Birth cohort studies are the most appropriate type of design to determine the causal relationship between potential risk factors during the prenatal or postnatal period and the health status of the newborn up to childhood and potentially adulthood. To date, there has been a growth in interest regarding observational population-based studies which are performed to provide answers to specific research questions for defined populations, for instance, assessing the exposure to environmental pollutants or drugs on the risk of developing a disease. Birth cohorts based on the recruitment and active follow-up of mothers and children allow the collection of biological material, and specific clinical and genetic information. However, they require a considerable amount of time and resources and, besides being usually of limited size, they are exposed to the risk of the loss of subjects to follow-up, with decreased statistical power and possible selection bias. For these reasons, linking the medical birth register with administrative health records for mothers and babies is increasingly being used in countries with a universal healthcare system, allowing researchers to identify large and unselected populations from birth, and to reconstruct relevant traits and care pathways of mothers and newborns. This Special Issue of the International Journal of Environmental Research and Public Health focuses on the current state of knowledge on perinatal and postnatal exposures and adverse pregnancy, maternal, fetal and neonatal outcomes through population-based birth cohort studies, with a specific focus on real-word data. The 12 accepted articles covered a wide range of themes that can be addressed specifically through birth cohort study design; however, only three were based on real word data with record-linkage to health administrative databases. In particular, two papers have addressed the topic of socioeconomic status considering several indicators both at the individual and contextual level. Two papers focused on inflammatory bowel diseases, both as an outcome of perinatal and antibiotic exposure in early life and as a condition associated with asthma, among children identified in a birth cohort based on a Regional Medical Birth Register. Three articles focused on medication use during pregnancy and its impact on maternal and fetal health. The effect of exposure to prenatal environmental risk factors on perinatal and childhood outcomes has been considered in two papers. Two papers analyzed ad hoc nationwide prospective birth cohorts set in Japan and UK. Finally, we included a systematic review with meta-analysis to evaluate the relation between growth restriction at birth and congenital heart defects. We think that this Special Issue may contribute to enriching the discussion of future challenges, opportunities, strengths and limitations for all research topics that can be investigated using a population-based birth cohort study design.
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