Abstract / Summary
ObjectivesTo assess the association between armed conflict exposure and neonatal outcomes, including preterm birth, stillbirth, neonatal mortality, and anthropometric measures.MethodsWe conducted this systematic review following PRISMA guidelines. PubMed, EMBASE, Web of Science, and SCOPUS were searched from inception to January 2026. Studies examining neonatal outcomes among populations exposed to armed conflict, compared with non-exposed or pre-war populations were included. Meta-analyses were conducted using RevMan 5.4 software.ResultsSeven studies encompassing diverse conflict settings met the inclusion criteria. No significant associations were observed for preterm birth (OR 0.80, 95% CI 0.61–1.05), stillbirth (OR 0.98, 95% CI 0.93–1.05), or neonatal mortality (OR 1.07, 95% CI 0.73–1.56) after accounting for heterogeneity. Conflict-exposed neonates had higher birth weight (MD 1.56 kg, 95% CI 0.55–2.56) and head circumference (MD 0.60 cm, 95% CI 0.47–0.74).ConclusionThe absence of adverse associations should not be interpreted as evidence of protection. These findings highlight methodological limitations in conflict epidemiology and the urgent need for community-based surveillance systems capturing outcomes among vulnerable populations unable to access healthcare during armed conflicts.