Poster Session 2
Category: Health Equity/Community Health
Poster Session 2
Roy Bitan, MD, MHA
Lis Hospital for Women’s Health
Tel Aviv, Tel Aviv, Israel
Racheli Magnezi, PhD
Department of Management, Health Systems Management Program, Bar Ilan University, Ramat Gan, Israel
Ramat Gan, HaMerkaz, Israel
Uri Amikam, MD, MHA (he/him/his)
MFM Specialist
Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center
Tel Aviv, Tel Aviv, Israel
To assess the impact of evacuation from conflict zones on obstetric and neonatal outcomes during a large-scale armed conflict that commenced in Israel in October 2023.
Study Design:
A retrospective cohort study was conducted using data from nine university-affiliated hospitals in Israel. Deliveries between October 7, 2023, and April 7, 2024, were included. Women residing in government-designated evacuation zones formed the study group, while women from non-evacuated regions served as controls. Electronic medical records were reviewed, including maternal demographics, obstetric history, comorbidities, and obstetric and neonatal outcomes. Propensity score matching (1:3) was performed based on maternal age, socioeconomic status, parity, and the presence of chronic comorbidities.
Results:
The total cohort included 14,017 deliveries, of which 321 (2.3%) were from evacuated zones. In the unmatched cohort, evacuated women had higher rates of pregestational diabetes mellitus and malignancy, and they were more likely to belong to lower socioeconomic groups and to identify as Jewish. Preterm birth (PTB) was more common in the evacuated group (7.2% vs. 4.9%, p=0.058, respectively), approaching statistical significance. Postpartum hemorrhage (PPH) was significantly lower in the evacuated group (1.6% vs. 4.4%, p=0.013, respectively). Other obstetric and neonatal outcomes did not differ significantly between the two groups. Following matching (288 evacuated vs. 864 controls), baseline characteristics were well-balanced. The trend toward increased PTB in the evacuated group persisted (7.3% vs. 4.6%, p=0.081, respectively). The incidence of PPH remained significantly less frequent in the evacuated group (1.4% vs. 4.5%, p=0.015, respectively).
Conclusion:
Evacuation during conflict was associated with a non-significant trend toward an increased incidence of PTB and a significantly lower incidence of PPH. These findings emphasize the need for nuanced evaluation of maternal stress and health system adaptations during wartime displacement.