Building a Maternal and Child Cohort Amidst Lebanon’s Socioeconomic Collapse: Preliminary Results and Navigating Research Challenges

Abstract In recent years, research has shown how connected systems influence health. Lebanon's financial predicament and political unrest have created a multifaceted crisis landscape with shortage in essential services. Social determinants like socioeconomic status and social support along with maternal mental health have been linked to preterm birth. Preterm infants are particularly disadvantaged, needing comprehensive, multidisciplinary support for optimal development. This study delves into exploring the impact of the social environment on preterm infants' developmental outcomes amidst Lebanon’s complex crises. Exploring the links between determinants of health and preterm outcomes gains urgency in this context. Lebanon's healthcare and economic deterioration over the past years is expected to amplify these risks, emphasizing the need to understand their impacting on both birth outcomes and infants’ cognitive development. We aimed to establish a prospective cohort study to evaluate the impact of the social environment on birth and developmental outcomes. This multicenter prospective cohort faced challenges that can be categorized into recruitment, follow-up, and in data collection challenges. Emigration of Lebanese citizens affected recruitment, reducing the pool of eligible participants. Birth rates decreased due to the socioeconomic and political crises. Follow-up assessments were hindered by rising healthcare costs and obstacles with transportation. Whilst the study is still ongoing, preliminary results highlight the importance of the social environment and contextual conditions. The WHO Quality of Life Questionnaire scores of the preterm infants’ mothers were significantly lower than those of term infants across physical, psychological, and social domains. Stress levels were noted to be high across most of the mothers. Economic challenges decreased the purchasing power and limited income measurement in the cohort. Findings from this study aim to provide critical data on the crises’ effect on social determinants, child developmental outcomes, and their relationship. Results can have important implications for informed resource allocation and timely interventions.