{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:08:54Z","timestamp":1792188534573,"version":"4.4.0"},"reference-count":44,"publisher":"Aerospace Medical Association","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:p><jats:bold>INTRODUCTION:<\/jats:bold> Military aviation poses unique occupational risks, including exposures to intermittent hypoxia, high gravitational force, and toxic materials, in addition to circadian disruption, cosmic radiation, and ergonomic stressors also present in commercial flight. We sought to investigate whether a military aviation officer\u2019s career is associated with adverse maternal or fetal health outcomes.<\/jats:p>\n<jats:p><jats:bold>METHODS:<\/jats:bold> We conducted a retrospective cohort study of female aviation and nonaviation officers in the Military Health System from October 2002 to December 2019. Exposure was identified as assignment of an aviation occupation code. Maternal and fetal health outcomes were identified by International Classification of Diseases codes from medical records. Regression analysis was used to estimate adjusted relative risks (aRR).<\/jats:p>\n<jats:p><jats:bold>RESULTS:<\/jats:bold> Included in the study were 25,929 active-duty female officers, with 46,323 recorded pregnancies and 32,853 recorded deliveries; 2131 pregnancies were diagnosed in aviation officers. Pregnant aviation officers had a decreased risk of composite adverse pregnancy outcomes [aRR 0.82 (0.73\u20130.92)], including gestational diabetes [aRR 0.69 (0.57\u20130.85)] and gestational hypertension [aRR 0.84 (0.71\u20130.99)]. Pregnant aviation officers had a decreased risk of depression prior to delivery [aRR 0.43 (0.35\u20130.53)] and hyperemesis gravidarum [aRR 0.74 (0.57\u20130.96)], but an increased risk of placental complications [aRR 1.15 (1.02\u20131.30)] and fetal growth restriction [aRR 1.36 (1.16\u20131.60)].<\/jats:p>\n<jats:p><jats:bold>DISCUSSION:<\/jats:bold> Pregnant military aviation officers have an increased risk of placental complications and fetal growth restriction in spite of a lower risk of gestational diabetes and gestational hypertension. Further research is needed to determine how flight-related occupations impact pregnancy.<\/jats:p>\n<jats:p><jats:bold>Stark CM, Sorensen IS, Royall M, Dorr M, Brown J, Dobson N, Salzman S, Susi A, Hisle-Gorman E, Huggins BH, Nylund CM. <jats:italic>Maternal and fetal health risks among female military aviation officers<\/jats:italic>. Aerosp Med Hum Perform. 2024; 95(9):675\u2013682.<\/jats:bold><\/jats:p>","DOI":"10.3357\/amhp.6416.2024","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T04:32:00Z","timestamp":1724301120000},"page":"675-682","source":"Crossref","is-referenced-by-count":2,"title":["Maternal and Fetal Health Risks Among Female Military Aviation Officers"],"prefix":"10.3357","volume":"95","author":[{"given":"Christopher M.","family":"Stark","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian S.","family":"Sorensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Royall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeline","family":"Dorr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Dobson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Salzman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apryl","family":"Susi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Hisle-Gorman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian H.","family":"Huggins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cade M.","family":"Nylund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1911","reference":[{"issue":"11","key":"B1","series-title":"J Occup Environ Med.","first-page":"980","article-title":"Mortality among US commercial pilots and navigators","volume":"40","author":"Nicholas JS","year":"1998","unstructured":"Nicholas JS, Lackland DT, Dosemeci M, Mohr LC Jr, Dunbar JB,  Mortality among US commercial pilots and navigators. J Occup Environ Med. 1998; 40(11):980\u2013985. 10.1097\/00043764-199811000-00008"},{"key":"B2","year":"2021","unstructured":"Pressurized cabins. 