Famine’s hidden toll: Gaza sees spike in premature births and birth defects

Two senior physicians in Gaza reported that widespread malnutrition has led to a surge in severe congenital defects, including hydrocephalus and spina bifida.

Hydrocephalus is a condition in which cerebrospinal fluid accumulates in the brain, raising pressure inside the skull. Symptoms vary by age, but headaches and double vision are common.

Spina bifida is another congenital disorder in which the spine and the membranes surrounding the spinal cord fail to close properly during early fetal development.

Doctors also report an increase in neural tube defects—serious developmental abnormalities affecting the brain and spinal cord—that are closely linked to folic acid deficiency during pregnancy.

In addition to hydrocephalus and spina bifida, which can cause severe disability or even death if untreated, physicians have noted rising rates of premature births, cleft palate, jaundice, and congenital heart disease.

“I’ve never seen this many premature or defective babies,” said Asaad Nawaja, senior pediatrician at Nasser Medical Complex in Khan Younis. Speaking to The Telegraph, he described the situation as overwhelming for doctors and nurses.

Nawaja added that severe shortages of medical equipment have made treating babies born with congenital defects nearly impossible.

In Gaza City’s al-Shifa Hospital, where famine conditions have recently been confirmed, neurosurgeon Maher Kamel reported that in the past two weeks he operated on six infants with hydrocephalus, aged between 15 days and four months.

Hydrocephalus—caused by fluid buildup in the brain that enlarges the head—can only be treated surgically by inserting a shunt, a thin tube with a valve that drains excess fluid, reducing pressure and preventing brain damage.

“The problem is not just the number of cases but the treatment itself,” Kamel said. “We’ve completely run out of shunts. We only have three operating rooms, most of them occupied with emergencies. Even if a hydrocephalus patient comes in, we can’t help them.”

While precise figures are lacking, experts suspect a rise in congenital defects in Gaza. They say conditions in the strip likely drive an increase in neural tube defects, as the link between hunger and such abnormalities is well established.

Famine and widespread malnutrition in Gaza

According to Gaza’s Health Ministry, at least 185 people died from malnutrition last month alone, bringing the total to 361.

Reports estimate around 43,000 children under five and more than 55,000 pregnant or nursing women are suffering from malnutrition.

Mothers and infants are especially vulnerable. Babies face heightened risks due to extreme shortages of infant formula in the besieged enclave.

Medical experts point to acute malnutrition as the leading factor behind the surge in birth defects.

Andrew Whitelaw, a neonatal medicine specialist at the University of Bristol, said Gaza’s food scarcity provides a clear explanation for the increase:

“There’s no doubt that long-term shortages of fresh food mean pregnant women haven’t been getting enough folic acid, which is crucial to lowering neural tube defects.”

In most countries, folic acid supplements are standard for women planning pregnancies because of their vital role in early fetal development.

Whitelaw added that beyond food shortages, extreme stress and the near-total absence of prenatal care also contribute to the rising rates of birth defects.

Previous studies have shown that chronic stress raises cortisol and other hormone levels in pregnant women, increasing the risk of complications and premature birth.

Research also links exposure to environmental toxins from armed conflict with higher rates of birth defects.

A major 2020 review found that congenital defects and premature births in Gaza rose sharply after the 2014 war. Between 2011 and 2016, the prevalence of congenital anomalies in newborns nearly doubled—from 1.1 percent to 1.8 percent.

Rosemary Townsend, honorary consultant in obstetrics at the University of Edinburgh, noted: “Wherever there is conflict and war, there is an increase in congenital defects at birth.”

She explained that disrupted prenatal care, malnutrition, and the toxic effects of weaponry all play a role. Townsend warned that the full scale of damage may not yet be visible: “What we’re seeing now are babies affected nine months ago in the womb. For babies conceived during the current famine, the situation will be much worse.”