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Perinatal outcomes during wartime: a multicenter retrospective cohort study in Israel, 2022-2024
Roy Bitan1,2,3, Racheli Magnezi4, Inbal Reuveni5,6
1Department of Management, Health Systems Management Program, Bar Ilan University, Ramat Gan, Israel. roybitan2611@gmail.com.
BMC Pregnancy and Childbirth
|October 30, 2025
Summary
Wartime exposure increased risks for pregnant women, leading to higher rates of premature rupture of membranes (PROM), preterm PROM (PPROM), gestational diabetes mellitus (GDM), and postpartum hemorrhage (PPH). These pregnancy complications highlight the need for support during conflict.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Psychosomatic Medicine
Background:
- Armed conflicts significantly disrupt healthcare and increase psychological stress for pregnant women.
- This stress can lead to adverse pregnancy and birth outcomes.
Purpose of the Study:
- To assess the impact of wartime conditions on pregnancy and birth outcomes among Israeli women.
- To identify specific complications associated with conflict exposure during pregnancy.
Main Methods:
- A retrospective cohort study analyzed 30,868 deliveries from October 2022 to April 2024.
- Compared a conflict-exposed group (post-October 7, 2023) with a control group from the previous year.
- Utilized electronic medical records and multivariable logistic regression, adjusting for confounders.
Main Results:
- Conflict-exposed women showed higher rates of premature rupture of membranes (PROM) (15.4% vs. 11.5%), preterm PROM (PPROM) (3.4% vs. 3%), gestational diabetes mellitus (GDM) (10.8% vs. 10.0%), and postpartum hemorrhage (PPH) (4.4% vs. 3.6%).
- No significant differences were found in preterm birth rates or low birth weight.
- Multivariable analysis confirmed independent links between conflict exposure and increased risks of PROM, PPROM, GDM, and PPH.
Conclusions:
- Wartime exposure is linked to increased risks of GDM, PPROM, and PPH.
- Findings emphasize the need for research on war-related stress impacts on pregnancy.
- Highlights the importance of psychological and medical support for pregnant women during conflict.
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