Exploring maternal and neonatal health in a conflict-affected setting: cross-sectional findings from Gaza

Women experiencing armed conflict during pregnancy face a significantly higher risk of maternal and neonatal complications, including low-birthweight (LBW) babies, due to factors such as violence, stress, food insecurity, and limited access to healthcare. This study aims to explore maternal and neonatal health, as well as antenatal care (ANC) access during the war in Gaza.

This cross-sectional study involved 500 consecutive women and newborns delivered at the three largest obstetric centers in the Gaza Strip over a three-week span in late October and early November 2024. The research collected sociodemographic details, maternal obstetric histories, maternal nutrition variables, maternal stress effects, and other impacts from the conflict, as well as neonatal outcomes, including birthweight. Frequencies, percentages, and the median and interquartile range (IQR) were used to describe the data. The Mann-Whitney test was applied to compare birthweights between populations based on sex and geographical location.

The median maternal age was 28. Nearly half (52.63%) had a normal baseline body mass index (BMI). Most (84.03%) reported a very low monthly income. The prevalence of maternal anemia was 50.4%. A majority of participants (62.73%) reported an insufficient quantity of food, while 73.6% noted a lack of dietary diversity. Over half consumed, on average, only two full meals daily, and their diets largely lacked animal protein. Only 36.68% attended eight or more ANC visits, and just 58.4% established their first ANC contact during the first trimester. The most common reason for the lack of ANC was the inability to afford transportation. Moreover, 69.46% adhered to folic acid and iron supplementation. Most (90.42%) participants reported moderate to high stress levels, with 40.92% and 33.93% feeling almost always or often endangered. The prevalence of LBW was 10.8%, and the median weight was 3100 g.

This study illustrates the vulnerability of pregnant women during conflicts and emphasizes the responsibility of those involved in conflicts to protect pregnant women and newborns and safeguard their future development and health.