14 CFR \u00a7 25.841. 2021. [Accessed April 7, 2024]. Available from https:\/\/www.ecfr.gov\/current\/title-14\/chapter-I\/subchapter-C\/part-25\/subpart-D\/subject-group-ECFRc61d71ee0787390\/section-25.841."},{"issue":"2","key":"B3","series-title":"Epidemiology.","first-page":"192","article-title":"Miscarriage among flight attendants","volume":"26","author":"Grajewski B","year":"2015","unstructured":"Grajewski B, Whelan EA, Lawson CC, Hein MJ, Waters MA,  Miscarriage among flight attendants. Epidemiology. 2015; 26(2):192\u2013203. 10.1097\/EDE.0000000000000225"},{"issue":"5","key":"B4","series-title":"Aviat Space Environ Med.","first-page":"533","article-title":"Reproductive disorders and pregnancy outcomes among female flight attendants","volume":"77","author":"Lauria L","year":"2006","unstructured":"Lauria L, Ballard TJ, Caldora M, Mazzanti C, Verdecchia A. Reproductive disorders and pregnancy outcomes among female flight attendants. Aviat Space Environ Med. 2006; 77(5):533\u2013539."},{"issue":"1\u20134","key":"B5","series-title":"Radiat Prot Dosimetry.","first-page":"433","article-title":"In-flight dose estimates for aircraft crew and pregnant female crew members in military transport missions","volume":"125","author":"Alves JG","year":"2007","unstructured":"Alves JG, Mairos JC. In-flight dose estimates for aircraft crew and pregnant female crew members in military transport missions. Radiat Prot Dosimetry. 2007; 125(1\u20134):433\u2013437."},{"issue":"8","key":"B6","series-title":"Aviat Space Environ Med.","first-page":"828","article-title":"Flight attendant radiation dose from solar particle events","volume":"85","author":"Anderson JL","year":"2014","unstructured":"Anderson JL, Mertens CJ, Grajewski B, Luo L, Tseng CY, Cassinelli 2nd RT. Flight attendant radiation dose from solar particle events. Aviat Space Environ Med. 2014; 85(8):828\u2013832. 10.3357\/ASEM.3989.2014"},{"issue":"2","key":"B7","series-title":"Scand J Work Environ Health.","first-page":"94","article-title":"Pregnancy outcome among offspring of airline pilots and cabin attendants","volume":"29","author":"Irgens \u00c5","year":"2003","unstructured":"Irgens \u00c5, Irgens LM, Reitan JB, Haldorsen T, Tveten U. Pregnancy outcome among offspring of airline pilots and cabin attendants. Scand J Work Environ Health. 2003; 29(2):94\u201399. 10.5271\/sjweh.710"},{"issue":"2","key":"B8","series-title":"PLoS One.","first-page":"e0228639","article-title":"Air travel during pregnancy and the risk of adverse pregnancy outcomes as gestational age and weight at birth: a retrospective study among 284,069 women in Israel between the years 2000 to 2016","volume":"15","author":"Shalev Ram H","year":"2020","unstructured":"Shalev Ram H, Ram S, Miller N, Rosental YS, Chodick G. Air travel during pregnancy and the risk of adverse pregnancy outcomes as gestational age and weight at birth: a retrospective study among 284,069 women in Israel between the years 2000 to 2016. PLoS One. 2020; 15(2):e0228639. 10.1371\/journal.pone.0228639"},{"issue":"10","key":"B9","series-title":"J Physiol.","first-page":"2639","article-title":"Intermittent hypoxia impairs uterine artery function in pregnant mice","volume":"597","author":"Badran M","year":"2019","unstructured":"Badran M, Abuyassin B, Ayas N, Laher I. Intermittent hypoxia impairs uterine artery function in pregnant mice. J Physiol. 2019; 597(10):2639\u20132650. 10.1113\/JP277775"},{"issue":"6","key":"B10","series-title":"Environ Health Perspect.","first-page":"855","article-title":"Maternal occupational exposure to noise during pregnancy and hearing dysfunction in children: a nationwide prospective cohort study in Sweden","volume":"124","author":"Selander J","year":"2016","unstructured":"Selander J, Albin M, Rosenhall U, Rylander L, Lewn\u00e9 M, Gustavsson P. Maternal occupational exposure to noise during pregnancy and hearing dysfunction in children: a nationwide prospective cohort study in Sweden. Environ Health Perspect. 2016; 124(6):855\u2013860. 