The Impact of Extreme Environmental and Security Conditions on Prematurity and Low Birth Weight Rates

April 11, 2026 updated by: Erez Nadir, MD, Hillel Yaffe Medical Center

Do Extreme Environmental and Security-related Conditions Affect the Rates of Prematurity and Low Birth Weight?

Numerous reports indicate that various extreme environmental and security-related situations during pregnancy may increase the risk of prematurity, LBW, and miscarriage, as these events increase both the incidence and intensity of maternal stress.

Study Objective: To map and validate this phenomenon within the catchment area of the Hillel Yaffe Medical Center.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Detailed Description

Background Prematurity accounts for approximately 10% of all births. A preterm infant is defined as a baby born before 37 completed weeks of gestation, calculated from the first day of the last menstrual period (LMP). Low birth weight (LBW) is defined as a birth weight below 2,500 grams. Both prematurity and LBW are associated with various early and late complications, the frequency and severity of which increase as gestational age and birth weight decrease.

Numerous reports indicate that various extreme environmental and security-related situations during pregnancy may increase the risk of prematurity, LBW, and miscarriage, as these events increase both the incidence and intensity of maternal stress. Examples of such conditions include pandemics, wars, economic collapses, and environmental disasters, such as earthquakes or storms. In instances of economic collapse, the impact manifests more frequently as fetal growth restriction (FGR) than as prematurity. Pandemics are more closely associated with prematurity, although some reports indicated a decrease in prematurity rates during the COVID-19 pandemic - likely due to a reduction in the diagnosis of pregnancy complications -with a concurrent increase in miscarriage rates.

These situations are characterized by unexpected changes in residence, decreased food security, shifts in disease vectors, socioeconomic instability, and alterations in air quality, temperature, and precipitation, all of which can impact expectant mothers. An additional factor is the diversion of medical resources toward emergency needs during these events, often at the expense of routine prenatal care.

Study Objective: To map and validate this phenomenon within the catchment area of the Hillel Yaffe Medical Center. This study aims to examine the correlation between the occurrence of extreme environmental and significant security events in Israel and the increase in the rate of preterm and LBW infants at our center.

Israel experiences natural extreme environmental events, economic crises, and pandemics, similar to the rest of the world. Additionally, security-related emergencies (wars and military operations) occur in Israel with high frequency.

Annual birth data is regularly published. Furthermore, the Israel Neonatal Association has maintained a database of all infants born weighing 1,500 grams or less since 1995. Comprehensive birth data from Hillel Yaffe Medical Center is fully available to the research team. By cross-referencing this data, we can investigate the link between maternal exposure to extreme conditions and neonatal outcomes. This is a preliminary study focusing on our center's birth population; if significant correlations are identified, a larger-scale national study may follow.

________________________________________ Methods Initially, the researchers will precisely define the events categorized as "extreme environmental and security situations" and establish the specific timeframes for these periods.

Data Collection:

Data will be collected regarding:

  • Total number of births.
  • Incidence of prematurity and infants Small for Gestational Age (SGA).
  • Relevant demographic data.

Statistical Analysis:

The study will compare data from "event periods" against "routine/calm periods." As this is a population-based study rather than a sample, standard sampling discussions are not applicable.

  • Normal Distribution: If data are normally distributed, the Z-test will be used.
  • Non-Normal Distribution: Non-parametric tests (Wilcoxon, Mann-Whitney, etc.) will be employed.
  • Categorical Data: The Chi-square (χ2) test will be used for comparisons.
  • Significance: Statistical significance will be defined as p < 0.05.

Study Type

Observational

Enrollment (Actual)

100000

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Israel
      • Hadera, Israel, 38100
        • Hillel Yaffe Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

All infants born in Hillel Yaffe medical center since 01/01/1995

Description

Inclusion criterion:

All infants born in Hillel Yaffe medical center since 01/01/1995

Exclusion criteria:

None

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
extreme environmental and security-related situations
pandemics, wars, economic collapses, and environmental disasters, such as earthquakes or storms
Other: No intervention
Only collecting the number of newborn infants in each group. No intervention
No extreme environmental and security-related situations
All other times
Other: No intervention
Only collecting the number of newborn infants in each group. No intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Prematurity OR LBW rate per month
Time Frame: 25 years
prematurity or low birth weight rate
25 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Hillel Yaffe Medical Center

Investigators

  • Principal Investigator: Erez Nadir, MD, Hillel Yaffe Medical Center

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 1990

Primary Completion (Estimated)

December 1, 2027

Study Completion (Estimated)

December 1, 2028

Study Registration Dates

First Submitted

April 6, 2026

First Submitted That Met QC Criteria

April 11, 2026

First Posted (Actual)

April 15, 2026

Study Record Updates

Last Update Posted (Actual)

April 15, 2026

Last Update Submitted That Met QC Criteria

April 11, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 0015-26-HYMC-IL

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Confident data

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Low Birth Weight

Clinical Trials on No intervention

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Georgia

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe