Dysregulated Neuroimmune and Anhedonia-Like Behavioral Response Following Peripheral Immune Challenge in Mice Carrying the Val66Met Brain-Derived Neurotrophic Factor Polymorphism.

Substance use is a wide-spread problem within the United States (US), with past-month national data indicating that 59% of people used tobacco or vape, 47.5% use alcohol, and 16.8% use an illicit drug (). High rates of substance misuse are observed among female veterans (), who are also more likely to develop health problems compared to their male counterparts (Agabio, et al., 2019). Female veterans are the fastest growing segment of the veteran population, projected to make up 18% of veterans by 2040 (). Despite reports of past-month heavy drinking among female veterans of reproductive age as 27%−32% (), recent Veterans Health Administration (VHA) administrative data indicates that female veterans with substance use disorders (SUD), relative to male veterans with SUD, are less likely to initiate or complete VHA substance use care in adjusted analyses (). As the number of females serving in the military has increased, so too has the number of servicemembers and veterans who are pregnant or postpartum. In a national survey of active duty females, more than 40% reported having been pregnant since joining the military (). Similarly, data showed an exponential increase in VHA-covered births, with 260 in fiscal year (FY) 2000, 1,902 in FY 2010, and 5,583 in FY 2019 (). Pregnant servicemembers may receive pregnancy care through a military treatment facility (on active duty), the Department of Defense (DoD) healthcare system or through community providers (). Because VHA does not provide routine prenatal or pregnancy care within its facilities, such care is contracted to community partners, with a VHA-based maternity care coordination program to help organize care (; ). Therefore, it is essential that community and VHA providers are aware of and screening for health factors, including substance use, among female servicemembers and veterans. Substance use during the perinatal period (i.e., pregnancy and 1-year postpartum; ) is particularly risky. Perinatal substance use is associated with greater likelihood of postpartum depression (), suicide (), re-occurrence of stress/trauma (), and poorer retention in home-based perinatal care (). Furthermore, perinatal substance use has been linked to adverse pregnancy outcomes among US hospital births (; ) and to negative infant outcomes (; ; ). Despite most individuals achieving abstinence for at least one substance during pregnancy, many relapsed by three months after delivery (), highlighting the need for continued screening () and support throughout the postpartum period.