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Study Finds No Gulf War Link to Birth Defect Risk

TIMES MEDICAL WRITER

The children of men and women who served in the Persian Gulf War have no increased risk of birth defects, according to a long-awaited government-sponsored study made public today involving more than 75,000 babies of U.S. military personnel born since the war.

That finding goes far toward settling a controversy that has vexed researchers and haunted veterans. Many who had a child born with a physical defect wondered if it was the legacy of chemicals, drugs, vaccines or infectious agents encountered during the seven-month military venture, which ended in February 1991. The possibility prompted congressional hearings, small-scale studies and numerous heartbreaking news stories about “the tiny victims of [Operation] Desert Storm,” as Life magazine put it.

But the largest, most comprehensive study of the question, reported in the New England Journal of Medicine, found virtually no difference in observable defects in 33,998 babies of Gulf War veterans and 41,463 babies of military personnel who did not serve in the war. In both groups, minor defects occurred in 7.5% of babies and major ones in 1.9%. Moreover, the rates are similar to those observed in the civilian population--the Centers for Disease Control and Prevention has found that 8.4% of American babies have a birth defect of some kind, while 1.9% have a severe one.

“I would expect this study to have a substantial benefit in easing the fears of current and future parents, and in reassuring those few whose children have birth defects, that the problems are not related to service in the Gulf,” said Dr. John C. Bailar, a University of Chicago medical epidemiologist. He headed an Institute of Medicine panel that reviewed research on the health consequences of the Gulf War.

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“It’s good news,” said the new study’s lead author, David Cowan, an epidemiologist at a private firm, ARS Technologies, hired by the Walter Reed Army Institute of Research to perform the analysis. “The overwhelming majority of babies born to Gulf War veterans are healthy, and veterans concerned about having babies in the future should be relieved.”

The researchers note that the study--which analyzed birth records between 1991 and 1993 at 135 military hospitals--cannot answer every question posed about the potential hazards of Gulf service to veterans’ descendants.

Although the report analyzed birth defects ranging in severity from large birthmarks to brain damage, it did not look at miscarriage rates or fertility problems. Nor did it focus on subgroups of people exposed to particularly harsh conditions or agents, which might place them at special risk of reproductive problems.

Co-author Dr. Gregory Gray of the Naval Health Research Center in San Diego said other large studies were currently underway to pin down lingering questions such as whether Gulf War duty is linked to miscarriages or infertility.

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“The data are reassuring, but really and truly this is not the end of the story,” said Dr. Sharon Cooper, a developmental pediatrician at Womack Army Medical Center at Fort Bragg, N.C. One shortcoming, she said, was that the study did not take into account all developmental abnormalities. She cited two high-profile cases of Persian Gulf veterans’ children who would not even have been counted in this study: one died of a heart problem, the other of liver cancer.

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Betty Mekdeci, head of the Orlando-based Assn. of Birth Defect Children, said the issue wasn’t settled because the study “left out large groups of veterans who should have been monitored.” Using unscientific survey methods, her group has documented 300 afflicted babies of Gulf War veterans, she said. “Our data doesn’t prove there’s a link to the Gulf, but there is something going on here.”

But Bailar, an authority on research methods, said the new findings fall in line with those of other, albeit smaller, studies. “At the present, I think the scientific consensus is overwhelmingly in favor of the conclusion that no risk has been found,” he said. “I’m not excluding the possibility of future evidence, but the persons who disagree are a tiny minority who have not been able to put forward a coherent argument for their point of view.”

Cowan acknowledged that statistics are cold comfort to Persian Gulf veterans with an afflicted child. “A scientific response to an emotional issue is not going to be satisfying to the parents of children with a heartbreaking problem,” he said.

It was not immediately clear how the findings would affect government policy, if at all. Veterans groups and health advocates believing that Persian Gulf service increased birth defect risks have criticized the military health care system. Currently, children of military personnel are eligible for free treatment at military facilities only while a parent remains in the service; but if wartime duty caused a birth defect, advocates say, the military should provide lifetime medical coverage to a child.

Dr. Edward Martin, acting assistant secretary of Defense for health affairs, declined to comment on the policy implications. But he said in a statement that “the findings in this large study provide some reassurance.”


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