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. 2020 May 21;17(10):3614.
doi: 10.3390/ijerph17103614.

An Italian Network of Population-Based Birth Cohorts to Evaluate Social and Environmental Risk Factors on Pregnancy Outcomes: The LEAP Study

Teresa Spadea  1 , Barbara Pacelli  2 , Andrea Ranzi  3 , Claudia Galassi  4 , Raffaella Rusciani  1 , Moreno Demaria  5 , Nicola Caranci  2 , Paola Michelozzi  6 , Francesco Cerza  6 , Marina Davoli  6 , Francesco Forastiere  7   8 , Giulia Cesaroni  6
Affiliations

An Italian Network of Population-Based Birth Cohorts to Evaluate Social and Environmental Risk Factors on Pregnancy Outcomes: The LEAP Study

Teresa Spadea et al. Int J Environ Res Public Health. .

Abstract

In Italy, few multicentre population-based studies on pregnancy outcomes are available. Therefore, we established a network of population-based birth cohorts in the cities of Turin, Reggio Emilia, Modena, Bologna, and Rome (northern and central Italy), to study the role of socioeconomic factors and air pollution exposure on term low birthweight, preterm births and the prevalence of small for gestational age. In this article, we will report the full methodology of the study and the first descriptive results. We linked 2007-2013 delivery certificates with municipal registry data and hospital records, and selected singleton livebirths from women who lived in the cities for the entire pregnancy, resulting in 211,853 births (63% from Rome, 21% from Turin and the remaining 16% from the three cities in Emilia-Romagna Region). We have observed that the association between socioeconomic characteristics and air pollution exposure varies by city and pollutant, suggesting a possible effect modification of both the city and the socioeconomic position on the impact of air pollution on pregnancy outcomes. This is the largest Italian population-based birth cohort, not distorted by selection mechanisms, which has also the advantage of being sustainable over time and easily transferable to other areas. Results from the ongoing multivariable analyses will provide more insight on the relative impact of different strands of risk factors and on their interaction, as well as on the modifying effect of the contextual characteristics. Useful recommendations for strategies to prevent adverse pregnancy outcomes may eventually derive from this study.

Keywords: air pollution; population-based birth cohorts; pregnancy outcomes; socioeconomic status.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Prevalence of high air pollution exposure (>75th percentile) by city and maternal education.
Figure 2
Figure 2
Prevalence of high air pollution exposure (>75th percentile) by city and maternal occupation.
Figure 3
Figure 3
Prevalence of high air pollution exposure (>75th percentile) by city and maternal citizenship.
Figure 4
Figure 4
Prevalence of high air pollution exposure (>75th percentile) by city and 2011 census block deprivation index.
See this image and copyright information in PMC

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