Research projects continue on Gulf War veterans reproductive health

The federal government is continuing to fund medical research studies on the reproductive health of Gulf War veterans. The chief goal of these studies is to determine if Gulf War military service has resulted in increased birth defects among children conceived by veterans after their Gulf War service.

Five projects on reproductive health currently underway are part of the *total program of 91 medical research studies* that have been initiated by federal agencies in an effort to look at the patterns and causes of Gulf War illnesses. Two studies on this subject have been completed.

The first federally-financed research study on reproductive health—published in 1996 and designated HHS-4—looked at two Mississippi National Guard units that had been the subject of considerable public attention because of birth defect reports. The medical records on all 55 post-war births to those veterans were reviewed for birth defects and other health problems. Five of the children had birth defects, each one of a different kind.

This study concluded: "The rate of birth defects of all types in children born to this group of veterans is similar to that expected in the general population. Perhaps the most significant finding is that a variety of birth defects was observed and clustering of any one type or affected system did not occur." In addition, the frequencies of premature birth and low birth weight were similar to those of the general population.

The *second study*, published June 5, 1997, and designated DOD-1C, was much more comprehensive. It studied almost 34,000 births in military hospitals to Gulf War veterans and compared them to 41,000 births in the same time frame to military personnel not assigned to the Gulf.

Some 7.45 percent of the Gulf War vets had children with birth defects, while 7.59 percent of the children born to non-Gulf War veterans had birth defects. The study concluded: "This report provides substantial evidence that the children of Gulf War veterans do not have an increased risk of birth defects."

However, this research project had some limitations, including: coverage of only live births and not stillbirths or miscarriages; military records on births exclude defects diagnosed weeks or months after birth; the research was done in military hospitals, so excludes Reservists and others discharged from active-duty soon after the war. At this time, there are another five federally-funded studies on reproductive health among Gulf War veterans underway.

The third study (DOD-1D) being conducted is comparing rates of infertility and miscarriage in Gulf War veterans and non-deployed veterans, covering one of the gaps in the second study, which only examined live births. This study is based on questionnaires sent to 16,000 couples, half of which have at least one partner with Gulf War service and half of which do not. Due for completion in 1998, the study will include telephone interviews with 5,000 of these couples.

The fourth study (DOD-1G) is looking at births in seven states: Arizona; Arkansas; California; Georgia; Hawaii; Iowa; and Oklahoma. These states keep records on congenital anomalies, discovered not only at birth, but through the first 12 months of life, thus addressing another limitation in the second study. Also scheduled for completion in 1998, this study will be looking at Gulf War vets, non-deployed veterans, and the general population. It will investigate birth defects for those three groups both before and after the Gulf War, thus closing other gaps in the second study.

The fifth study (DOD-35) will determine whether the names of veterans who served in the Gulf War can be linked to the California birth defect registry and other vital statistics data. The names of all 700, 000 Gulf War veterans will be matched with the computerized list, which the state of California maintains for admissions to all hospitals in the state.

In this way, the live born children of both active-duty and reserve personnel can be identified. It is due for completion in 1998.

The sixth study (DOD-44) focuses on vaginal burning syndrome and is designed to determine if there is any linkage to service in the Gulf War. This study began only recently and is not due to be finished until 1999.

The seventh study (VA-47) focuses upon mustard gas and its possible impact on reproductive health. It will be looking not only at Gulf War veterans, but also at personnel who have been stationed at Bluegrass Army Depot, a mustard storage site for many decades. These two populations will be interviewed about reproductive difficulties and developmental problems in their children. Completion date for this study is much farther away, not until 2000.

In addition, two other studies not formally classified as reproductive health involve research on reproductive issues.

One of those (VA-2) involves a survey of 30,000 veterans, evenly divided between those with and without Gulf War service. It is a comprehensive study of broad health problems, including birth problems such as birth defects and low birth weight. Medical information from the interviews will be verified by review of medical records for 4,000 of these individuals. The final phase of the study will include physical examinations of 4,000 veterans and their family members. It is also due for completion in 1998.

The other study (DOD-30), which has just begun, looks exclusively at women in the military and aims to determine if there are any medical differences between those who served in the Gulf War and those who did not. Almost 50,000 women served in the Gulf War. A major focus of this study will be on the reproductive experience of the two groups. It is due for completion in 1999.

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