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This study investigates the profound impact of the protracted humanitarian crisis in the conflict zone of Syam on the mental health of healthcare professionals, employing a systematic meta-analytical approach across 47 independent studies (N = 12,487) published between 2011 and 2023. The findings reveal an alarmingly high prevalence of burnout, reaching 78.3% (95% CI [75.2–81.4]), with emotional exhaustion recorded as the most dominant dimension (M = 3.89; SD = 0.76). Additionally, secondary trauma was identified in 65.7% of all respondents (95% CI [62.4–69.0]), with the primary symptoms manifesting as post-traumatic stress disorder (PTSD) at 44.2% and depression at 39.8%. Meta-regression analysis demonstrated that the duration of exposure to conflict (β = 0.42; p < 0.001) and the intensity of workload (β = 0.38; p < 0.001) served as significant predictors of burnout. Meanwhile, the lack of psychosocial support (OR = 2.34; 95% CI [1.89–2.79]) and critical resource scarcity (OR = 1.98; 95% CI [1.65–2.31]) were strongly correlated with the emergence of secondary trauma among healthcare professionals. Furthermore, diverging from the more individualistic frameworks employed in the studies of Bdaiwi et al. (2020) and Bou-Karroum et al. (2020), this research explores the intricate entanglement of organizational and situational determinants that concurrently shape the mental health landscape of medical personnel operating in the Syam conflict zone. Moreover, the study's original contribution lies in identifying resilience adaptation patterns observed in 34.2% of participants, revealing that endurance capacity was cultivated through collective coping strategies and close peer support. According to the researchers, this study offers a new lens for designing community-based psychological interventions that are both sustainable and contextually grounded for healthcare providers affected by the protracted armed conflict in Syam.

Hypertension in pregnancy is one of the leading causes of maternal mortality, with a global prevalence of 5–10% (Khedagi & Bello, 2021). This study aims to analyze the effect of reproductive status—maternal age, gravidity, and parity—on the incidence of hypertension in pregnancy at Prof. Dr. Chairuddin P. Lubis Educational Hospital, Medan. A case-control design was employed with 96 respondents, consisting of 48 cases and 48 controls. Bivariate analysis revealed that pregnant women aged ≥35 years have a 2.839-fold higher risk of developing hypertension compared to those aged <35 years (OR=2.839; 95% CI: 1.123–7.177; p=0.027). First pregnancy (primigravida) increases the risk by 2.742 times compared to multigravida (OR=2.742; 95% CI: 1.047–7.178; p=0.040), while nulliparous women have a 2.714-fold higher risk compared to those who have given birth (OR=2.714; 95% CI: 1.101–6.693; p=0.030). Multivariate analysis identified maternal age ≥35 years and nulliparity as the most significant predictors (p=0.005). These findings align with studies by Wiranto & Putriningtyas (2021), Hinkosa et al. (2020), and Luo et al. (2020), which confirmed that advanced maternal age and nulliparity increase the risk of pregnancy complications. The novelty of this research lies in integrating all three reproductive status factors as simultaneous predictors of hypertension risk, providing a new perspective compared to previous studies focused on single variables. Based on these findings, early detection and targeted health education for high-risk mothers are strongly recommended.