5.12
Reproductive health
Information about fertility difficulties and pregnancies fathered was collected by
questionnaire at the time of the baseline study for the period commencing 1 January 1992,
and at follow up for the period commencing 1 January 2000. These two data sources were
pooled so as to collate reproductive health information for the complete period from 1992 to
the time of the follow up study.
5.12.1
Fertility difficulties since 1992
Table 1 shows that a significantly higher proportion of Gulf War veterans than comparison
group participants (13% versus 8% respectively) reported difficulty fathering a pregnancy
since January 1992, despite trying for at least 12 months. Of those, Gulf War veterans were
also significantly less likely than the comparison group participants to report having a cause
for their infertility found (24% versus 41%). However, Gulf War veterans and comparison
group participants who reported difficulty fathering a pregnancy since January 1992, were
equally likely to have sought or undertaken infertility treatment and to have fathered a
pregnancy since the time of their difficulties with fertility.
Table 1 Difficulty fathering a pregnancy and treatment for infertility since January 1992
Gulf War
veterans
N=697
n (%)
Comparison group
N=659
n (%)
RR
Adj RR (95% CI)
93 (13.4)
55 (8.4)
1.60
1.44 (1.05-1.99)
Sought or undertaken
infertility treatment
48 (51.6)
34 (61.8)
0.83
0.84 (0.61-1.14)
Cause for infertility
found
21 (24.4)
19 (41.3)
0.59
0.55 (0.34-0.87)
Fathered a pregnancy
since then
59 (64.8)
27 (50.0)
1.30
1.34 (0.99-1.82)
Difficulty fathering a
pregnancy since 1992
5.12.2
Pregnancies fathered since 1992
In total, 57% of Gulf War veterans (n=399) and 50% of comparison group participants
(n=331) reported fathering at least one pregnancy since 1992. This difference between the
two groups was not statistically significant (RR 1.14, adj RR 1.05, 95% CI 0.96-1.15). For
those who had fathered a pregnancy, the average numbers of pregnancies fathered per
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participant was the same for the two groups; equalling 2.1 (sd 1.4) in the Gulf War veteran
group and 2.1 (sd 1.4) in the comparison group (RR 0.99, adj RR 0.98, 95% CI 0.89-1.07).
The total number of fathered pregnancies reported since 1992 was 910 by the Gulf War
veteran group and 760 by the comparison group. The outcomes of these pregnancies are
shown in Table 2. Gulf War veterans and comparison group participants were equally likely
to father a pregnancy that resulted in a live birth, miscarriage, still birth or termination.
Further information, about those pregnancies which resulted in a live birth, is shown in Table
3. There was no statistically significant difference between the two study groups in regard to
the proportion of live births which were premature, of low birth weight or of very low birth rate.
Approximately 90% of live born Gulf War veteran babies, and 85% of live born comparison
group babies were full-term and normal birth weight.
Table 2 Outcome of pregnancies fathered since 1992
Gulf War veterans’
pregnancies
N=910
n (%)
Comparison group
pregnancies
N=760
n (%)
RR
Adj RR (95% CI)
Live birth
736 (80.9)
611 (80.4)
1.00
1.00
Miscarriage
132 (14.5)
112 (14.7)
0.98
0.99 (0.75-1.31)
Pregnancy outcomes
Still birth
5 (0.6)
6 (0.8)
0.69
0.64 (0.20-2.12)
Termination
37 (4.1)
31 (4.1)
0.99
1.02 (0.63-1.67)
Gulf War veterans’ live
births
N=736
n (%)
Comparison group
live births
N=611
n (%)
RR
Adj RR (95% CI)
Premature birth (<= 36
weeks)
78 (10.6)
94 (15.4)
0.69
0.67 (0.42-1.05)
Low birth weight (<2500
grams)
65 (8.8)
76 (12.4)
0.71
0.70 (0.42-1.17)
Very low birth weight
(<1500 grams)
16 (2.2)
12 (2.0)
1.11
0.84 (0.26-2.73)
Table 3 Live birth outcomes since 1992
Live birth outcomes
5.12.3
Reproductive health at follow up
In the postal questionnaire, significantly more Gulf War veterans than comparison group
participants reported impotence which had been doctor-diagnosed or treated since January
2001 (the approximate time of the baseline study); 8.5% versus 4.5% respectively, RR 1.89,
adj RR 2.06, 95% CI 1.30-3.29. Gulf War veterans were also more likely than the
comparison group participants to report problems with sexual functioning in the month prior
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to follow up (32% versus 24%, RR 1.35, adj RR 1.39, 95% CI 1.17-1.65) and loss of interest
in sex in the month prior to follow up (43% versus 32%, RR 1.33, adj RR 1.34, 95% CI 1.161.54).
5.12.4
Key findings
Gulf War veterans were significantly more likely than comparison group participants to report
difficulty fathering a pregnancy since January1992, despite trying for at least 12 months (13%
vs 8% respectively). Of those who reported difficulty fathering a pregnancy, Gulf War
veterans were significantly less likely than comparison group participants to have had a
cause for their infertility found (24% vs 41%) but equally likely to have sought or undertaken
infertility treatment, and to have fathered a pregnancy, since the time of their difficulties with
fertility.
Approximately one half of all male participants had fathered a pregnancy at some time since
1992 and the average number of pregnancies, for each of those participants, was just above
two. There was no difference between the two groups on these reproductive health
measures.
Approximately 80% of all fathered pregnancies since 1992 were reported to have resulted in
a live birth, approximately 15% resulted in a miscarriage, less than 1% resulted in a still birth
and 4% were terminated. Approximately 90% of live born Gulf War veteran babies, and 85%
of live born comparison group babies were full-term and normal birth weight. There were no
statistically significant differences between the two study groups in regard to these
pregnancy outcomes.
Since the baseline study a larger proportion of Gulf War veterans than comparison group
participants reported doctor-diagnosed or treated impotence (8.5% vs 4.5%). Further, in the
month prior to the follow up study, Gulf War veterans were more likely than the comparison
group to report problems with sexual functioning (32% vs 24%) and loss of interest in sex
(43% vs 32%).
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