Ann Arbor VA Healthcare System, Ann Arbor, Michigan; Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan.
Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan; Department of Veterans Affairs, Center for Clinical Management Research, Ann Arbor, Michigan.
Womens Health Issues. 2020 Jul-Aug;30(4):292-298. doi: 10.1016/j.whi.2020.04.002. Epub 2020 May 13.
Researchers have examined predictors of Veterans Affairs (VA) service use by women veterans in general, but less is known about predictors of VA service use by pregnant veterans. This study examined characteristics associated with planned and actual VA service use by pregnant veterans.
This study includes data from 510 pregnant veterans enrolled in the Center for Maternal and Infant Outcomes Research in Translation Study. Women veterans completed phone interviews during their first trimester and at 3 months postpartum. The Center for Maternal and Infant Outcomes Research in Translation surveys assessed medical and mental health conditions, VA health care use, trauma history, and pregnancy complications. We conducted bivariate and multivariable logistic regression models assessing planned and actual use of VA services during pregnancy.
Lifetime post-traumatic stress disorder (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.11-2.69) and history of military sexual trauma (OR, 1.85; 95% CI, 1.19-2.87) were significantly associated with planned VA service use in multivariable models. Lifetime diagnoses of anxiety (OR, 1.78; C.I., 1.15-2.75) were associated with an increased likelihood of actual VA use during pregnancy, whereas Hispanic ethnicity (OR, 0.59; 95% CI, 0.36-0.96), younger age (OR, 0.95; 95% CI, 0.91-0.99), and access to private health insurance (OR, 0.55; 95% CI, 0.37-0.84) were associated with a decreased likelihood of actual VA service use during pregnancy.
Results emphasize the association between high-risk mental health characteristics and specific demographic characteristics with VA service use among pregnant veterans. Study findings highlight a continued need for women's health care at the VA, as well as the availability of VA providers knowledgeable about perinatal health issues, and informed community providers regarding women veterans' health.
研究人员已经研究了一般退伍军人事务部（VA）服务使用的预测因素，但对于怀孕退伍军人的 VA 服务使用预测因素知之甚少。本研究探讨了与计划和实际 VA 服务使用相关的特征怀孕退伍军人。
本研究包括参加母婴成果研究转化研究中心的 510 名怀孕退伍军人的数据。女性退伍军人在怀孕初期和产后 3 个月通过电话进行访谈。母婴成果研究转化研究中心的调查评估了医疗和心理健康状况、VA 医疗保健使用、创伤史和妊娠并发症。我们进行了二变量和多变量逻辑回归模型，评估了怀孕期间计划和实际使用 VA 服务的情况。
在多变量模型中，终生创伤后应激障碍（OR，1.73；95%置信区间 [CI]，1.11-2.69）和军事性创伤史（OR，1.85；95% CI，1.19-2.87）与计划使用 VA 服务显著相关。在多变量模型中，终生诊断为焦虑症（OR，1.78；CI，1.15-2.75）与怀孕期间实际使用 VA 的可能性增加相关，而西班牙裔（OR，0.59；95% CI，0.36-0.96）、年龄较小（OR，0.95；95% CI，0.91-0.99）和获得私人医疗保险（OR，0.55；95% CI，0.37-0.84）与怀孕期间实际使用 VA 服务的可能性降低相关。
研究结果强调了高危心理健康特征与特定人口统计学特征与怀孕退伍军人使用 VA 服务之间的关联。研究结果强调了 VA 为妇女提供医疗保健的持续需求，以及 VA 提供者对围产期健康问题的了解，以及向了解妇女退伍军人健康问题的社区提供者提供信息。
