Nineteen were killed in Russian strikes in the town of Misraba yesterday, while the remainder died the same day in regime strikes and shelling in other areas, the Syrian Observatory for Human Rights said.
Seven children and 11 women were among those killed, according to the head of the Britain-based war monitor, Rami Abdel Rahman.
Victims were taken to a hospital in Douma, where an AFP correspondent saw rescuers bringing in mostly women and children.
A medical source at the hospital told AFP: "Among the wounded were two women in their 20s. One of them lost both eyes and the other lost one eye."
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Eastern Ghouta, one of the last remaining opposition strongholds in Syria, is controlled mostly by rebels from the Jaish al-Islam (Army of Islam) group.
It has been under government siege since 2013, causing severe food and medicine shortages for around 400,000 residents.
The monitor relies on a network of sources inside Syria and says it determines whose planes carry out raids according to type, location, flight patterns and munitions used.
The bombardment comes despite Eastern Ghouta being one of four "de-escalation zones" agreed by Russia, as well as regime backer Iran and rebel supporter Turkey, to help halt fighting around Syria.
Jaish al-Islam leader Mohammed Alloush on Thursday accused the regime of preparing an assault on the opposition stronghold.
The Al-Watan newspaper, which is close to the government, on Thursday said the army was gathering its troops on the outskirts of Harasta.
The war in Syria has killed more than 340,000 people and displaced millions from their homes since it began in 2011 with the brutal repression of anti-government protests.
The latest raids came after at least seven civilians, including five children, were killed Tuesday by air strikes in northwestern Idlib province, the last outside government control, the Observatory said.
The government push on the edge of Idlib province -- also a "de-escalation zone" -- follows two months of sporadic fighting that the United Nations says has displaced more than 60,000 people.
Russia first launched bombing raids in 2015 in support of Syrian President Bashar al-Assad's forces. The strikes have helped Assad regain control over much of the war-ravaged country.
Russia's defence ministry on Thursday said two servicemen were killed in a mortar attack by Islamist militants at the Hmeimim airbase in northwestern Syria on New Year's Eve, but denied media reports seven military planes were destroyed.
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