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Open AccessFeature PaperArticle

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

Department of Epidemiology, ASL TO3 Piedmont Region, 10095 Grugliasco (TO), Italy
Regional Health and Social Care Agency, Emilia-Romagna Region, 40127 Bologna, Italy
Centre for Environmental Health and Prevention, Regional Agency for Prevention, Environment and Energy of Emilia-Romagna, 40127 Bologna, Italy
Unit of Clinical Epidemiology, Città della Salute e della Scienza University Hospital and Centre for Cancer Prevention (CPO), 10126 Turin, Italy
Regional Environmental Protection Agency, Piedmont, 10135 Turin, Italy
Department of Epidemiology—Lazio Regional Health Service, ASL Roma 1, 00147 Roma, Italy
Institute for Biomedical Research and Innovation, National Research Council, 90146 Palermo, Italy
Science Policy & Epidemiology, King’s College, London SE1 9NH, UK
Authors to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(10), 3614;
Received: 31 March 2020 / Revised: 17 May 2020 / Accepted: 18 May 2020 / Published: 21 May 2020
(This article belongs to the Special Issue Population-Based Birth Cohort Studies in Epidemiology)
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. View Full-Text
Keywords: socioeconomic status; air pollution; pregnancy outcomes; population-based birth cohorts socioeconomic status; air pollution; pregnancy outcomes; population-based birth cohorts
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Spadea, T.; Pacelli, B.; Ranzi, A.; Galassi, C.; Rusciani, R.; Demaria, M.; Caranci, N.; Michelozzi, P.; Cerza, F.; Davoli, M.; Forastiere, F.; Cesaroni, G. An Italian Network of Population-Based Birth Cohorts to Evaluate Social and Environmental Risk Factors on Pregnancy Outcomes: The LEAP Study. Int. J. Environ. Res. Public Health 2020, 17, 3614.

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