The Impact of Military Sexual Trauma and Warfare Exposure on Women Veterans' Perinatal Outcomes

Objective: In the general population, history of trauma is associated with a range of adverse perinatal outcomes, which have long-term negative consequences for both mother and child. Research examining the impact of trauma, particularly trauma occurring during military service, on perinatal outcomes among women veterans is still in its nascence. The current study examined if warfare exposure and military sexual trauma (MST) contributed unique variance to the prediction of a broad range of adverse perinatal outcomes (i.e., preterm birth, full-term birth, infant birth weight, postpartum depression and/or anxiety). Method: Women veterans living across the U.S. (oversampled for veterans living in high crime communities) completed a mail-based survey, and reported information about all pregnancies that occurred since enlistment in the military. They also reported on warfare exposure and MST using the Deployment Risk and Resilience Inventory. Results: A total of 911 women reported on 1,752 unique pregnancies. Results revealed that MST, but not warfare exposure, was associated with having a lower infant birth weight (B = -17.30, SE = 5.41), a slight decrease in the likelihood of having a full-term birth (OR = .97, 95% CI [.93, 1.00]), and an increased likelihood of experiencing postpartum depression and/or anxiety (OR = 1.09, 95% CI [1.10, 1.14]) above and beyond age at pregnancy, racial/ethnic minority status, childhood violence exposure, and warfare exposure. Conclusions: Findings highlight the importance of screening for MST during pregnancy and trauma-informed obstetric care. Clinical Impact Statement This study found that military sexual trauma (MST), but not exposure to warfare, predicted negative perinatal outcomes among women veterans above and beyond known risk factors for adverse perinatal outcomes. Specifically, women who reported more MST were less likely to have a full-term birth infant, more likely to have a lower birth weight infant, and more likely to report experiencing postpartum depression and/or anxiety. Results suggest the importance of screening for MST during pregnancy. It also highlights the significance of trauma-informed obstetrics care.