(932) Changes in Maternal and Infant Healthcare Utilization Following Armed Conflict: A Nationwide Retrospective Cohort Study

To assess the impact of armed conflict on maternal and neonatal healthcare utilization in the postpartum period.

Study Design:

A retrospective cohort study analyzing maternal and neonatal healthcare utilization in the postpartum period was conducted using data from nine university-affiliated hospitals between October 7, 2022, and April 7, 2024. In October 2023, an armed conflict commenced in Israel. The cohort was divided into two groups: the conflict-exposed group (women who delivered during the six months following October 7, 2023) and the control group (women who delivered during the same calendar period in the preceding year). Data extracted from electronic medical records included maternal demographics, comorbidities, and detailed information on postpartum healthcare utilization, including hospitalizations, emergency department visits, and outpatient consultations for both mothers and their newborns.

Results:
The study included 29,395 deliveries, 14,616 in the conflict-exposed group and 14,779 in the control group. No significant differences were observed between the groups in maternal demographics or preexisting comorbidities. Compared to the control group, women in the conflict-exposed group had shorter postpartum hospitalizations (mean 3.1 ± 2.2 vs. 3.3 ± 2.2 days, p< 0.001), fewer postpartum gynecologic emergency department visits (0.2 ± 0.7 vs. 0.8 ± 0.8, p< 0.001), and their infants had shorter neonatal hospitalizations (2.6 ± 2.9 vs. 2.8 ± 3.2 days, p< 0.001) as well as fewer pediatric outpatient visits (6.3 ± 8.6 vs. 7.5 ± 9.8, p< 0.001). No significant differences were found in maternal or neonatal hospital readmissions.

Conclusion:

Exposure to armed conflict was associated with decreased utilization of postpartum healthcare services and shorter hospital stays for mothers and newborns. These findings may reflect limited access to care, shifting healthcare-seeking behavior, or systemic adaptations under emergency conditions. Further investigation is needed to assess the long-term implications of reduced postnatal follow-up in conflict settings and to inform future policy planning.