# Examining Pre-Pregnancy Health and Maternal Outcomes among Women Veterans

> **NIH VA IK2** · VETERANS HEALTH ADMINISTRATION · 2021 · —

## Abstract

Background. In the United States, two women die every day from pregnancy-related complications. Non-
Hispanic Black women die at 3 to 4 times the rate of non-Hispanic White women, and women living in rural
areas and women with low income are also at increased risk. For every pregnancy-related death, about 100
more women nearly die due to severe maternal morbidity (SMM), or complications from pregnancy and/or
delivery that result in significant lasting health consequences. Research suggests that >60% of these deaths
and SMM events are preventable, and that improving women’s health before pregnancy (e.g., managing
chronic medical and mental health conditions) may be one key to prevention. Little is known about women
Veterans’ pre-pregnancy health risks and maternal outcomes. Preliminary data from pilot work suggest that the
rate of pregnancy-associated deaths among Veterans using VA maternity care benefits is nearly double the
national rate. Because women Veterans have a high prevalence of chronic medical and mental health
conditions, and given that half (48%) of women Veterans age 18-45 identify as non-White and 25% live in rural
areas, it is critical to examine the role of these pre-pregnancy health risks in adverse maternal outcomes and to
explore how patterns of comorbid health risk factors vary among women from vulnerable subgroups.
Significance / Impact. The proposed research will fill major gaps in the literature about the etiology of
maternal mortality and SMM both within and outside of VA, and directly aligns with VHA and HSR&D priorities
around women’s health and health equity. Innovation. This study is the first to examine the impact of pre-
pregnancy health risks on maternal outcomes among a national cohort of women Veterans and the first to
examine whether social characteristics modify associations between pre-pregnancy health and maternal
outcomes. Specific Aims. Aim 1 is a quantitative study to classify women Veterans according to co-occurring
pre-pregnancy health risks, describe associations between risk profile groups and adverse maternal outcomes,
and identify how these associations vary across population subgroups. Aim 2 is a qualitative study to examine
women Veterans’ pre-pregnancy healthcare needs, experiences, and preferences. Aim 3 involves intervention
development, refinement, and pilot testing with the input of key VA clinical and operational informants and
women Veterans. Methodology. Aim 1 will use latent class analysis and multiple regression to examine a
national cohort of over 30,000 pregnancies to women Veterans in FY2010-2019. Aim 2 will recruit and
interview ~30 women Veterans about their experiences and needs related to pre-pregnancy health and health
care in VA. Aim 3 will recruit ~6 VA clinical and operational informants and ~3 women Veterans for a VA
stakeholder advisory panel, 5-10 women Veterans and their providers to provide feedback on intervention
components, and 10-15 women Veterans and providers to pilot...

## Key facts

- **NIH application ID:** 10314239
- **Project number:** 1IK2HX003327-01A1
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** Deirdre A Quinn
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-09-01 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10314239

## Citation

> US National Institutes of Health, RePORTER application 10314239, Examining Pre-Pregnancy Health and Maternal Outcomes among Women Veterans (1IK2HX003327-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10314239. Licensed CC0.

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