In the past 20 years, birth cohort studies to assess the risks to developing children from harmful chemicals in air, water and food have been undertaken in many countries. These birth cohort studies usually started during pregnancy and followed children through adolescence or beyond. Participation in such studies has major personal, familial, societal and political impacts as more awareness towards environmental exposures and preventive measures arise.
The Danube Region is a functional area defined by its river basin. Geographically it concerns primarily but not exclusively: Germany (Baden-Württemberg and Bavaria), Austria, the Slovak Republic, the Czech Republic, Hungary, Slovenia, Romania and Bulgaria within the EU, and Croatia (now in EU), Serbia, Bosnia and Herzegovina, Montenegro, the Republic of Moldova and Ukraine (the regions along the Danube) outside. With over 100 million people, and a fifth of EU surface, the area is vital for Europe. In a review published in the journal Reviews in Environmental Health, the authors describe the lack of birth cohorts in the Danube area and the benefits and strategy for establishing as cohort with parental engagement before and after birth.
The Danube Region is a major international hydrological basin and ecological corridor. This requires a regional approach to nature conservation, spatial planning and water management. Pollution does not respect national borders and especially air pollution is reported as high.
Planned interventions throughout a child’s life
The neonatal and maternal mortality rates are also high when compared to the rest of Europe. Setting up a birth cohort in the Danube area enables mapping of the major challenges related to maternal, prenatal and post natal health as well as preventive actions to be taken. The authors’ planned but not yet financed study has the family in focus and they intend to recruit families before pregnancy and follow up by several interview/internet based questionnaires to promote lifestyle improvements and report successful interventions throughout the childhood.
A birth cohort in the Danube area could apply the established methodologies for prenatal exposure and birth outcome measurements and establish a platform for targeted health promotion in couples planning pregnancies. The proposal included a strong socioeconomic part focusing on the participant’s active registration of exposures to environmental toxicants and health indicators of disease and wellbeing, combined with questionnaires scoring the participants willingness to change their lifestyles and to pay for their children’s wellbeing.
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Lisbeth E. Knudsen, Zorana J. Andersen, Radim J. Sram, Markéta Braun Kohlová, Eugen S. Gurzau, Aleksandra Fucic, Laura Gribaldo et al.: Perinatal health in the Danube region – new birth cohort justified, 18.10.2016