Prevalence of birth defects among infants of Gulf War veterans in Arkansas, Arizona, California, Georgia, Hawaii, and Iowa, 1989-1993
BACKGROUND Epidemiologic studies of birth defects among infants of Gulf War veterans (GWV) have been limited to military hospitals, anomalies diagnosed among newborns, or self‐reported data. This study was conducted to measure the prevalence of birth defects among infants of GWVs and nondeployed vet...
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| Veröffentlicht in: | Birth defects research. A Clinical and molecular teratology 2003-04, Vol.67 (4), p.246-260 |
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| container_title | Birth defects research. A Clinical and molecular teratology |
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| creator | G. Araneta, Maria Rosario Schlangen, Karen M. Edmonds, Larry D. Destiche, Daniel A. Merz, Ruth D. Hobbs, Charlotte A. Flood, Timothy J. Harris, John A. Krishnamurti, Diane Gray, Gregory C. |
| description | BACKGROUND
Epidemiologic studies of birth defects among infants of Gulf War veterans (GWV) have been limited to military hospitals, anomalies diagnosed among newborns, or self‐reported data. This study was conducted to measure the prevalence of birth defects among infants of GWVs and nondeployed veterans (NDV) in states that conducted active case ascertainment of birth defects between 1989–93.
METHODS
Military records of 684,645 GWVs and 1,587,102 NDVs were electronically linked with 2,314,908 birth certificates from Arizona, Hawaii, Iowa, and selected counties of Arkansas, California, and Georgia; 11,961 GWV infants and 33,052 NDV infants were identified. Of these, 450 infants had mothers who served in the Gulf War, and 3966 had NDV mothers.
RESULTS
Infants conceived postwar to male GWVs had significantly higher prevalence of tricuspid valve insufficiency (relative risk [RR], 2.7; 95% confidence interval [CI], 1.1–6.6; p = 0.039) and aortic valve stenosis (RR, 6.0; 95% CI, 1.2–31.0; p = 0.026) compared to infants conceived postwar to NDV males. Among infants of male GWVs, aortic valve stenosis (RR, 16.3; 95% CI, 0.09–294; p = 0.011) and renal agenesis or hypoplasia (RR, 16.3; 95% CI, 0.09–294; p = 0.011) were significantly higher among infants conceived postwar than prewar. Hypospadias was significantly higher among infant sons conceived postwar to GWV women compared to NDV women (RR, 6.3; 95% CI, 1.5–26.3; p = 0.015).
CONCLUSION
We observed a higher prevalence of tricuspid valve insufficiency, aortic valve stenosis, and renal agenesis or hypoplasia among infants conceived postwar to GWV men, and a higher prevalence of hypospadias among infants conceived postwar to female GWVs. We did not have the ability to determine if the excess was caused by inherited or environmental factors, or was due to chance because of myriad reasons, including multiple comparisons. Although the statistical power was sufficient to compare the combined birth defects prevalence, larger sample sizes were needed for less frequent individual component defects. Birth Defects Research (Part A) 67:246–260, 2003. Published 2003 Wiley‐Liss, Inc. |
| doi_str_mv | 10.1002/bdra.10033 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_73523829</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>73523829</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4613-e3056ab3c2322e65d6eaf4fc6950750a59d7558c8af0455fd7c11e0212a6b49f3</originalsourceid><addsrcrecordid>eNp9kE1vEzEQhlcIREvhwg9AvsABZYs_1vb6mASaVooKRaAerVnvuJhudou9aSh3_jcOCe2Nkx97npmR36J4yegxo5S_a9oIWxLiUXHIZMVLqhV9fM-SHxTPUvqeXaG1flocMF7LSil6WPz-FPEWOuwdksGTJsTxG2nRoxsTgdXQX5HQe-jzLZcX686TS4jkFkeM0KdcJNN4nQnSJFP4NfQwIXPogh9iHzIvcIhXWziFDYQwIdC35GzY5BdmalMyY8Tz4omHLuGL_XlUfD358GV-Wi4_Ls7m02XpKsVEiYJKBY1wXHCOSrYKwVfeKSPzLylI02opa1eDp5WUvtWOMaSccVBNZbw4Kt7s5t7E4cca02hXITnsOuhxWCerheSi5iaLb3eii0NKEb29iWEF8c4yareh223o9m_oWX61n7puVtg-qPuUs_B6L0By0PmcnAvpwas0N9Tw7LGdtwkd3v1npZ29_zz9t7zc9YQ04s_7HojXVmmhpb08X9jliZjNLtiFVeIPZCOl1g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>73523829</pqid></control><display><type>article</type><title>Prevalence of birth defects among infants of Gulf War veterans in Arkansas, Arizona, California, Georgia, Hawaii, and Iowa, 1989-1993</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>G. Araneta, Maria Rosario ; Schlangen, Karen M. ; Edmonds, Larry D. ; Destiche, Daniel A. ; Merz, Ruth D. ; Hobbs, Charlotte A. ; Flood, Timothy J. ; Harris, John A. ; Krishnamurti, Diane ; Gray, Gregory C.</creator><creatorcontrib>G. Araneta, Maria Rosario ; Schlangen, Karen M. ; Edmonds, Larry D. ; Destiche, Daniel A. ; Merz, Ruth D. ; Hobbs, Charlotte A. ; Flood, Timothy J. ; Harris, John A. ; Krishnamurti, Diane ; Gray, Gregory C.</creatorcontrib><description>BACKGROUND
Epidemiologic studies of birth defects among infants of Gulf War veterans (GWV) have been limited to military hospitals, anomalies diagnosed among newborns, or self‐reported data. This study was conducted to measure the prevalence of birth defects among infants of GWVs and nondeployed veterans (NDV) in states that conducted active case ascertainment of birth defects between 1989–93.
