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Reproductive Health

Military service presents unique environmental and occupational exposure. As the number of female service members increases, understanding how specific exposure effect reproductive health is important to protecting the health and readiness of service members and their families.



As the number of women on active duty continues to increase and more occupational specialties within the armed forces open to female service members, there is a growing need to understand how diverse military exposures effect reproductive health. Specifically, our researchers evaluate associations of outcomes with specific exposures such as vaccines and those related to deployment, occupation, or geographic location.

The Birth and Infant Health Registry (BIHR) was established in 1998 at the direction of the Assistant Secretary of Defense for Health Affairs with the main goal of increasing understanding of the impact military service has on reproductive health by conducting systematic surveillance of DoD beneficiary births and studying reproductive health outcomes.

Additionally, the Registry team manages the National Smallpox Vaccine in Pregnancy Registry (NSVIPR) and the BioThrax® (Anthrax) Vaccine in Pregnancy Registry (BAVPR), which actively monitor outcomes that follow inadvertent vaccination during pregnancy.


  • The research done by the Registry support the health of military families by addressing their reproductive health concerns with strong science and surveillance.


  • Increase understanding of the reproductive health effects of military service.
  • Examine birth defect rates in military families by investigating population level prevalence following specific exposures.
  • Study other infant outcomes such as preterm birth, low birthweight, and sex ratio.
  • Study pregnancy outcomes such as loss, preterm labor, and preeclampsia.


    The Registry’s researchers and data analysts have direct access to large military databases, allowing for thorough capture of all birth outcomes for infants born to military families.

    Core Data Sources:
  • Military Health System Data Repository (MDR)
  • Defense Enrollment Eligibility Reporting System (DEERS)
  • Defense Manpower Data Center (DMDC)

    Study population:
  • Military Health System beneficiaries, including service members and their families

    Infant outcomes:
  • Data is captured through the first year of life and up to 5 years of age for those with continuous TRICARE enrollment

Key Facts and Findings

  • The Registry contains data on over 1.6 million infants
  • More than 100,000 beneficiary infants are born and added to the Registry annually
  • Birth defect rates are similar for military women and dependent wives, and are consistent with civilian populations

Vaccine in Pregnancy Registries

For more information about the active vaccine in pregnancy registries, click on the links below:

To refer a patient to either the NSVIPR or the BAVPR, please complete and return this Anthrax Vaccine in Pregnancy Referral Form.

Please contact the Registry team at with any questions.