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Objectives: Maternal occupational exposures during early pregnancy can be detrimental to foetus health and have short- and long-term health effects on the child. This study examined their association with adverse birth outcomes., Methods: The study included 3938 nulliparous women from the Italian NINFEA mother-child cohort. Their occupational exposures during the first trimester of pregnancy were assessed through prospectively collected questionnaire information and job-exposure matrices. Associations between maternal exposures and birthweight, preterm birth, and delivery by caesarean section were analysed by multivariable linear and logistic regression models. An exploratory factor analysis was carried out to explore co-exposure profiles in association with birth outcomes., Results: Women exposed to passive smoking at work and those who reduced their working hours during pregnancy were found to have an increased likelihood of all analysed birth outcomes. Children of mothers performing a demanding work were less likely to be born preterm [OR 0.72 (95% CI 0.54 to 0.95)] and more likely to have a higher birthweight [β = 40.4 g (95% CI 7.5 to 73.4)]. Maternal exposures to heat and dust were associated with a lower birthweight [β = -160.1 g (95% CI -299.6 to -20.7)] and increased odds of caesarean section [OR 6.99 (95% CI 2.36 to 25.47)], respectively., Conclusions: This study provides some evidence of the selection of healthy population into the workforce and of association between work-related passive smoking, heat and dust and adverse birth outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 d’Errico et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Urban environmental exposures associate with adult depression, but it is unclear whether they are associated to postpartum depression (PPD). We investigated associations between urban environment exposures during pregnancy and PPD. We included women with singleton deliveries to liveborn children from 12 European birth cohorts (N with minimum one exposure = 30,772, analysis N range 17,686–30,716 depending on exposure; representing 26–46 % of the 66,825 eligible women). We estimated maternal exposure during pregnancy to ambient air pollution with nitrogen dioxide (NO 2) and particulate matter (PM 2.5 and PM 10), road traffic noise (L den), natural spaces (Normalised Difference Vegetation Index; NDVI, proximity to major green or blue spaces) and built environment (population density, facility richness and walkability). Maternal PPD was assessed 3–18 months after birth using self-completed questionnaires. We used adjusted logistic regression models to estimate cohort-specific associations between each exposure and PPD and combined results via meta -analysis using DataSHIELD. Of the 30,772 women included, 3,078 (10 %) reported having PPD. Exposure to PM 10 was associated with slightly increased odds of PPD (adjusted odd ratios (OR) of 1.08 [95 % Confidence Intervals (CI): 0.99, 1.17] per inter quartile range increment of PM 10) whilst associations for exposure to NO 2 and PM 2.5 were close to null. Exposure to high levels of road traffic noise (≥65 dB vs. < 65 dB) was associated with an OR of 1.12 [CI: 0.95, 1.32]. Associations between green spaces and PPD were close to null; whilst proximity to major blue spaces was associated with increased risk of PPD (OR 1.12, 95 %CI: 1.00, 1.26). All associations between built environment and PPD were close to null. Multiple exposure models showed similar results. The study findings suggest that exposure to PM 10, road traffic noise and blue spaces in pregnancy may increase PPD risk, however future studies should explore this causally. [ABSTRACT FROM AUTHOR]