METHODS
Military records of 684,645 GWVs and 1,587,102 NDVs were electronically linked with 2,314,908 birth certificates from Arizona, Hawaii, Iowa, and selected counties of Arkansas, California, and Georgia; 11,961 GWV infants and 33,052 NDV infants were identified. Of these, 450 infants had mothers who served in the Gulf War, and 3966 had NDV mothers.
RESULTS
Infants conceived postwar to male GWVs had significantly higher prevalence of tricuspid valve insufficiency (relative risk [RR], 2.7; 95% confidence interval [CI], 1.1–6.6; p = 0.039) and aortic valve stenosis (RR, 6.0; 95% CI, 1.2–31.0; p = 0.026) compared to infants conceived postwar to NDV males. Among infants of male GWVs, aortic valve stenosis (RR, 16.3; 95% CI, 0.09–294; p = 0.011) and renal agenesis or hypoplasia (RR, 16.3; 95% CI, 0.09–294; p = 0.011) were significantly higher among infants conceived postwar than prewar. Hypospadias was significantly higher among infant sons conceived postwar to GWV women compared to NDV women (RR, 6.3; 95% CI, 1.5–26.3; p = 0.015).
CONCLUSION
We observed a higher prevalence of tricuspid valve insufficiency, aortic valve stenosis, and renal agenesis or hypoplasia among infants conceived postwar to GWV men, and a higher prevalence of hypospadias among infants conceived postwar to female GWVs. We did not have the ability to determine if the excess was caused by inherited or environmental factors, or was due to chance because of myriad reasons, including multiple comparisons. Although the statistical power was sufficient to compare the combined birth defects prevalence, larger sample sizes were needed for less frequent individual component defects. Birth Defects Research (Part A) 67:246–260, 2003. Published 2003 Wiley‐Liss, Inc.</description><identifier>ISSN: 1542-0752</identifier><identifier>EISSN: 1542-0760</identifier><identifier>DOI: 10.1002/bdra.10033</identifier><identifier>PMID: 12854660</identifier><identifier>CODEN: BDRPBT</identifier><language>eng</language><publisher>New York: Wiley Subscription Services, Inc., a Wiley company</publisher><subject>Adult ; aortic valve stenosis ; Arizona - epidemiology ; Arkansas - epidemiology ; Biological and medical sciences ; birth defects ; California - epidemiology ; Case-Control Studies ; Congenital Abnormalities - epidemiology ; Embryology: invertebrates and vertebrates. Teratology ; Female ; Fundamental and applied biological sciences. Psychology ; Georgia - epidemiology ; Gulf War veterans ; Hawaii - epidemiology ; Humans ; hypospadias ; Infant, Newborn ; Iowa - epidemiology ; Male ; Middle East ; Military Personnel - statistics & numerical data ; Persian Gulf War ; Population Surveillance ; Pregnancy ; Pregnancy Outcome ; Prevalence ; renal agenesis or hypoplasia ; Teratology. Teratogens ; tricuspid valve insufficiency ; tricuspid valve regurgitation ; Veterans - statistics & numerical data ; Warfare</subject><ispartof>Birth defects research. A Clinical and molecular teratology, 2003-04, Vol.67 (4), p.246-260</ispartof><rights>Copyright © 2003 Wiley‐Liss, Inc., A Wiley Company</rights><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4613-e3056ab3c2322e65d6eaf4fc6950750a59d7558c8af0455fd7c11e0212a6b49f3</citedby><cites>FETCH-LOGICAL-c4613-e3056ab3c2322e65d6eaf4fc6950750a59d7558c8af0455fd7c11e0212a6b49f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fbdra.10033$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fbdra.10033$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14729092$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12854660$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>G. Araneta, Maria Rosario</creatorcontrib><creatorcontrib>Schlangen, Karen M.</creatorcontrib><creatorcontrib>Edmonds, Larry D.</creatorcontrib><creatorcontrib>Destiche, Daniel A.</creatorcontrib><creatorcontrib>Merz, Ruth D.</creatorcontrib><creatorcontrib>Hobbs, Charlotte A.</creatorcontrib><creatorcontrib>Flood, Timothy J.</creatorcontrib><creatorcontrib>Harris, John A.</creatorcontrib><creatorcontrib>Krishnamurti, Diane</creatorcontrib><creatorcontrib>Gray, Gregory C.</creatorcontrib><title>Prevalence of birth defects among infants of Gulf War veterans in Arkansas, Arizona, California, Georgia, Hawaii, and Iowa, 1989-1993</title><title>Birth defects research. A Clinical and molecular teratology</title><addtitle>Birth Defects Research Part A: Clinical and Molecular Teratology</addtitle><description>BACKGROUND
