Partner Military Deployment During Wartime Is Associated with Maternal Depression and Impaired Bonding: A Matched-Control Study from the Israel-Hamas War

Abstract Purpose. The pregnancy and postpartum periods represent a time of heightened psychological vulnerability with implications for the offspring. Knowledge of the mental health of perinatal women exposed to armed conflict when their partner is in military deployment is scarce. Methods. This matched-control, survey-based study included a sample of 429 women recruited during the first months of the Israel-Hamas War who were pregnant or within six months postpartum. Women who had a partner in military deployment were matched primarily on demographics, prior mental health, and trauma exposure to women whose partner was no longer deployed. Results. We found that nearly 44% of pregnant women with a partner deployed endorsed probable depression. This group was more than twice as likely to endorse probable depression than matched pregnant controls. Likewise, postpartum women with a partner deployed reported significantly more maternal-infant attachment problems than the matched postpartum group of partners not deployed. Importantly, analysis showed that partner’s active deployment was related to maternal depression and attachment problems via reduced perceived social support. Conclusions. Partner military deployment during conditions of war can serve as a major psychological stressor for pregnant and postpartum women. It can heighten psychiatric morbidity and interfere with attachment to the infant in part by diminished social support. Implementation of community-based services for the peripartum population is crucial during times of war and other large-scale traumas. Article Highlights Partner military deployment increases risk for antepartum depression and maternal-infant bonding problems. Reduced social support explains these maternal outcomes. Clinical attention to the wellbeing of the peripartum population is warranted during times of collective trauma. Competing Interest Statement The authors have declared no competing interest. Funding Statement SD received funding from the National Institute of Child Health and Human Development (R01HD108619). HAK is a recipient of a Fellowship Grant from The American Physicians Fellowship for Medicine in Israel (APF). Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Institutional Review Board of Massachusetts General Hospital gave ethical approval for this work I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Footnotes textual changes in accordance with the journal guidelines. Data Availability The datasets generated and/or analysed during the current study are not publicly available due to anticipated ongoing collection of data for this study but are available from the corresponding author on reasonable request. Data availability The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.