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In summer 2014, southern Israel experienced rocket attacks from the Hamas-ruled Gaza strip on a nearly daily basis for over 50 consecutive days. We exploit this unexpected escalation in the Israeli-Palestinian conflict and variation across localities in Israel in the amount of sirens that warned of rocket attacks to measure the effect of conflict intensity on birth weight and gestation length among mothers who were pregnant during this period. In addition to the common notion that conflict intensity induces stress and anxiety, we also show that conflict intensity is correlated with absences from work and lack of prenatal care. Results on changes in birth outcomes are consistent with a detrimental effect of stress and reduced prenatal care and a beneficial effect of reduced work attendance during pregnancy. Our results demonstrate that multiple factors can impact birth outcomes when evaluating the effect of armed conflict and that the effects can also be qualitatively different.

To determine whether previously established mRNA signatures are predictive of early preeclampsia when evaluated by maternal cellular transcriptome analysis in samples collected before clinical manifestation. We profiled gene expression at exon-level resolution in whole blood samples collected longitudinally from 49 women with normal pregnancy (controls) and 13 with early preeclampsia (delivery Results: (1) Average expression of the 16-gene untargeted cellular mRNA signature was higher in women diagnosed with early preeclampsia at 32–34 weeks of gestation, yet more importantly, also prior to diagnosis at 28–32 weeks and 22–28 weeks of gestation, compared to controls (all, p H19)], fibronectin 1 (FN1), tubulin beta-6 class V (TUBB6), and formyl peptide receptor 3 (FPR3) had a sensitivity of 0.85 (0.55–0.98) and a specificity of 0.92 (0.8–0.98) for prediction of early preeclampsia at 22–28 weeks of gestation. (3) H19, FN1, and TUBB6 were increased in women with early preeclampsia as early as 11–17 weeks of gestation (all, p single-cell placental signatures, including the 20-gene signature of extravillous trophoblast (all, p MMP11, SLC6A2, and IL18BP) predicted early preeclampsia at 11–17 weeks of gestation with a sensitivity of 0.83 (0.52–0.98) and specificity of 0.94 (0.79–0.99). Circulating early transcriptomic markers for preeclampsia can be found either by untargeted profiling of the cellular transcriptome or by focusing on placental cell-specific mRNAs. The untargeted cellular mRNA signature was consistently increased in early preeclampsia after 22 weeks of gestation, and individual mRNAs of this signature were significantly increased as early as 11–17 weeks of gestation. Several single-cell placental signatures predicted future development of the disease at 11–17 weeks and were also increased in women already diagnosed at 32–34 weeks of gestation.