Study Examines Pregnancy and Mental Health Conditions among Female OEF/OIF Veterans Using VA Healthcare
CITATION:
Mattocks K, Skanderson M, Goulet J, Brandt C, et al. Pregnancy and Mental Health among Women Veterans Returning from Iraq and Afghanistan. Journal of Women’s Health December 2010;19(12):2159-2166.
BACKGROUND:
Like men, many women returning from military service may experience mental health problems, but the juxtaposition of pregnancy and mental health-related issues is of special concern because pregnancy itself can precipitate or exacerbate mental health conditions. Understanding care use patterns and health outcomes among pregnant Veterans is challenging, as women traditionally have not used the VA healthcare system. However, studies currently underway suggest that OEF/OIF women Veterans are among the fastest growing segments of new VA healthcare users, with as many as 44% electing to use VA healthcare. This study sought to determine the prevalence of mental health problems among 43,078 OEF/OIF women Veterans who received a pregnancy diagnosis in the VA healthcare system over a five-year study period (2003-2008). Using VA data, investigators assessed mental healthcare use for several conditions (e.g., depression, bipolar disorder, PTSD, schizophrenia, anxiety disorder, substance abuse), as well as pre-natal care.
FINDINGS:
- Although a relatively small proportion of OEF/OIF women Veterans received VA healthcare related to pregnancy (7%), a substantial proportion of these women (32%) received one or more mental health diagnoses compared with 21% of women without a pregnancy-related condition.
- Compared with all women Veterans enrolled in VA healthcare, Veterans with a pregnancy were twice as likely to have a diagnosis of depression, anxiety, PTSD, bipolar disorder, or schizophrenia than those without a pregnancy.
- The most common mental health diagnoses among Veterans with a pregnancy were anxiety (43%), depression (36%), and PTSD (21%), followed by bipolar disorder (3%), and alcohol abuse/dependence (3%). [Sum is greater than 100% due to comorbidity.]
- Veterans with a pregnancy were significantly more likely to have a service-connected disability than those without a pregnancy.
- 71% of Veterans with a pregnancy were either never married or no longer married.
- On average, women Veterans experienced their index pregnancy nearly two years after returning from their last deployment.
LIMITATIONS:
- A substantial proportion of Veterans in this study received pre-natal care outside the VA healthcare system, and there were no data on women who did not access VA healthcare.
- This study relied on VA administrative data, so findings may be subject to misclassification due to incomplete data.
AUTHOR/FUNDING INFORMATION:
This study was funded by HSR&D (DHI 07-065). Drs. Goulet and Brandt are part of HSR&D’s Pain Research, Informatics, Medical Comorbidities, and Education Center in West Haven, CT.
Mattocks K, Skanderson M, Goulet J, Brandt C, et al. Pregnancy and Mental Health among Women Veterans Returning from Iraq and Afghanistan. Journal of Women’s Health December 2010;19(12):2159-2166.