Perinatal depression during armed conflict in Israel: Mental health risks and challenges, a cross-sectional study

Background: The recent armed conflict between Israel and Hamas (October 7,2023) has impacted various populations, including perinatal women, whose mental health can be particularly vulnerable to deterioration during periods of conflict. This study aimed to assess the prevalence of perinatal depression symptoms (PNDs) during the war and identified related risk factors for PNDs. Methods: This cross-sectional study included 862 women who were pregnant or up to 12 months postpartum. Participants filled out an online self-report questionnaire. PNDs were measured using the Edinburgh Postnatal Depression Scale (EPDS). Bivariate analyses (t-tests, χ² tests) were performed to examine associations between demographic, socioeconomic, and post-traumatic stress disorder (PTSD) symptoms and war-related variables, and PND. Multivariable logistic regression was used to identify independent risk factors for PND symptoms (EPDS ≥10). Results: The prevalence of PNDs was 32.7 %, with an EPDS score of 10 or higher. Suicidal thoughts were reported by 8 % of participants and PTSD was reported by 30 %. Statistically significant associations were found between PNDs and posttraumatic stress disorder, with women who experienced PTSD being 2.5 times more likely to report PNDs. Other factors associated with increased risk of PNDs included loneliness, pregnancy status (pregnant women were 1.5 times more likely to report PNDs, reduction of family income due to the war, war-related property damage, and history of mental health diseases. Conclusion: The findings demonstrate the severe impact of the war on the mental health of perinatal women, highlighting the need for provision of targeted mental health support during and after conflict situations to mitigate these adverse effects.