{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T05:45:24Z","timestamp":1771307124716,"version":"3.50.1"},"reference-count":36,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2020,6,25]],"date-time":"2020-06-25T00:00:00Z","timestamp":1593043200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Prehosp. Disaster med."],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1049023X2000076X_as1\"><jats:title>Background:<\/jats:title><jats:p>Sulphur mustard (HD) is a lipophilic caustic alkylating vesicant (blister agent) that has mutagenic and carcinogenic effects. Among the studied perturbations are long-term genitourinary (GU) and fertility effects. Approximately 50,000 Iranian soldiers and civilians were exposed to HD during the Iraq-Iran war (1980-1989). This study questioned the wives of Iraq-Iran war veterans to determine the effects of male HD-exposure on pregnancy complications, adverse pregnancy outcomes, and secondary infertility.<\/jats:p><\/jats:sec><jats:sec id=\"S1049023X2000076X_as2\"><jats:title>Methods:<\/jats:title><jats:p>A retrospective, survey-based cohort study was conducted of wives of Iranian military veterans that survived HD-associated injuries while serving in Ahvaz, Iran during the Iraq-Iran war (1980-1989), as compared to non-exposed veterans serving concomitantly. Patients were identified from a database of injured veterans maintained by the Foundation of Martyrs and Veterans Affairs (Iran) via a systematic random sampling method utilizing a random number table. Using a validated questionnaire, collected data included: demographics; type and severity of chemical injury; spouse\u2019s obstetric history (pregnancy number, duration, complications, and outcomes before and after spouse\u2019s chemical injury); and secondary infertility.<\/jats:p><\/jats:sec><jats:sec id=\"S1049023X2000076X_as3\"><jats:title>Results:<\/jats:title><jats:p>An increase in spontaneous abortion (P = .03), congenital anomalies (P &lt; .0001), and secondary infertility (P = .003) were observed. These findings were greatest amongst those with HD injuries affecting &gt;50% body surface area. No difference in stillbirth, premature birth, or low birth weight was observed.<\/jats:p><\/jats:sec><jats:sec id=\"S1049023X2000076X_as4\"><jats:title>Conclusion:<\/jats:title><jats:p>Exposure to HD in combat may have long-lasting fertility effects on soldiers and their spouses, including spontaneous abortion, congenital anomalies, and secondary infertility. Further investigation is needed into the long-term effects of HD exposure as well as methods to better protect soldiers.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1049023x2000076x","type":"journal-article","created":{"date-parts":[[2020,6,25]],"date-time":"2020-06-25T05:37:53Z","timestamp":1593063473000},"page":"477-481","source":"Crossref","is-referenced-by-count":4,"title":["Pregnancy Outcomes of Wives of Chemical and Non-Chemical Weapons Exposed Veterans in Ahvaz, Iran: A Retrospective Cohort Study"],"prefix":"10.1017","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8928-8220","authenticated-orcid":false,"given":"Leila","family":"Karimi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8474-5090","authenticated-orcid":false,"given":"Andrew C.","family":"Miller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1813-3333","authenticated-orcid":false,"given":"Alberto A.","family":"Castro Bigalli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Somaye","family":"Makvandi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0914-8768","authenticated-orcid":false,"given":"Hossein","family":"Amini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1678-7608","authenticated-orcid":false,"given":"Amir","family":"Vahedian-Azimi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2020,6,25]]},"reference":[{"key":"S1049023X2000076X_ref1","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1111\/j.1365-2605.2008.00938.x","article-title":"Chronic mustard toxicity on the testis: a historical cohort study two decades after exposure","volume":"32","author":"Amirzargar","year":"2009","journal-title":"Int J Androl."},{"key":"S1049023X2000076X_ref4","first-page":"59","article-title":"Long-term effect of exposure to mustard gas on male infertility","volume":"9","author":"Shakeri","year":"2007","journal-title":"Iran Red Crescent Med J."},{"key":"S1049023X2000076X_ref25","first-page":"499","article-title":"Risk factor of preterm labor in the west of Iran: a case-control study","volume":"43","author":"Derakhshi","year":"2014","journal-title":"Iran J Public Health."},{"key":"S1049023X2000076X_ref8","unstructured":"8. 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