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

Koriann Cox, PhD

Boston Veteran’s Administration Healthcare System
The Impact of Military Sexual Trauma and Warfare Exposure on Women Veterans’ Perinatal Outcomes

Scientific Abstract

Background: In the general population, history of trauma is associated with a range of adverse perinatal outcomes (e.g., low birth weight, depression), 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.

Methods: 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 birthweight, postpartum depression and/or anxiety). Women veterans living across the United States were invited to participate and those veterans living in high crime communities were oversampled. Interested participants 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. A total of 911 women reported on 1,752 unique pregnancies.

Results: Results revealed that MST, but not warfare exposure, was associated with having a lower infant birthweight (B = -17.30, SE = 5.41), a slight decrease in the likelihood of having a full-term birth (OR = 0.97, 95% CI = 0.93, 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: Results on the impact of MST on birth outcomes were consistent with the current literature on the impact of trauma on perinatal outcomes in the general population. Findings highlight the importance of screening for MST during pregnancy and trauma-informed obstetric care. Further work should examine potential moderating or mediating factors between the impact of MST on negative perinatal outcomes in order to identify targets for further intervention.

research Areas


Koriann B. Cox, PhD, Annie B. Fox, PhD, Emilie Paul, PhD, Dawne Vogt, PhD, Tara E. Galovski, PhD, & Yael I. Nillni, PhD