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

  • Ran BarzilayEmail author
  • Gabriella M. Lawrence
  • Adi Berliner
  • Raquel E. Gur
  • Maya Leventer-Roberts
  • Abraham Weizman
  • Becca Feldman
Original Contribution


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.


Gestational stress Neurodevelopment ADHD Autism spectrum disorder Depression Resilience 



Research reported in this publication was supported by the National Institute of Mental Health of the National Institutes of Health under Award number K23MH120437.

Compliance with ethical standards

Conflict of interest

Dr. Barzilay serves on the scientific board and reports stock ownership in ‘Taliaz Health’, with no conflict of interest relevant to this work. All other authors declare no potential conflict of interest.

Supplementary material

787_2019_1426_MOESM1_ESM.docx (14 kb)
Supplementary file1 (DOCX 13 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Lifespan Brain Institute, Penn MedicineChildren’s Hospital of PhiladelphiaPhiladelphiaUSA
  2. 2.Department of Child and Adolescent Psychiatry and Behavioral ScienceChildren’s Hospital of PhiladelphiaPhiladelphiaUSA
  3. 3.Clalit Research InstituteChief Physician’s Office, Clalit Health ServicesTel AvivIsrael
  4. 4.Research Unit, Geha Mental Health Center, Sackler Faculty of MedicineTel Aviv UniversityPetah-TikvaIsrael

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