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As war drags on in Ukraine, doctors warn of rise in premature births

Amina Tsoi’s twin babies are healthy girls. They bicker, as siblings do, and they both have a curious appetite for cheese, “like little mice,” their mother says. But they are small for one-year-olds, a legacy of their premature birth during the first weeks of Russia’s invasion of Ukraine.

For seven months, Ms. Tsoi enjoyed a happy and healthy pregnancy, largely without complications. Then, one morning in February last year, explosions erupted in the town where she lived, near Mykolaiv, in southern Ukraine, which faced an increase in missile strikes and skirmishes on the ground.

“My mother-in-law came into our room and said, ‘The war has started,'” Ms Tsoi said. “And I started to panic.”

Ms Tsoi, then 20, escaped all shelling and was apparently unhurt. But in the days that followed, she lost sight in one eye and gained 14 pounds because she was retaining water. After undergoing an emergency caesarean, during which she lost enough blood to require two transfusions, her daughters, born six weeks premature, clung on to life in incubators.

Russia’s invasion of Ukraine killed tens of thousands of soldiers and civilians and injured many thousands more. The mental burden of war also took a heavy toll. For pregnant women, stress can be particularly dangerous, with doctors and hospital officials warning of a sharp rise in maternal health issues such as premature births.

Preterm babies are more likely to develop respiratory, neurological and digestive complications. People born particularly prematurely can have serious physical and mental health problems. Twins or other multiple births are likely to be born early, even in normal times.

After more than a year of war, official statistics on maternal health in Ukraine are scarce. Figures on premature births, for example, can be misleading because many pregnant women, especially those with health problems, were evacuated to other countries after the Russian invasion began. But doctors in multiple interviews, particularly in areas close to the fighting, reported high rates of premature births, increased cases of high blood pressure during pregnancy and a higher rate of caesarean sections, attributing the complications to the extraordinary tension of carrying a child through a period of danger and dislocation.

“You can see that the course of the pregnancy has become more difficult,” said Dr Liudmyla Solodzhuk, 58, medical director of a hospital in Mykolaiv, a town near the front line. “Usually the birth of a new human being means happiness, and now it means anxiety,” she added.

The effort to protect pregnant women from the strains of war has become a medical priority, Dr. Solodzhuk noted, with medical staff trying new ways to distract patients from the harsh sounds of war outside.

“We said the bombings were fireworks,” she said, “in honor of the birth of their children.”

Dr. Solodzhuk’s hospital in Mykolaiv reported that the number of caesarean sections and early births increased by 5%. Government statistics show a smaller increase in premature births in the wider Mykolaiv region and other parts of southern and eastern Ukraine, where the fighting is heaviest, but these figures are complicated by the large number of residents who fled.

Musical duo Tvorchi, Ukraine’s entry into the Eurovision Song Contest in Liverpool, England last month, gave the issue new visibility when, during a red carpet event ahead of the competition, performers wore costumes with the names and weights of babies born early.

For the pregnant women who remained after the Russian invasion, any hope that the fighting would soon be over proved futile.

Inna Harbuz, then 30, was pregnant with twins and living in Mykolaiv when Russian missiles began hitting the town. His family decided it would be safer to move elsewhere, only for an early Russian advance to take the nearby village they had been to. As much as possible, the family tried to stay out of sight.

“We started hiding in the basement every day, mostly afraid that the Russians would find us,” Ms Harbuz said, adding that the fear of being discovered by invading troops was worse than facing the threats. rocket fire in Mykolaiv.

On October 28, Ms. Harbuz suffered internal bleeding from a prematurely detached placenta. By then, the Russian troops had been pushed back from the village and her family rushed her to a hospital in Mykolaiv where she underwent an emergency caesarean section. Her twin sons, born prematurely, were placed on life support.

Some seven months later, both boys are doing well. But the family decided to stay in the village rather than return to Mykolaiv, which still comes under regular bombardment.

After Ms Tsoi’s twins were born, they had health problems and she said she had to check their heartbeat, eyesight and weight regularly. At 9 months they still couldn’t stand and the family worried, but “they are both running now,” she said recently.

Mrs. Tsoi blames the war for turning her pregnancy into such an ordeal. Even during her C-section, conflict was inevitable. “I started crying on the operating table,” she said. “It was very scary because I could hear a lot of explosions and gunfire outside.”

She only found her daughters on the eighth day after giving birth. At that time they were still powered by tubes and the fighting outside was getting worse. At one point, hospital staff and patients were forced to huddle together in the basement for safety reasons.

The traumatic experience was almost too much for Ms. Tsoi. “Within a month, I had horrible depression,” she said. “I shouted at my husband to take us out overseas, otherwise I can’t stand it, I just won’t survive.”

Ms Tsoi’s husband drove the family to the border with Moldova but had to return to Ukraine as men of fighting age are not allowed to leave.

A few months later, Mrs. Tsoi and her daughters returned to Ukraine and rented a house near Odessa to be closer to her husband. The girls are in good health, but they are behind normal growth and development targets for their age.

For Ms. Tsoi, the war transformed her pregnancy from a joyous experience into one she would rather forget.

“I still can’t believe I survived it,” she said.

nytimes Eur

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