Epidemiologic studies of birth defects among infants of Gulf War veterans (GWV) have been limited to military hospitals, anomalies diagnosed among newborns, or self‐reported data. This study was conducted to measure the prevalence of birth defects among infants of GWVs and nondeployed veterans (NDV) in states that conducted active case ascertainment of birth defects between 1989–93.
METHODS
Military records of 684,645 GWVs and 1,587,102 NDVs were electronically linked with 2,314,908 birth certificates from Arizona, Hawaii, Iowa, and selected counties of Arkansas, California, and Georgia; 11,961 GWV infants and 33,052 NDV infants were identified. Of these, 450 infants had mothers who served in the Gulf War, and 3966 had NDV mothers.
RESULTS
Infants conceived postwar to male GWVs had significantly higher prevalence of tricuspid valve insufficiency (relative risk [RR], 2.7; 95% confidence interval [CI], 1.1–6.6; p = 0.039) and aortic valve stenosis (RR, 6.0; 95% CI, 1.2–31.0; p = 0.026) compared to infants conceived postwar to NDV males. Among infants of male GWVs, aortic valve stenosis (RR, 16.3; 95% CI, 0.09–294; p = 0.011) and renal agenesis or hypoplasia (RR, 16.3; 95% CI, 0.09–294; p = 0.011) were significantly higher among infants conceived postwar than prewar. Hypospadias was significantly higher among infant sons conceived postwar to GWV women compared to NDV women (RR, 6.3; 95% CI, 1.5–26.3; p = 0.015).
CONCLUSION
We observed a higher prevalence of tricuspid valve insufficiency, aortic valve stenosis, and renal agenesis or hypoplasia among infants conceived postwar to GWV men, and a higher prevalence of hypospadias among infants conceived postwar to female GWVs. We did not have the ability to determine if the excess was caused by inherited or environmental factors, or was due to chance because of myriad reasons, including multiple comparisons. Although the statistical power was sufficient to compare the combined birth defects prevalence, larger sample sizes were needed for less frequent individual component defects. Birth Defects Research (Part A) 67:246–260, 2003. Published 2003 Wiley‐Liss, Inc.</description><subject>Adult</subject><subject>aortic valve stenosis</subject><subject>Arizona - epidemiology</subject><subject>Arkansas - epidemiology</subject><subject>Biological and medical sciences</subject><subject>birth defects</subject><subject>California - epidemiology</subject><subject>Case-Control Studies</subject><subject>Congenital Abnormalities - epidemiology</subject><subject>Embryology: invertebrates and vertebrates. Teratology</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Georgia - epidemiology</subject><subject>Gulf War veterans</subject><subject>Hawaii - epidemiology</subject><subject>Humans</subject><subject>hypospadias</subject><subject>Infant, Newborn</subject><subject>Iowa - epidemiology</subject><subject>Male</subject><subject>Middle East</subject><subject>Military Personnel - statistics & numerical data</subject><subject>Persian Gulf War</subject><subject>Population Surveillance</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Prevalence</subject><subject>renal agenesis or hypoplasia</subject><subject>Teratology. Teratogens</subject><subject>tricuspid valve insufficiency</subject><subject>tricuspid valve regurgitation</subject><subject>Veterans - statistics & numerical