U.S.-led coalition airstrikes targeting the Islamic State in Iraq and Syria (ISIS) in two provinces in Syria killed 472 civilians in May, according to the Syrian Observatory for Human Rights (SOHR).

The United Kingdom-based human rights monitor said the death toll was the highest since coalition-led raids began in the fall of 2014.

Coalition forces have targeted Raqqa province, where the ISIS stronghold in the city of Raqqa is located, killing 250 civilians, including 53 children, according to the monitor.

Human rights groups and monitors have warned that civilians are increasingly at risk the closer coalition forces push to Raqqa.

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Groups have also raised questions as to whether U.S. policies regarding the airstrikes have changed under the Trump administration.

President Trump memorably said on the 2016 campaign trail that he would "bomb the sh--" out of ISIS.

Trump signed executive action in January that would review the U.S.’s anti-ISIS strategy that “recommended changes to any United States rules of engagement and other United States policy restrictions that exceed the requirements of international law regarding the use of force against ISIS.”

The move marked a sharp contrast from the Obama administration policies on strikes in the region, which were often met with criticism from defense hawks, who claimed the coalition missed major opportunities to target ISIS forces.

The Pentagon investigated an airstrike that was aimed at al-Qaeda leaders in March that killed civilians. The strike targeted a building that was near a mosque. A Pentagon spokesman said they did not judge the building to be a mosque at the time of the strike.