusion For pregnant service members with current PTSD, no associations with adverse infant outcomes were noted, and these patients initiated care earlier and had higher PNC utilization scores compared to pregnant service members without current PTSD. Universal health care coverage and utilization of PNC in this population may mitigate adverse pregnancy outcomes observed in civilian populations of patients with PTSD.

Taylor & Francis

Article
REACH Publication

Department of Gynecologic Surgery & Obstetrics, Naval Medical Center San Diego, MAL
Leidos, Inc, LMA
Leidos, Inc, ATB
Leidos, Inc, GRG
Leidos, Inc, CH
Deployment Health Research Department, Naval Health Research Center, LMA
Deployment Health Research Department, Naval Health Research Center, ATB
Deployment Health Research Department, Naval Health Research Center,GRG
Deployment Health Research Department, Naval Health Research Center,AMSC
Deployment Health Research Department, Naval Health Research Center, CH