Peer-reviewed article
Impact of Armed Conflicts on Neonatal Health: A Scoping Review
Shela Akbar Ali Hirani, Oladayo Nathaniel Awojobi ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This scoping review brings together 29 articles published between 2006 and 2025 on how armed conflict affects the health of newborns in their first 28 days. Armed conflict was linked to higher neonatal death, preterm birth, low birth weight, congenital anomalies and illness. The review describes several routes of harm, including violence, disrupted health care, displacement, food insecurity, environmental hazards and maternal stress. It calls for stronger health systems, continued maternal and newborn services, and mental health and psychosocial support for mothers.
Key points
- Four themes emerged: war-driven neonatal adversity, health system collapse, risks of alternative and non-formal care practices, and stress-related biological and epigenetic changes.
- Armed conflict was associated with higher neonatal mortality, preterm birth, low birth weight, congenital anomalies and neonatal morbidity.
- Pathways included violence exposure, healthcare disruption, displacement, food insecurity, environmental hazards and maternal psychological stress.
- Emerging evidence of epigenetic changes suggests possible longer-term consequences.
- Priorities include health system resilience, continuity of maternal-newborn services and maternal mental health and psychosocial support.
Limitations
The abstract does not name the specific countries or conflicts covered, so findings cannot be tied to particular places. It also reports associations from a scoping review, which maps evidence rather than testing interventions, and notes that protracted conflict settings are underrepresented.
Abstract
Introduction/Objective Armed conflicts threaten maternal and neonatal health, yet evidence on neonatal outcomes remains fragmented. This scoping review mapped evidence on armed conflict’s impact on neonatal health and identified pathways influencing outcomes. Methods This scoping review followed Arksey and O’Malley’s framework and PRISMA-ScR guidelines. MEDLINE/PubMed, Web of Science, Embase, Global Health (CABI), and CINAHL were searched, supplemented by Google Scholar and reference-list screening. Articles published from 2006 to 2025 reporting neonatal health outcomes (0-28 days) in conflict-affected settings were included. Maternal and pregnancy-related factors were considered when linked to neonatal outcomes. Twenty-nine articles were synthesized thematically. Results Four overarching themes emerged: (1) war-driven neonatal adversity, (2) health system collapse impact, (3) risks associated with alternative and non-formal care practices, and (4) stress-associated biological and epigenetic changes. Armed conflict was associated with increased neonatal mortality, preterm birth, low birth weight, congenital anomalies, and neonatal morbidity. Pathways included violence exposure, healthcare disruption, displacement, food insecurity, environmental hazards, and maternal psychological stress. Discussion Conflict affects neonatal health through interconnected biological, social, environmental, and health system pathways. Health system disruption, reduced access to skilled care, unsafe care practices, and maternal stress may compound adverse outcomes. Emerging evidence of epigenetic changes suggests potential longer-term consequences and underscores the need for integrated humanitarian and health system responses. Conclusion Priorities include strengthening health system resilience, ensuring continuity of maternal-newborn services, and integrating context-appropriate maternal mental health and psychosocial support. Further research should identify feasible, culturally responsive, and scalable interventions in underrepresented and protracted conflict settings.