Adverse fetal and neonatal impact of war conflicts during pregnancy: A systematic review

Abstract

The aim of the present study was to establish the fetal and neonatal impact of war conflicts during pregnancy. A systematic review was conducted according to The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and relevant publications available in the PubMed, Scopus and Web of Science, and PsycINFO databases. Primary and quantitative studies were eligible for inclusion. To be included, studies had to be redacted in Spanish or English and evaluate maternal exposure to a war or terrorist attack during pregnancy, with consideration being given of the consequences of this for fetal and/or neonatal development. Systematic, narrative and exploratory literature reviews were excluded, as were meta-analyses and studies in which the sample differed from the sample of interest, the focus was on other stressful factors that differed from a war conflict and the consequences examined did not comprise the impact of a war during pregnancy on the fetus or neonate. The methodological quality of included articles was assessed using the CASP (Critical Appraisal Skills Programme) tool. A total of 28 articles were included, with an included sample of n = 664,980 mother-infant dyads, exposed to war conflicts. The adverse impact of prenatal stress suffered by mothers during periods of war revealed that, (1) in the short-term, babies were at greater risk of having a low birth weight and impinged length and being born prematurely, whilst mothers were more likely to suffer a miscarriage. (2) In the long-term, babies exposed to war during the prenatal period had a higher risk of experiencing alterations to their neurodevelopment, mental disorders and pathophysiological diseases. The stress suffered by mothers during the prenatal period can bring about a number of negative consequences over both the short- and long-term in babies, especially, in terms of their physical and neurological development. It is important to conduct further research on the topic with the aim of detecting and treating the early stages of maternal psychological illnesses experienced during pregnancy due to war conflict and, in this way, achieve benefits for pregnant women and future generations.