Characteristics of Pregnant Veterans: A Descriptive Retrospective Medical Record Study

INTRODUCTION: To optimize reproductive outcomes for pregnant Veterans, more information is needed about their unique risk profile. The purpose of this study was to describe rates of (1) mental health diagnoses, (2) military-related trauma, (3) lifestyle behaviors, and (4) pregnancy risks among Pregnant Veterans (PVs); and to test whether these risks were associated with adverse pregnancy outcomes. MATERIALS AND METHODS: A retrospective review of electronic medical records was conducted for all PVs who used Veterans Administration (VA) maternity care benefits at a large, urban VA medical center between January 1, 2018 and January 1, 2020 (n = 519). Data were extracted, coded, and analyzed based on national guidelines for adverse risk and maternal/fetal outcomes. Rates of pregnancy risk factors among civilians were extracted from published literature. RESULTS: Pregnant Veterans with complete data on study variables (n = 281) had a mean age of 31.9 (SD = 5.02) and were from diverse racial and ethnic groups (45% African American, 15% Latinex). Pregnant Veterans compared to the general population, were more likely to be unemployed (17% vs. 5%) and homeless (2% vs. <1%), and to have higher rates of mental health (MH) diagnoses (77% vs. 16%). Pregnant Veterans also had higher rates than civilians for miscarriage (18% vs. 10%) and preterm births (13% vs. 10%), but military sexual trauma (MST), combat exposure, unemployment, mental health, pre-pregnancy tobacco use, and pre-pregnancy substance use were not predictors of adverse outcomes among PVs. CONCLUSIONS: Pregnant Veterans experience adverse pregnancy outcomes and pregnancy risks at higher rates than the general population. Maternal morbidity and mortality are indicators of healthcare quality for women. The VA should address pregnancy disparities if they are to remain a national healthcare leader.