Long-Term Imprint of Prenatal War Trauma on Brain Structure: Evidence from Genetically Informed Neuroimaging

The global rise in armed conflicts has raised concerns about their long-term consequences. While the immediate mental and physical impacts of war are well documented, the effects on unborn children of expecting mothers remain poorly understood. Here, we leverage a large dataset (N=37,856) combining historical World War II bombing records with brain imaging and genetic data to examine whether in-utero exposure to air raids is associated with lasting differences in adult brain structure, cognition, and physical health. Using a pre-registered quasi-experimental design controlling for genetic and environmental factors, we find that exposure during the last trimester within 2 km of bombings is associated with lower gray matter volume, which partially mediates adverse effects on intelligence and obesity. These findings suggest a plausible pathway linking prenatal trauma to long-term differences in neurodevelopmental and functional outcomes, underscoring the vulnerability of the fetal brain to acute stress and highlighting the importance of protecting pregnant women during armed conflicts.