Enrieco Outcomes

The project showed that many pregnancy and birth cohorts exist with information on
environmental exposures and health outcomes, yet to a lesser extend Eastern Europe.
Considerable expertise and experience is associated with these cohorts, complimented by
great effort. Overall, greater and more efficient use needs to be made of the existing cohort
data at the European level to provide timely response to key policy questions and concerns
about “new” environmental exposures, to improve methodology and power, understanding of
geographical and cultural inequalities in disease, exposure and health related behaviours.
Replication of findings with important public health implications in different settings should be
addressed, as well as improvement of statistical power through combined analysis. Cohorts
should also improve links with routinely collected environmental and health data, as much
data is currently available, but unused.

Follow-up of existing cohorts is essential to determine health effects in later life of pre-natal
and early childhood exposure, for which there is some but not conclusive evidence. New
environmental exposures, or existing environmental exposures under new conditions would
benefit from new pregnancy and birth cohorts to enable evaluation of any potential health
effects. Cohorts provide important environmental exposure, health and environmental
exposure-response data, yet the amount and detail of information provided on environment
and health varies considerably. Different initiatives have tried to combine data from various
cohorts to increase e.g. power (overall and subgroups) to overcome a tendency of individual
reporting. Existing European birth and mother-child cohorts provide a real potential for
combined analyses on pregnancy-related outcomes and child health outcomes in relation to
environmental exposures.

Combining data from various cohorts requires careful consideration of the aims, protocols,
data, ethical issues, analyses and management, and it is time and labour intensive but
potential fruitful. At the time of presenting these results, limited resources were available for