Pediatric Health Risks Among Children of Female Military Aviation Officers

INTRODUCTION: Female aviators and aircrew face unique occupational exposures, including noise, whole-body vibrations, toxic chemicals, intermittent hypoxia, and high gravitational forces. We evaluated associations between maternal occupations as aviators and aircrew during pregnancy and adverse pediatric health outcomes. METHODS: We conducted a retrospective cohort study of children born to female U.S. military officers from October 2002 to December 2019. Exposure was defined as the mother serving in an aviation or aircrew occupation at time of birth. Adverse health outcomes were identified by International Classification of Diseases codes. Cox proportional hazards regression was performed, adjusting for maternal age at delivery, maternal race and ethnicity, and marital status. A post hoc power analysis was performed. RESULTS: T he study included 18,637 female officers. There were 1144 children of fixed-wing aviation officers and 25,889 children of non-aviation officers. There was decreased risk of adverse neurodevelopmental outcomes [hazard ratio (HR), 0.81; 95% confidence interval (CI), 0.68–0.95], speech delay (HR, 0.72; 95% CI, 0.59–0.89), and other and unspecified congenital anomalies (HR, 0.74; 95% CI, 0.60–0.90) for children of aviators. There was no increased risk for any of the adverse pediatric outcomes. Five outcomes had sufficient sample size to detect significance. DISCUSSION: A lthough this study suggests that children of military officers in aviation careers do not have an increased risk for adverse pediatric outcomes, it was underpowered and cannot conclusively imply safety of maternal aviation occupational exposures during pregnancy. Further research must evaluate how prenatal exposure to flight affects subsequent pediatric health outcomes.