Children represented a small proportion of deaths, about 9 percent, in the first two years of the war. But since 2013, that proportion has more than doubled. Now nearly 1 in 4 civilian deaths are children, Guha-Sapir and her team report in the journal Lancet Global Health.

“This increase is directly associated with the use of aerial bombings,” Guha-Sapir says. “We conclude that the use of bombs ends up targeting children and women more than targeting combatants.”