10.1289\/ehp.1509874"},{"key":"B11","series-title":"Sci Total Environ.","first-page":"141476","article-title":"Occupational exposure to whole body vibrations and birth outcomes \u2013 a nationwide cohort study of Swedish women","volume":"751","author":"Skr\u00f6der H","year":"2021","unstructured":"Skr\u00f6der H, Pettersson H, Norl\u00e9n F, Gustavsson P, Rylander L,  Occupational exposure to whole body vibrations and birth outcomes \u2013 a nationwide cohort study of Swedish women. Sci Total Environ. 2021; 751:141476. 10.1016\/j.scitotenv.2020.141476"},{"issue":"2","key":"B12","series-title":"Obstet Gynecol.","first-page":"e64","article-title":"ACOG committee opinion no. 746: air travel during pregnancy","volume":"132","year":"2018","unstructured":"ACOG committee opinion no. 746: air travel during pregnancy. Obstet Gynecol. 2018; 132(2):e64\u2013e66. 10.1097\/AOG.0000000000002757"},{"key":"B13","author":"Taylor JW","year":"2024","unstructured":"Taylor JW, Guilmartin JF. Military aircraft. 2024. [Accessed April 7, 2024]. Available from https:\/\/www.britannica.com\/technology\/military-aircraft."},{"key":"B14","year":"2014","unstructured":"Department of Defense. 14. System safety. In: Department of Defense handbook: airworthiness certification criteria. Washington (DC): Department of Defense; 2014:436\u2013451. Report No.: MIL-HDBK-516C. [Accessed April 7, 2024]. Available from https:\/\/daytonaero.com\/wp-content\/uploads\/MIL-HDBK-516C-from-ASSIST.pdf."},{"issue":"6","key":"B15","series-title":"Aerosp Med Hum Perform.","first-page":"550","article-title":"Incidence of G-induced loss of consciousness and almost loss of consciousness in the Royal Air Force","volume":"88","author":"Slungaard E","year":"2017","unstructured":"Slungaard E, McLeod J, Green ND, Kiran A, Newham DJ, Harridge SD. Incidence of G-induced loss of consciousness and almost loss of consciousness in the Royal Air Force. Aerosp Med Hum Perform. 2017; 88(6):550\u2013555. 10.3357\/AMHP.4752.2017"},{"issue":"10","key":"B16","series-title":"Int J Environ Res Public Health.","first-page":"5395","article-title":"Occupational exposures and environmental health hazards of military personnel","volume":"18","author":"Geretto M","year":"2021","unstructured":"Geretto M, Ferrari M, De Angelis R, Crociata F, Sebastiani N,  Occupational exposures and environmental health hazards of military personnel. Int J Environ Res Public Health. 2021; 18(10):5395. 10.3390\/ijerph18105395"},{"key":"B17","series-title":"Aerospace medicine waiver guide.","article-title":"Pregnancy","author":"Weir L","year":"2023","unstructured":"Weir L, Hicks A, Lee M, Schmidt M. Pregnancy. In: Aerospace medicine waiver guide.  Wright-Patterson AFB (OH): U.S. Air Force School of Aerospace Medicine; 2023. [Accessed April 7, 2024]. Available from https:\/\/www.afrl.af.mil\/711HPW\/USAFSAM\/."},{"key":"B18","series-title":"Clin Epidemiol.","first-page":"1129","article-title":"Impact of the transition from ICD\u20139\u2013CM to ICD\u201310\u2013CM on the identification of pregnancy episodes in US health insurance claims data","volume":"12","author":"Sarayani A","year":"2020","unstructured":"Sarayani A, Wang X, Thai TN, Albogami Y, Jeon N, Winterstein AG. Impact of the transition from ICD\u20139\u2013CM to ICD\u201310\u2013CM on the identification of pregnancy episodes in US health insurance claims data. Clin Epidemiol. 2020; 12:1129\u20131138. 10.2147\/CLEP.S269400"},{"issue":"18","key":"B19","series-title":"Circulation.","first-page":"e902","article-title":"Adverse pregnancy outcomes and cardiovascular disease risk: unique opportunities for cardiovascular disease prevention in women: a scientific statement from the American Heart Association","volume":"143","author":"Parikh NI","year":"2021","unstructured":"Parikh NI, Gonzalez JM, Anderson CA, Judd SE, Rexrode KM,  Adverse pregnancy outcomes and cardiovascular disease risk: unique opportunities for cardiovascular disease prevention in women: a scientific statement from the American Heart Association. Circulation. 2021; 143(18):e902\u2013e916. 10.1161\/CIR.0000000000000961"},{"key":"B20","year":"2023","unstructured":"Centers for Disease Control and Prevention. How does CDC identify severe maternal morbidity? 