London School of Hygiene & Tropical Medicine

The first epidemiological study to be conducted in the UK on reproduction following service in the Gulf War in the early '90s is published today in the International Journal of Epidemiology.

It will, for the most part, prove reassuring to those who fear serving in the Gulf may have had an adverse effect on their reproductive health as the researchers conclude that veterans are no more likely to have a stillbirth or a child with chromosomal abnormalities than their armed service colleagues who were not deployed to the Gulf.

The study has been funded by the Ministry of Defence and administered by the Medical Research Council (MRC). It was produced by staff at the London School of Hygiene & Tropical Medicine (LSHTM). It is the first epidemiological study of the reproductive outcome for UK armed service personnel serving in the first Gulf War, and sought to determine whether the children of UK Gulf War veterans were more likely to suffer congenital malformations or for the pregnancies to end in miscarriage or stillbirth.

Concerns were raised following the first Gulf War about apparent clusters of birth defects and miscarriages among children of Gulf War veterans and the possible pre-natal effects of hazardous exposures due to and during the War. However, there have been few epidemiological studies on reproductive outcome following service in the Gulf War, and most of these have been conducted on US troops.

The findings reveal no strong evidence for a link between a father's deployment to the Gulf War and increased risk of stillbirth or of chromosomal malformations, syndromes or certain specific malformations in offspring. Female veterans, meanwhile, were found to be at no greater risk of miscarriage than the comparison group, but there were too few stillbirths or malformations reported to allow for meaningful analysis.

However, the research findings did reveal some areas of concern. There was some evidence for an increased risk of malformations of the genital and renal system, and of other non-specific defects, but these associations were weakened when the analysis was restricted to clinically confirmed conditions (evidence from doctors). The researchers also found a 40% increased risk of miscarriage among the pregnancies of Gulf War veterans. According to Dr Pat Doyle, Head of the Department of Epidemiology and Public Health at LSHTM, and one of the report's authors, these figures need to be interpreted with caution:

'Overall, we found no evidence that service in the Gulf is linked to fathering children with most major defects and this will be reassuring to veterans and their families', she explains. 'Although we did find a 40% increased risk of miscarriage among pregnancies reported by male Gulf War veterans, this may be the result of underreporting of early miscarriages by the control group, and we cannot at this stage conclude that there is a real link between miscarriage and a father's service in the Gulf War. We are now studying this in more depth.

'The findings of this report should, on balance, offer hope and reassurance to men and women who served in the first Gulf War, and who have felt anxious about whether their reproductive health, and the health of their families, has been adversely affected. The study shows that they are no more likely to experience a stillbirth or a child with chromosomal abnormalities than troops who did not serve in the Gulf'.

To interview Dr Pat Doyle, please contact LSHTM's Press Office on 07941 294885.

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