data</subject><subject>Warfare</subject><issn>1542-0752</issn><issn>1542-0760</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1vEzEQhlcIREvhwg9AvsABZYs_1vb6mASaVooKRaAerVnvuJhudou9aSh3_jcOCe2Nkx97npmR36J4yegxo5S_a9oIWxLiUXHIZMVLqhV9fM-SHxTPUvqeXaG1flocMF7LSil6WPz-FPEWOuwdksGTJsTxG2nRoxsTgdXQX5HQe-jzLZcX686TS4jkFkeM0KdcJNN4nQnSJFP4NfQwIXPogh9iHzIvcIhXWziFDYQwIdC35GzY5BdmalMyY8Tz4omHLuGL_XlUfD358GV-Wi4_Ls7m02XpKsVEiYJKBY1wXHCOSrYKwVfeKSPzLylI02opa1eDp5WUvtWOMaSccVBNZbw4Kt7s5t7E4cca02hXITnsOuhxWCerheSi5iaLb3eii0NKEb29iWEF8c4yareh223o9m_oWX61n7puVtg-qPuUs_B6L0By0PmcnAvpwas0N9Tw7LGdtwkd3v1npZ29_zz9t7zc9YQ04s_7HojXVmmhpb08X9jliZjNLtiFVeIPZCOl1g</recordid><startdate>200304</startdate><enddate>200304</enddate><creator>G. Araneta, Maria Rosario</creator><creator>Schlangen, Karen M.</creator><creator>Edmonds, Larry D.</creator><creator>Destiche, Daniel A.</creator><creator>Merz, Ruth D.</creator><creator>Hobbs, Charlotte A.</creator><creator>Flood, Timothy J.</creator><creator>Harris, John A.</creator><creator>Krishnamurti, Diane</creator><creator>Gray, Gregory C.</creator><general>Wiley Subscription Services, Inc., a Wiley company</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200304</creationdate><title>Prevalence of birth defects among infants of Gulf War veterans in Arkansas, Arizona, California, Georgia, Hawaii, and Iowa, 1989-1993</title><author>G. Araneta, Maria Rosario ; Schlangen, Karen M. ; Edmonds, Larry D. ; Destiche, Daniel A. ; Merz, Ruth D. ; Hobbs, Charlotte A. ; Flood, Timothy J. ; Harris, John A. ; Krishnamurti, Diane ; Gray, Gregory C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4613-e3056ab3c2322e65d6eaf4fc6950750a59d7558c8af0455fd7c11e0212a6b49f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>aortic valve stenosis</topic><topic>Arizona - epidemiology</topic><topic>Arkansas - epidemiology</topic><topic>Biological and medical sciences</topic><topic>birth defects</topic><topic>California - epidemiology</topic><topic>Case-Control Studies</topic><topic>Congenital Abnormalities - epidemiology</topic><topic>Embryology: invertebrates and vertebrates. Teratology</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Georgia - epidemiology</topic><topic>Gulf War veterans</topic><topic>Hawaii - epidemiology</topic><topic>Humans</topic><topic>hypospadias</topic><topic>Infant, Newborn</topic><topic>Iowa - epidemiology</topic><topic>Male</topic><topic>Middle East</topic><topic>Military Personnel - statistics & numerical data</topic><topic>Persian Gulf War</topic><topic>Population Surveillance</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Prevalence</topic><topic>renal agenesis or hypoplasia</topic><topic>Teratology. Teratogens</topic><topic>tricuspid valve insufficiency</topic><topic>tricuspid valve regurgitation</topic><topic>Veterans - statistics & numerical data</topic><topic>Warfare</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>G. Araneta, Maria Rosario</creatorcontrib><creatorcontrib>Schlangen, Karen M.</creatorcontrib><creatorcontrib>Edmonds, Larry D.</creatorcontrib><creatorcontrib>Destiche, Daniel A.</creatorcontrib><creatorcontrib>Merz, Ruth D.</creatorcontrib><creatorcontrib>Hobbs, Charlotte A.</creatorcontrib><creatorcontrib>Flood, Timothy J.</creatorcontrib><creatorcontrib>Harris, John A.</creatorcontrib><creatorcontrib>Krishnamurti, Diane</creatorcontrib><creatorcontrib>Gray, Gregory C.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Birth defects research. A Clinical and molecular teratology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>G. Araneta, Maria Rosario</au><au>Schlangen, Karen M.</au><au>Edmonds, Larry D.</au><au>Destiche, Daniel A.</au><au>Merz, Ruth D.</au><au>Hobbs, Charlotte A.</au><au>Flood, Timothy J.</au><au>Harris, John A.</au><au>Krishnamurti, Diane</au><au>Gray, Gregory C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence of birth defects among infants of Gulf War veterans in Arkansas, Arizona, California, Georgia, Hawaii, and Iowa, 1989-1993</atitle><jtitle>Birth defects research. A Clinical and molecular teratology</jtitle><addtitle>Birth Defects Research Part A: Clinical and Molecular Teratology</addtitle><date>2003-04</date><risdate>2003</risdate><volume>67</volume><issue>4</issue><spage>246</spage><epage>260</epage><pages>246-260</pages><issn>1542-0752</issn><eissn>1542-0760</eissn><coden>BDRPBT</coden><abstract>BACKGROUND