2023. [Accessed April 7, 2024]. Available from https:\/\/www.cdc.gov\/reproductivehealth\/maternalinfanthealth\/smm\/severe-morbidity-ICD.htm."},{"issue":"2","key":"B21","series-title":"Sultan Qaboos Univ Med J.","first-page":"e172","article-title":"Ergonomic stressors among pregnant healthcare workers: impact on pregnancy outcomes and recommended safety practices","volume":"21","author":"Francis F","year":"2021","unstructured":"Francis F, Johnsunderraj SE, Divya KY, Raghavan D, Al-Furgani A,  Ergonomic stressors among pregnant healthcare workers: impact on pregnancy outcomes and recommended safety practices. Sultan Qaboos Univ Med J. 2021; 21(2):e172\u2013e181. 10.18295\/squmj.2021.21.02.004"},{"issue":"8","key":"B22","series-title":"PLoS One.","first-page":"e0272218","article-title":"Shift work and sleep duration are associated with adverse pregnancy outcomes in a predominantly Latinx population with high rates of obesity","volume":"17","author":"Larson JM","year":"2022","unstructured":"Larson JM, Bazalakova MH, Godecker A, DelBeccaro M, Aagaard KM, Antony KM. Shift work and sleep duration are associated with adverse pregnancy outcomes in a predominantly Latinx population with high rates of obesity. PLoS One. 2022; 17(8):e0272218. 10.1371\/journal.pone.0272218"},{"key":"B23","series-title":"J Reprod Immunol.","first-page":"104166","article-title":"Sleep deprivation during pregnancy leads to poor fetal outcomes in Sprague-Dawley rats","volume":"160","author":"Li J","year":"2023","unstructured":"Li J, Peng X, Zhong H, Liu S, Shi J,  Sleep deprivation during pregnancy leads to poor fetal outcomes in Sprague-Dawley rats. J Reprod Immunol. 2023; 160:104166. 10.1016\/j.jri.2023.104166"},{"key":"B24","series-title":"Front Immunol.","first-page":"531543","article-title":"Maternal-fetal inflammation in the placenta and the developmental origins of health and disease","volume":"11","author":"Goldstein JA","year":"2020","unstructured":"Goldstein JA, Gallagher K, Beck C, Kumar R, Gernand AD. Maternal-fetal inflammation in the placenta and the developmental origins of health and disease. Front Immunol. 2020; 11:531543. 10.3389\/fimmu.2020.531543"},{"issue":"19","key":"B25","series-title":"J Clin Med.","first-page":"5736","article-title":"Gestational diabetes mellitus \u2013 recent literature review","volume":"11","author":"Modzelewski R","year":"2022","unstructured":"Modzelewski R, Stefanowicz-Rutkowska MM, Matuszewski W, Bandurska-Stankiewicz EM. Gestational diabetes mellitus \u2013 recent literature review. J Clin Med. 2022; 11(19):5736. 10.3390\/jcm11195736"},{"issue":"210","key":"B26","series-title":"Evid Rep Technol Assess (Full Rep).","first-page":"1","article-title":"Screening and diagnosing gestational diabetes mellitus","volume":"2012","author":"Hartling L","year":"2012","unstructured":"Hartling L, Dryden DM, Guthrie A, Muise M, Vandermeer B,  Screening and diagnosing gestational diabetes mellitus. Evid Rep Technol Assess (Full Rep). 2012; 2012(210):1\u2013327."},{"issue":"1","key":"B27","series-title":"Br Med Bull.","first-page":"173","article-title":"Long-term consequences for offspring of diabetes during pregnancy","volume":"60","author":"Van Assche FA","year":"2001","unstructured":"Van Assche FA, Holemans K, Aerts L. Long-term consequences for offspring of diabetes during pregnancy. Br Med Bull. 2001; 60(1):173\u2013182. 10.1093\/bmb\/60.1.173"},{"issue":"12","key":"B28","series-title":"Nutrients.","first-page":"3645","article-title":"Gestational diabetes mellitus: predictive value of fetal growth measurements by ultrasonography at 22-24 weeks: a retrospective cohort study of medical records","volume":"12","author":"Jin D","year":"2020","unstructured":"Jin D, Rich-Edwards JW, Chen C, Huang Y, Wang Y,  Gestational diabetes mellitus: predictive value of fetal growth measurements by ultrasonography at 22-24 weeks: a retrospective cohort study of medical records. Nutrients. 2020; 12(12):3645. 