title: [Reproductive health in high environmental risk areas in Sicily Region (Southern Italy) in the period 2007-2013].
abstract: BACKGROUND
  Augusta-Priolo (SR), Gela (CL), and Milazzo (ME) cities, located in Sicily Region (Southern Italy), are included among the areas at high environmental risk in Italy and the national legislation classifies them among the polluted sites of national interest for environmental remediation. In the past, these areas had high contamination from industrial complexes.
  
  
  OBJECTIVE
  assessment of reproductive health through the analysis of data from the birth reports of all hospital of Sicily Region in 2007-2013.
  
  
  METHODS
  geographical population study; analysis of reproductive health through analysis of pregnancy outcomes occurred in Sicily from women of childbearing age (10-55 years; excluding women who remain anonymous) with record linkage with population data (neighbouring municipalities and whole region, considered as not exposed areas).
  
  
  METHODS
  sex ratio, stillbirth rates, proportion of multiple births, low birth weight, very low birth weight, gestational age <37 weeks, proportion of small for gestational age.
  
  
  RESULTS
  in the period 2007-2013, an average annual number of 43,000 births (51.4% males) occurred. Sex ratio was not significantly modified in comparison with local and regional values. Several indicators in each area were similar when compared with the local reference population or with regional population. Stillbirths were significantly higher only in Augusta-Priolo area vs. the local population (OR: 2.26; CI95% 1.07-4.80), and slightly higher vs. regional population. Multiple births were significantly higher in Augusta-Priolo area (OR: 1.19; CI95% 1.01-1.41) and in the town of Siracusa (OR: 1.15; CI95% 1.01-1.316) when compared with regional population, and slightly higher vs. local population. Prematurity was significantly higher only in the area of Milazzo compared to the regional population (OR: 1.20; CI95% 1.02-1.41), and slightly higher compared to the local population. No excess of low birth weight (<2,500 grams) and small for gestational age (almost 37 weeks) babies was observed in these areas.
  
  
  CONCLUSIONS
  according to this study, pregnancy outcomes were not clearly affected in these areas although some modifications were noted in Augusta and in Milazzo. The surveillance of reproductive health is of paramount importance to understand the effects of air pollution on morbidity and mortality in these areas.
authors.affiliation: Osservatorio epidemiologico, Dipartimento per le attività sanitarie e osservatorio epidemiologico, Assessorato della salute, Regione siciliana, Palermo. achille.cernigliaro@regione.sicilia.it.
authors.forename: Achille
authors.initials: A
authors.lastname: Cernigliaro
authors.affiliation: Osservatorio epidemiologico, Dipartimento per le attività sanitarie e osservatorio epidemiologico, Assessorato della salute, Regione siciliana, Palermo.
authors.forename: Elisa
authors.initials: E
authors.lastname: Tavormina
authors.affiliation: Osservatorio epidemiologico, Dipartimento per le attività sanitarie e osservatorio epidemiologico, Assessorato della salute, Regione siciliana, Palermo.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Dardanoni
authors.affiliation: Osservatorio epidemiologico, Dipartimento per le attività sanitarie e osservatorio epidemiologico, Assessorato della salute, Regione siciliana, Palermo.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Scondotto
mesh_terms: D000293:Adolescent; D000328:Adult; D000397:Air Pollution / Q000009:adverse effects*; D002648:Child; D004787:Environmental Pollution / Q000009:adverse effects*; D019652:Extraction and Processing Industry; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D060728:Reproductive Health / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012802:Sicily / Q000453:epidemiology; D050497:Stillbirth / Q000453:epidemiology*