Poster Session 4
Category: Prematurity
Poster Session 4
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
Roza Shperling-Berkovitz, MD, MPH
Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center
ichilov, 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 examine whether varying levels of missile exposure during armed conflict are associated with differences in obstetric outcomes, specifically preterm birth (PTB), and low birth weight (LBW) (< 2,500 grams).
Study Design:
A retrospective cohort study utilizing data from nine university-affiliated hospitals in Israel. Women who gave birth between October 7, 2023, and April 7, 2024, were included. In October 2023, an armed conflict commenced in Israel. Based on the number of missile alerts in their area of residence during this period, parturients were classified into three exposure groups: low (0–5 missiles) (less than once a month), medium (6–30 missiles), and high ( >30 missiles) (more than once a week). The rates of PTB (< 37 gestational weeks) and LBW (< 2,500 grams) were compared between groups. Multivariate logistic regression adjusted for confounders.
Results:
Overall, 10,392 women were included: 3,212 in the low-exposure group, 4,525 in the medium-exposure group, and 2,655 in the high-exposure group. Women in the low-exposure group were significantly younger and had lower socioeconomic status compared to the other groups (p< 0.001); preexisting comorbidities were comparable. Regarding obstetric outcomes, no statistically significant differences were found between groups in the rates of PTB or LBW. However, in multivariate logistic regression analysis adjusting for maternal age, parity, socioeconomic status, and maternal comorbidities, the association between high missile exposure and PTB approached statistical significance (adjusted odds ratio 1.25, 95% Confidence Interval 0.98–1.60; P-value=0.077).
Conclusion:
Despite the assumption that higher missile exposure increases stress, no significant differences in PTB or LBW were found across exposure levels. This may reflect the Israeli healthcare system's resilience and preparedness during wartime, maintaining prenatal, mental health, and obstetric care even in heavily affected areas. Further research is needed on long-term developmental outcomes and personalized stress responses in pregnancy.