10.3390\/nu12123645"},{"key":"B29","series-title":"SAGE Open Med.","first-page":"2050312119843700","article-title":"Hypertension in pregnancy: pathophysiology and treatment","volume":"7","author":"Braunthal S","year":"2019","unstructured":"Braunthal S, Brateanu A. Hypertension in pregnancy: pathophysiology and treatment. SAGE Open Med. 2019; 7:2050312119843700. 10.1177\/2050312119843700"},{"issue":"7","key":"B30","series-title":"J Obstet Gynaecol Can.","first-page":"642","article-title":"Gestational hypertension and preeclampsia: are they the same disease?","volume":"36","author":"Melamed N","year":"2014","unstructured":"Melamed N, Ray JG, Hladunewich M, Cox B, Kingdom JC. Gestational hypertension and preeclampsia: are they the same disease? J Obstet Gynaecol Can. 2014; 36(7):642\u2013647. 10.1016\/S1701-2163(15)30545-4"},{"issue":"1","key":"B31","series-title":"Hypertension.","first-page":"36","article-title":"Associations of blood pressure change in pregnancy with fetal growth and gestational age at delivery: findings from a prospective cohort","volume":"64","author":"Macdonald-Wallis C","year":"2014","unstructured":"Macdonald-Wallis C, Tilling K, Fraser A, Nelson SM, Lawlor DA. Associations of blood pressure change in pregnancy with fetal growth and gestational age at delivery: findings from a prospective cohort. Hypertension. 2014; 64(1):36\u201344. 10.1161\/HYPERTENSIONAHA.113.02766"},{"issue":"4","key":"B32","series-title":"J Occup Environ Med.","first-page":"e245","article-title":"Healthcare avoidance in aircraft pilots due to concern for aeromedical certificate loss: a survey of 3765 pilots","volume":"64","author":"Hoffman WR","year":"2022","unstructured":"Hoffman WR, Aden J, Barbera RD, Mayes R, Willis A,  Healthcare avoidance in aircraft pilots due to concern for aeromedical certificate loss: a survey of 3765 pilots. J Occup Environ Med. 2022; 64(4):e245\u2013e248. 10.1097\/JOM.0000000000002519"},{"issue":"3\u20134","key":"B33","series-title":"Mil Med.","first-page":"e446","article-title":"Self-reported health care avoidance behavior in U.S. military pilots related to fear for loss of flying status","volume":"188","author":"Hoffman WR","year":"2023","unstructured":"Hoffman WR, Aden JK, Barbera D, Tvaryanas A. Self-reported health care avoidance behavior in U.S. military pilots related to fear for loss of flying status. Mil Med. 2023; 188(3\u20134):e446\u2013e450. 10.1093\/milmed\/usac311"},{"issue":"1","key":"B34","series-title":"Air Med J.","first-page":"30","article-title":"Flight crew physical fitness: a baseline analysis","volume":"14","author":"Shaner S","year":"1995","unstructured":"Shaner S, Brooks C, Osborn R, Hull M, Falcone RE. Flight crew physical fitness: a baseline analysis. Air Med J. 1995; 14(1):30\u201332. 10.1016\/1067-991X(95)90029-2"},{"issue":"1","key":"B35","series-title":"BMC Sports Sci Med Rehabil.","first-page":"153","article-title":"Changes in physical fitness and body composition of pilot cadets before and after a process of directed flight preparation","volume":"14","author":"Prokopczyk A","year":"2022","unstructured":"Prokopczyk A, Wochy\u0144ski Z. Changes in physical fitness and body composition of pilot cadets before and after a process of directed flight preparation. BMC Sports Sci Med Rehabil. 2022; 14(1):153. 10.1186\/s13102-022-00547-6"},{"issue":"6","key":"B36","series-title":"JAMA Psychiatry.","first-page":"550","article-title":"Association between physical activity and risk of depression: a systematic review and meta-analysis","volume":"79","author":"Pearce M","year":"2022","unstructured":"Pearce M, Garcia L, Abbas A, Strain T, Schuch FB,  Association between physical activity and risk of depression: a systematic review and meta-analysis. JAMA Psychiatry. 2022; 79(6):550\u2013559. 10.1001\/jamapsychiatry.2022.0609"},{"key":"B37","series-title":"Front Med (Lausanne).","first-page":"809270","article-title":"Emerging progress in nausea and vomiting of pregnancy and hyperemesis gravidarum: challenges and opportunities","volume":"8","author":"Liu C","year":"2022","unstructured":"Liu C, Zhao G, Qiao D, Wang L, He Y,  Emerging progress in nausea and vomiting of pregnancy and hyperemesis gravidarum: challenges and opportunities. Front Med (Lausanne). 