Poster Session 4
Category: Public Health/Global Health
Poster Session 4
Tamar Wainstock, PhD (she/her/hers)
Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev
Beer Sheva, HaDarom, Israel
Polina Schwarzman, MD
Soroka University Medical Center
Soroka University Medical Center, HaDarom, Israel
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Eyal Sheiner, MD, PhD
Deichmann Lerner Full Professor of Obstetrics & Gynecology; Chairman of the Division of OBY&GYN
Soroka University Medical Center, Faculty of Health Sciences, Ben‑Gurion University of the Negev
beer sheva, HaDarom, Israel
Armed conflicts represent an acute and severe source of maternal stress, yet their long-term effects on offspring immune outcomes remain underexplored. This study aimed to evaluate whether in utero exposure to maternal stress induced by military conflict influences the incidence of infectious morbidity during childhood and adolescence.
Study Design:
A retrospective population-based cohort study was conducted, including all singleton live births at a large tertiary medical center between 2008 and 2021. During this period, two distinct military conflicts occurred in the region, each lasting up to three weeks. Offspring were categorized as “exposed” if gestation overlapped with either conflict, and “unexposed” if not. The primary outcome was the incidence of the first diagnosis of infectious morbidity documented in either hospital or community-based records, up to age 18 years. Multivariable Cox proportional hazards models were used to estimate the association between prenatal conflict exposure and offspring infectious diseases, adjusting for clinically relevant variables.
Results:
Of the 130656 offspring in the study, 22481 (17.2%) were exposed in-utero to war, and 8922 (6.8%) were exposed specifically during first trimester . Offspring exposed in utero to war had a lower risk of infectious morbidities (252.91/ 1000 person years, versus 309.45/1000 person years, p=0.013, Graph). The risk for infectious diseases was lower, regardless of the trimester of exposure, preterm delivery, gestational diabetes, maternal age, caesarean delivery and ethnicity (aHR=0.97; 0.95-0.99), using a Cox proportional hazards model.
Conclusion:
Prenatal exposure to maternal stress related to brief military conflicts, is associated with a reduced risk of childhood infectious morbidity. These unexpected findings suggest a potential adaptive or compensatory immune mechanism in the exposed offspring. Further research is warranted to explore the underlying biological pathways and to determine whether the nature, timing, or duration of stress exposure plays a role in shaping immune resilience.