How to Better Assess the Real Role of the Environment in Pregnancy, From Past to Future: A Relational Open Data Infrastructure Covering 30,000 Births

Background and Aims: One of today's challenges in terms of understanding the real impact of the environment on pregnancy and its complications is the ability to work with real-life data that are correctly and extensively connected to data on the contamination of living environments and individualized exposures. We present a solution based on a data infrastructure that is directly usable for research. We describe (i) the methodological characteristics of the infrastructure, (ii) the geographical territory and environmental exposures covered by the infrastructure, and (iii) the initial description of the real-life health data of the included population. Methods: The infrastructure is a relational database that integrates routine obstetric care data from CHUB with individual environmental exposure data linked via home addresses. The infrastructure includes all deliveries at Besançon University Hospital (CHUB) from January 1, 2010, to December 31, 2021. Results: Our infrastructure included information on 20,376 women, 28,344 pregnancies, and 29,190 births. The infrastructure described includes 20% of deliveries in an administrative region of more than 1.5 million inhabitants. The quality of the data is linked to highly contrasted exposure of living areas within this region and temporal coverage of more than 10 years of obstetrical events. This infrastructure is a research tool with the capacity to incorporate data in the future. Conclusion: This infrastructure can be used to address a wide range of questions aimed at describing the phenomena of environmental exposure during pregnancy, multiple exposures and their cumulative effects, particularly the phenomena of mediation, interaction, or confusion.