Survey of Low Birthweight and Extremely Low Birthweight Events in a High Environmental Risk Area of Apulia, Italy
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RESEARCH PAPER
Survey of Low Birthweight and Extremely Low Birthweight Events in a High Environmental Risk Area of Apulia, Italy Paolo Trerotoli1 · Nicola Bartolomeo1 · Simona Leogrande2 · Sabrina Triggiani1 · Antonella Mincuzzi2 · Gabriella Serio1 · Aldo Sante Minerba2 Received: 9 July 2020 / Revised: 9 September 2020 / Accepted: 5 October 2020 © The Author(s) 2020
Abstract The association between environmental conditions and pregnancy outcome has been under investigation for a long time, but results appear to be inconclusive regarding damage to either the newborn or the mother. The aim of this study was to evaluate the distribution of hospitalization of newborns with low birthweight ( 1 for ELBW was observed, but these were all non-significant. Figure 3a shows that all districts had a very high and statistically significant RR of LBW events, with RRs ranging from 1.24 (95% UI 1.1–1.4) for Tamburi district to 1.47 (95% CI 1.2–1.8) for San Vito District. Analysis of the geographical distribution of RRs for ELBW in Taranto did not show patterns of significantly high RRs (Fig. 3b).
Discussion The results of the present survey showed a clear geographical pattern of RRs for LBW and ELBW. Higher RRs were observed near cities with high environmental risk owing to the presence of a carbon power plant (Brindisi), and a petroleum refinery and one the largest steel manufacturing facilities in Europe (Taranto). The environmental pollution in these areas requires greater attention, with respect to evaluation of the health of the resident population. In particular, newborn and pregnant women are more sensitive to the negative health effects of environmental pollution. This survey was conducted using current information sources like the HDFDB, one of the most reliable and complete resources of health-related information after registries such as the Cancer Registry and Death Cause Registry. As a data source for pregnancy and births, the Delivery Certificate can provide detailed information about mothers and newborns. However, these records are incomplete as only events occurring in a particular health district are recorded; information about residents hospitalized outside the district is not included on the certificate. Electronic health databases, rather than ad hoc studies, are often used to determine risk; these include electronic clinical records (Nobles et al. 2019; Seabrook et al. 2019), birth certificates (Xuea et al. 2018) or data from national statistical institutes. Many studies select events according to ICD-9 or ICD-10 codes. However, prospective or cohort studies are more appropriate for evaluating RRs of environmental exposure; otherwise, it is difficult to properly determine the duration and degree of exposure and the possible relationship with birth and pregnancy outcomes (Nie et al. 2018). In evaluating the association between location of residence and pollution source, it is necessary to evaluate the
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International Journal of Environmental Research
Fig. 1 Time series of raw rate of preterm imma
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