2022; 8:809270. 10.3389\/fmed.2021.809270"},{"key":"B38","series-title":"Prev Med.","first-page":"49","article-title":"Leisure-time physical activity before pregnancy and risk of hyperemesis gravidarum: a population-based cohort study","volume":"125","author":"Owe KM","year":"2019","unstructured":"Owe KM, St\u00f8er N, Wold BH, Magnus MC, Nystad W, Vikanes \u00c5V. Leisure-time physical activity before pregnancy and risk of hyperemesis gravidarum: a population-based cohort study. Prev Med. 2019; 125:49\u201354. 10.1016\/j.ypmed.2019.05.002"},{"issue":"1","key":"B39","series-title":"BMC Pregnancy Childbirth.","first-page":"374","article-title":"Hyperemesis gravidarum and placental dysfunction disorders","volume":"16","author":"Koudijs HM","year":"2016","unstructured":"Koudijs HM, Savitri AI, Browne JL, Amelia D, Baharuddin M,  Hyperemesis gravidarum and placental dysfunction disorders. BMC Pregnancy Childbirth. 2016; 16(1):374. 10.1186\/s12884-016-1174-7"},{"issue":"3","key":"B40","series-title":"Stud Fam Plann.","first-page":"187","article-title":"Underreporting of induced and spontaneous abortion in the United States: an analysis of the 2002 National Survey of Family Growth","volume":"38","author":"Jones RK","year":"2007","unstructured":"Jones RK, Kost K. Underreporting of induced and spontaneous abortion in the United States: an analysis of the 2002 National Survey of Family Growth. Stud Fam Plann. 2007; 38(3):187\u2013197. 10.1111\/j.1728-4465.2007.00130.x"},{"issue":"5","key":"B41","series-title":"Am J Obstet Gynecol.","first-page":"512.e1","article-title":"Race matters: maternal morbidity in the Military Health System","volume":"224","author":"Hamilton JL","year":"2021","unstructured":"Hamilton JL, Shumbusho D, Cooper D, Fletcher T, Aden J,  Race matters: maternal morbidity in the Military Health System. Am J Obstet Gynecol. 2021; 224(5):512.e1\u2013512.e6. 10.1016\/j.ajog.2021.02.036"},{"issue":"10","key":"B42","series-title":"Int J Environ Res Public Health.","first-page":"5849","article-title":"Aircrew health: a systematic review of physical agents as occupational risk factors","volume":"20","author":"Russo AC","year":"2023","unstructured":"Russo AC, Marqueze EC, Furst MS, de S\u00e1 E, Benevides EA,  Aircrew health: a systematic review of physical agents as occupational risk factors. Int J Environ Res Public Health. 2023; 20(10):5849. 10.3390\/ijerph20105849"},{"issue":"4","key":"B43","series-title":"Int J Environ Res Public Health.","first-page":"3401","article-title":"Organizational risk factors for aircrew health: a systematic review of observational studies","volume":"20","author":"Marqueze EC","year":"2023","unstructured":"Marqueze EC, de S\u00e1 E, Benevides EA, Russo AC, F\u00fcrst MS,  Organizational risk factors for aircrew health: a systematic review of observational studies. Int J Environ Res Public Health. 2023; 20(4):3401. 10.3390\/ijerph20043401"},{"key":"B44","year":"2021","unstructured":"U.S. Air Force. Section J: genitourinary & gynecology USAF medical standards, J57. In: Medical standards directory (MSD). 2021:36. [Accessed April 1, 2024]. Available from https:\/\/afspecialwarfare.com\/files\/MSD%2019%20Mar%202021.pdf."}],"container-title":["Aerospace Medicine and Human Performance"],"original-title":[],"link":[{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/95\/9\/article-p675.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/95\/9\/article-p675.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/95\/9\/article-p675.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:01:20Z","timestamp":1740096080000},"score":1,"resource":{"primary":{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/95\/9\/article-p675.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":44,"journal-issue":{"issue":"9"},"URL":"https:\/\/doi.org\/10.3357\/amhp.6416.2024","relation":{},"ISSN":["2375-6314","2375-6322"],"issn-type":[{"value":"2375-6314","type":"print"},{"value":"2375-6322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9]]}}}