Sign In

Reproductive Health

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



The U.S. Department of Defense (DoD) is tasked with protecting and promoting the health of service members and their families. Concerns exist that the unique occupational exposures inherent in military service may pose reproductive health risks. Additionally, the increasing number of women serving in the military underscores the need to identify any potential risks. Recognizing this, the Assistant Secretary of Defense for Health Affairs directed the establishment of a birth defects surveillance program for military families in 1998. As a result, the DoD Birth and Infant Health Research program was established and is led by the Naval Health Research Center.

Initially developed to monitor birth defects, the mission of the research program has expanded to conduct regular surveillance of births to military members and their immediate families and ongoing research of maternal, pregnancy, and infant health outcomes (including birth defects) to understand how military service affects reproductive health.

The research team also manages the National Smallpox Vaccine in Pregnancy Registry (NSVIPR) and the BioThrax® (Anthrax) Vaccine in Pregnancy Registry (BAVPR), two studies that actively enroll women who are inadvertently vaccinated during pregnancy. Once enrolled, these women are surveyed periodically, until there is an outcome (loss or live birth). Infants of mothers exposed to these vaccines are followed to monitor their health outcomes for either one year (BAVPR) or into early school age (NSVIPR).


  • The research conducted by the DoD Birth and Infant Health Research team supports the health of military families by assessing potential risks related to reproductive health outcomes. Findings are shared with military leadership and the scientific community to help direct future policies related to reproductive health.


  • Increase understanding of the reproductive health effects of military service
  • Examine birth defect rates in military families and investigate those rates based on 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 team’s researchers have direct access to large databases, allowing for thorough capture of:
  • Pregnancy and maternal outcomes among military members and their immediate families
  • All birth and health outcomes for infants born to military families up to their first birthday, or beyond for those with continuous care in the system through early school age

  • 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 immediate families

  • Health Outcomes:
  • Maternal and pregnancy (such as pregnancy loss, pre-eclampsia, preterm labor, gestational diabetes)
  • Infant (such as birth defects, preterm birth, birth weight, growth problems in utero or in infancy)

  • Potential Risk Factors:
  • Parent demographics (such as sponsor and maternal age, sponsor race/ethnicity)
  • Military-unique (such as deployment, geographical location, occupation)
  • Vaccinations (complete vaccination records for military members, as many are mandatory, provide the capability to assess risks/benefits related to vaccinations received in pregnancy)

Key Facts and Findings

  • Approximately 100,000 infants are born to military families annually and are included in the program’s surveillance and research
  • Over 1.8 million infants, born 1998-2014, are included in the database
  • Birth defect rates are similar for military women and dependent spouses, and are consistent with rates among civilians
  • Rates of maternal adverse outcomes (such as pregnancy loss) among active duty women are comparable to or lower than rates among the general U.S. population

Questions? Please contact the research team at with any questions.

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 vaccine in pregnancy research team at with any questions.