Impact of armed conflict on maternal and neonatal health and birth weight: a cross-sectional study in the Gaza-Strip

Background Women who experience armed conflict during pregnancy are at significantly higher risk of maternal and neonatal complications and having low-birth-weight (LBW) babies due to factors such as violence, stress, food insecurity, and health inaccessibility. This study aims to explore the implications of the 2023–2025 armed conflict in the Gaza Strip on maternal and neonatal health and its effect on birth weight and maternal access to antenatal care (ANC). Methods This cross-sectional study included 500 consecutive women and neonates delivered in three obstetric centers in different areas of the Gaza Strip in October and November 2024. The study collected sociodemographic information, maternal obstetric history, maternal nutrition, maternal stress and other impacts of the conflict, and neonatal outcomes, including birth weight. Frequencies, percentages, and median and interquartile range (IQR) were used to describe the data. Correlations between nonparametric continuous variables were tested with the Spearman correlation test. Mann-Whitney test was used to compare birth weight between populations based on residence and sex. Results The median age was 28. Nearly half (52.63%) had a normal baseline BMI. Most (84.03%) had a very low monthly income. The prevalence of maternal anemia was 50.4%. Most participants (62.73%) reported insufficient food quantity and 73.6% insufficient diversity. Over half consumed only two full meals daily on average, and the diet largely lacked animal protein. Only 36.68% had eight or more ANC visits, and only 58.4% could establish the first ANC contact during the first trimester. The commonest cause for the lack of ANC was the inability to afford transportation. Also, 69.46% adhered to folic acid and iron supplementation. Most (90.42%) participants reported moderate to high stress levels, with 40.92% and 33.93% feeling almost always or often endangered. The prevalence of LBW was 10.8%, and the median weight was 3100 gm. Discussion This study demonstrates the vulnerability of pregnant women during conflicts. It reveals the significant impacts of the 2023–2025 armed conflict in the Gaza Strip on maternal and neonatal health, including an increased LBW rate compared to pre-war data.