Gulf War Women's Health Cohort

About 7 percent of the nearly 700,000 military personnel who served in the 1991 Gulf War were women -- representing the largest proportion of U.S. women serving in a war zone in U.S. military history at that time. Previous studies have looked at rates of Gulf War illness in female and male Gulf War Veterans. Results from some studies suggest that Gulf War illness is more common in women Gulf War Veterans than their male counterparts. However, in the 25 years since the war, few studies have evaluated Gulf War illness and other medical conditions specifically as they affect women Veterans of the 1991 Gulf War. A small number of studies suggested excess rates of certain women's health problems. However, no research has been conducted to follow up on preliminary findings from studies conducted more over 10 years ago indicating that women Veterans of the Gulf War had excess rates of Gulf War illness, women's health issues, and adverse reproductive outcomes. Several studies have identified significantly elevated rates of birth defects and adverse reproductive outcomes among Gulf War Veterans. However, findings have varied across studies, with some studies showing elevated risks of stillbirths, miscarriages, and birth defects. There remains a need to evaluate birth outcomes in appropriate subgroups of veterans.

The objectives are to establish the Gulf War Women's Cohort, a large sample of women Veterans who served in the 1990-1991 Gulf War and a comparison group of women who served in other locations during that period. Another objective is to provide current, comprehensive data on the health status of women who served during the 1990-1991 Gulf War, and identify any specific conditions that affect Gulf War women Veterans at increased rates.

The specific aims are to assemble the Gulf War Women's Cohort from data collected from women Veterans who participated in previous and ongoing population studies of Gulf War era Veterans and to conduct a health survey to provide data on the current health status of women who served during the 1991 Gulf War era. A further aim is to provide scientific information about Veteran-reported pregnancy and birth outcomes among Gulf War era Women veterans. Gulf War illness and other high interest health outcomes will be evaluated in women Veteran subgroups, including subgroups identified by military deployment characteristics (e.g., location, exposures, branch of service). Changes in Gulf War era women Veterans' health over time will be assessed, and sex differences in Gulf War illness will be examined including female to male differences in the frequency of symptoms associated with Gulf War illness and the overall prevalence of Gulf War illness among Gulf War female and male Veterans.

The proposed study will utilize both existing datasets and newly collected survey data to examine the prevalence and patterns of Gulf War illness symptoms, diagnosed medical conditions, reproductive health, birth outcomes, and other health issues among women who served during the Gulf War. In studies for which it is feasible to re-contact participants, current data will be collected on women's symptoms and medical conditions and adverse reproductive outcomes, using postal survey questionnaires and telephone interviews. Statistical analyses of existing data will focus on health outcomes specifically affecting women. Female to male differences in Gulf War illness will be examined to determine whether Gulf War illness manifests differently in women. Taken overall, the study will include about 7,898 Veterans. This will include about 955 to 1,420 women Gulf War Veterans and an additional 680 to 854 women Veterans who were not deployed.

The project will provide a comprehensive picture of the health of women Gulf War Veterans. This includes assessment of current health status, changes in health symptoms and conditions over time, and possible differences in health outcomes associated with specific experiences and exposures during the war. The study will generate data that will improve our understanding of Gulf War illness in women Veterans who served in the Gulf War, women Gulf War Veteran's health, and adverse reproductive outcomes. The study will lay the groundwork for future research aimed at a short-term or longer-term improvement in clinical treatment of women Veterans with Gulf War illness.