Epidemiologic studies of birth defects among infants of Gulf War veterans (GWV) have been limited to military hospitals, anomalies diagnosed among newborns, or self‐reported data. This study was conducted to measure the prevalence of birth defects among infants of GWVs and nondeployed veterans (NDV) in states that conducted active case ascertainment of birth defects between 1989–93.
METHODS
Military records of 684,645 GWVs and 1,587,102 NDVs were electronically linked with 2,314,908 birth certificates from Arizona, Hawaii, Iowa, and selected counties of Arkansas, California, and Georgia; 11,961 GWV infants and 33,052 NDV infants were identified. Of these, 450 infants had mothers who served in the Gulf War, and 3966 had NDV mothers.
RESULTS
Infants conceived postwar to male GWVs had significantly higher prevalence of tricuspid valve insufficiency (relative risk [RR], 2.7; 95% confidence interval [CI], 1.1–6.6; p = 0.039) and aortic valve stenosis (RR, 6.0; 95% CI, 1.2–31.0; p = 0.026) compared to infants conceived postwar to NDV males. Among infants of male GWVs, aortic valve stenosis (RR, 16.3; 95% CI, 0.09–294; p = 0.011) and renal agenesis or hypoplasia (RR, 16.3; 95% CI, 0.09–294; p = 0.011) were significantly higher among infants conceived postwar than prewar. Hypospadias was significantly higher among infant sons conceived postwar to GWV women compared to NDV women (RR, 6.3; 95% CI, 1.5–26.3; p = 0.015).
CONCLUSION
We observed a higher prevalence of tricuspid valve insufficiency, aortic valve stenosis, and renal agenesis or hypoplasia among infants conceived postwar to GWV men, and a higher prevalence of hypospadias among infants conceived postwar to female GWVs. We did not have the ability to determine if the excess was caused by inherited or environmental factors, or was due to chance because of myriad reasons, including multiple comparisons. Although the statistical power was sufficient to compare the combined birth defects prevalence, larger sample sizes were needed for less frequent individual component defects. Birth Defects Research (Part A) 67:246–260, 2003. Published 2003 Wiley‐Liss, Inc.</abstract><cop>New York</cop><pub>Wiley Subscription Services, Inc., a Wiley company</pub><pmid>12854660</pmid><doi>10.1002/bdra.10033</doi><tpages>15</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Birth defects research. A Clinical and molecular teratology, 2003-04, Vol.67 (4), p.246-260 |
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| source | MEDLINE; Wiley Online Library All Journals |
| subjects | Adult aortic valve stenosis Arizona - epidemiology Arkansas - epidemiology Biological and medical sciences birth defects California - epidemiology Case-Control Studies Congenital Abnormalities - epidemiology Embryology: invertebrates and vertebrates. Teratology Female Fundamental and applied biological sciences. Psychology Georgia - epidemiology Gulf War veterans Hawaii - epidemiology Humans hypospadias Infant, Newborn Iowa - epidemiology Male Middle East Military Personnel - statistics & numerical data Persian Gulf War Population Surveillance Pregnancy Pregnancy Outcome Prevalence renal agenesis or hypoplasia Teratology. Teratogens tricuspid valve insufficiency tricuspid valve regurgitation Veterans - statistics & numerical data Warfare |
| title | Prevalence of birth defects among infants of Gulf War veterans in Arkansas, Arizona, California, Georgia, Hawaii, and Iowa, 1989-1993 |
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