Association between prenatal exposure to a 1-month period of repeated rocket attacks and neuropsychiatric outcomes up through age 9: a retrospective cohort study

Eur Child Adolesc Psychiatry. 2020 Aug;29(8):1135-1142. doi: 10.1007/s00787-019-01426-1. Epub 2019 Nov 4.


Exposure to gestational stress is implicated in increased risk for neuropsychiatric disorders in offspring. We assessed association between prenatal exposure to a 1-month period of repeated rocket attacks during the 2006 Second Lebanon War in Northern Israel and emergence of childhood neuropsychiatric disorders from birth through 9 years of age. Children born to women who were pregnant during the war (N = 6999) were identified and compared to children in the same district born a year later (N = 7054), whose mothers were not exposed to rocket attacks during pregnancy. Multivariable regression models assessed risk for attention deficit hyperactivity disorder, autism, epilepsy, depression and/or anxiety, or any of these disorders (composite outcome) in offspring. Models controlled for multiple confounders including parents' demographics, parity, maternal use of psychotropic medications during pregnancy, post-partum depression and parental psychiatric history. Results show that exposed and comparison groups did not differ with respect to demographics, parity or psychiatric history. Exposed and comparison groups were similar with regard to gestational age and weight at birth. Multivariable models did not demonstrate an association between exposure to rocket attacks during pregnancy and neuropsychiatric outcomes by age 9. No interactions were found between exposure and gestational trimester at exposure or child's sex. Our findings suggest that in utero exposure to isolated, 1-month repeated rocket attacks on a civilian population was not associated with major neuropsychiatric outcomes in children by age 9. Future studies should evaluate whether this exposure is associated with psychiatric and/or other health-related outcomes later in life.

Keywords: ADHD; Autism spectrum disorder; Depression; Gestational stress; Neurodevelopment; Resilience.

MeSH terms

  • Adult
  • Child
  • Child, Preschool
  • Cohort Studies
  • Explosions / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Neuropsychiatry / methods*
  • Pregnancy
  • Prenatal Exposure Delayed Effects / epidemiology*
  • Retrospective Studies
  • Time Factors
  • Young Adult