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Lead: A hidden humanitarian tragedy unfolds in Gaza’s neonatal wardsIn the overcrowded neonatal unit of Nasser Hospital in southern Gaza, newborns are battling life‑threatening congenital anomalies that health officials say are unprecedented. The surge reflects the broader devastation of Israel’s ongoing war, which has crippled food, water, and medical supplies for pregnant women and infants.Escalating congenital anomalies in Gaza’s neonatal wardsStories like that of Osama, a two‑month‑old born with a heart defect and enlarged brain ventricles, illustrate the grim reality. His mother Najia Zurub endured a pregnancy marked by severe food scarcity and lack of safe drinking water, delivering early under dire conditions. Other infants—Ahmed (hydrocephalus), Suheir (multiple facial deformities), and the recently deceased Iyal—share the same ward, underscoring a pattern of non‑genetic, war‑induced health issues.Staggering rise in stillbirths and neonatal deathsCongenital anomaly cases doubled in 2025 compared with 2022.Stillbirths surged by 140% over the same period.Neonatal deaths reached 457 last year, a 50% increase from pre‑war levels.Since the conflict began, at least 20,000 children have been killed.These figures were presented by the Gaza Ministry of Health and attributed by Zaher al‑Wahidi, director of the Health Information Unit, to five interlinked factors:Widespread hungerSevere decline in healthcare servicesOvercrowding in shelters and hospitalsExposure to contaminated drinking waterOngoing effects of Israeli air attacksHumanitarian and health system collapse under war conditionsPaediatrician Asaad al‑Nawajha explains that many of these anomalies develop when a fetus is exposed to adverse environmental stressors during the first trimester, a critical window for organ formation. With medical resources depleted, doctors warn that many affected infants cannot receive adequate treatment, compounding the mortality crisis.Live births in Gaza fell by more than 30% at the height of the bombardment and have only partially recovered, leaving a generation of children born into a fragile, under‑resourced system.Outlook for Gaza’s newborn health amid ongoing conflictIf the ceasefire remains fragile and daily attacks continue, the health system’s capacity to address these congenital conditions will further deteriorate. International humanitarian aid focused on nutrition, clean water, and medical supplies is essential to curb the rising tide of stillbirths and birth defects. Without a sustained reduction in hostilities, Gaza’s newborns face a prolonged battle for survival that extends far beyond the immediate dangers of war.