There is now reliable evidence that women living in areas of armed conflict are at significantly increased risk of having low birthweight babies, a Warwick University expert says today.
The identification of pregnancies at risk could improve the efficacy of antenatal care, say Dr James Keasley, of Warwick University, UK, and colleagues in BMJ Global Health today (29 November).
The authors say that civilians exposed to armed conflict are subject to persistent threats of bombing, and both biological and chemical weapons. "Increasingly over recent years, it is these civilians who have been most adversely affected by wars," they write.
"Armed conflicts reduce healthcare provision through the destruction of infrastructure, food and water supplies and sanitation systems," they explain. "This decreases the availability of antenatal and perinatal care for expectant mothers."
They reviewed 13 studies of birth weight involving more than a million women in 12 countries that had experienced armed conflict, including Bosnia, Israel, Libya, and Iraq. This showed a significant link between maternal exposure to armed conflict and increased rates of low birth weight.
The team point out: "The long-term health implications of low birthweight are significant, because individuals are at increased risk of ill health and death, and will require increased medical care throughout their lives.
They recommend that clinicians adjust care accordingly, such as increasing the frequency of ultrasound scans to track the growth of the baby, and be prepared to intervene if required. They also say it is just as important for clinicians in countries not affected by armed conflict to carefully monitor pregnant women who have been displaced by war.
Keasley, J. et al. Adverse effects of exposure to armed conflict on pregnancy: a systematic review. BMJ Global Health 29 November 2017 doi 10.1136/bmjgh-2017-000377 [abstract]
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