NINFEA project

Study design

NINFEA is an internet-based multi-purpose mother-child cohort ⁱ set up to investigate the effects of exposures acting during pre-natal and early post-natal life on infant, child and adult health.

Members of the cohort are all babies born to women who:

have access to the internet,
have enough knowledge of the Italian language to complete the online questionnaires,
become aware of the study,
volunteer to participate.

Women are recruited during pregnancy. To participate they register at the study website and complete a baseline online questionnaire (Q1).

Participants complete three principal online questionnaires :

during pregnancy (Q1),
6 months after delivery (Q2),
18 months after delivery (Q3).

The questionnaires include questions on the mother and/or the child on several exposures and some outcomes, including environmental exposures (passive smoking, traffic, residential history, maternal occupation and occupational exposures, noise, dampness), reproductive factors, medical history, anthropometrical measures, diet, supplements, health status, asthma, growth, etc.

Women are invited via email, telephone or mail to complete the Q2 and Q3 questionnaires.

Followup is conducted using both active and passive methods. Starting at age 4 of the child, specific outcomes are assessed every 2 years via ad hoc short online questionnaires. Passive followup involves linkage with available population registries, including the Hospital Inpatient Registry, the Birth Registry, the Cancer Registry, etc.

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ⁱ A cohort study is an investigation in which a group of individuals (the cohort) is identified and prospectively followed over time to detect health related events.

Publications

Costanza Pizzi Follow-up response rates 2018.
Patro Golab B, Santos S, Voerman E, Lawlor DA, Jaddoe VWV, Gaillard R; MOCO Study Group Authors. Influence of maternal obesity on the association between common pregnancy complications and risk of childhood obesity: an individual participant data meta-analysis. Lancet Child Adolesc Health 2018.
Richiardi L, Popovic M, Zugna D, Rusconi F, Merletti F, Pizzi C. Comunicare i dati della coorte italiana di nuovi nati NINFEA Epidemiol Prev 2018.
Popovic M, Pizzi C, Rusconi F, Gagliardi L, Galassi C, Trevisan M, Merletti F, Richiardi L. The role of maternal anorexia nervosa and bulimia nervosa before and during pregnancy in early childhood wheezing: findings from the NINFEA birth cohort study. Int J Eat Disord 2018; 1-10.
Vizzini L, Popovic M, Zugna D, Vitiello B, Trevisan M, Pizzi C, Rusconi F, Gagliardi L, Merletti F, Richiardi L. Maternal anxiety, depression and sleep disorders before and during pregnancy, and preschool ADHD symptoms in the NINFEA birth cohort study. Epidemiology and Psychiatric Sciences 2018; Apr 18:1-11.
Popovic M, Fasanelli F, Fiano V, Biggeri A, Richiardi L. Increased correlation between methylation sites in epigenome-wide replication studies: impact on analysis and results Epigenomics 2017; 9(12):1489-1502.
Popovic M, Pizzi C, Rusconi F, Gagliardi L, Galassi C, Trevisan M, Merletti F, Richiardi L. The role of maternal bulimia nervosa and anorexia nervosa before and during pregnancy in early childhood wheezing. Journal of Developmental Origins of Health and Disease. 2017; 8(s1): S1-S449. (10th World Congress 15-18 October 2017 Rotterdam, The Netherlands). The role of maternal bulimia nervosa and anorexia nervosa before and during pregnancy in early childhood wheezing Journal of Developmental Origins of Health and Disease 2017.
Strandberg-Larsen K, Poulsen G, Bech BH, Chatzi L, Cordier S, Dale MTG, Fernandez M, Henriksen TB, Jaddoe VW, Kogevinas M, Kruithof CJ, Lindhard MS, Magnus P, Nohr EA, Richiardi L, Rodriguez-Bernal CL, Rouget F, Rusconi F, Vrijheid M, Andersen AN. Association of light-to-moderate alcohol drinking in pregnancy with preterm birth and birth weight: elucidating bias by pooling data from nine European cohorts. Eur J Epidemiol 2017; 32(9):751-764.
Rusconi F, Zugna D, Annesi-Maesano I, Baïz N, Barros H, Correia S, Duijts L, Forastiere F, Inskip H, Kelleher CC, Larsen PS, Mommers M, Andersen AN, Penders J, Pike K, Porta D, Sonnenschein-van der Voort A, Sunyer J, Torrent M, Viljoen K, Vrijheid M, Richiardi L, Galassi C. Mode of Delivery and Asthma at School Age in 9 European Birth Cohorts Am J Epidemiol. 2017.
Stratakis N, Roumeliotaki T, Oken E, Ballester F, Barros H, Basterrechea M, Cordier S, de Groot R, den Dekker HT, Duijts L, Eggesbø M, Pia Fantini M, Forastiere F, Gehring U, Gielen M, Gori D, Govarts E, Inskip HM, Iszatt N, Jansen M, Kelleher C, Mehegan J, Moltó-Puigmartí C, Mommers M, Oliveira A, Olsen SF, Pelé F, Pizzi C, Porta D, Richiardi L, Rifas-Shiman SL, Robinson SM, Schoeters G, Strøm M, Sunyer J, Thijs C, Vrijheid M, Vrijkotte TG, Wijga AH, Kogevinas M, Zeegers MP, Chatzi L. Fish and seafood consumption during pregnancy and the risk of asthma and allergic rhinitis in childhood: a pooled analysis of 18 European and US birth cohorts. Int J Epidemiol. 2017 Feb 27. 2017; doi: 10.1093/ije/dyx007.
Costanza Pizzi Follow-up response rates 2016.
Pizzi C, Popovic M, Ivaldi P, Brunetti F, Casalone U, Saccona F, Sassu O, Barcellari S, Rusconi F, Gagliardi L, Merletti F, Richiardi L. "Open" data nella coorte di nuovi nati NINFEA 2016; XL Congresso AIE - Associazione Italiana di Epidemiologia.
Popovic M, Zugna D, Galassi C, Rusconi F, Gagliardi L, Migliore E, Merletti F, Richiardi L. Prenatal exposure to chemical products, early indoor environment and wheezing and eczema in infancy 2016; 28° Annual Conference ISEE - International Society for Environmental Epidemiology.
Vardavas CI, Hohmann C, Patelarou E, Martinez D, Henderson AJ, Granell R, Sunyer J, Torrent M, Fantini MP, Gori D, Annesi-Maesano I, Slama R, Duijts L, de Jongste JC, Aurrekoetxea JJ, Basterrechea M, Morales E, Ballester F, Murcia M, Thijs C, Mommers M, Kuehni CE, Gaillard EA, Tischer C, Heinrich J, Pizzi C, Zugna D, Gehring U, Wijga A, Chatzi L, Vassilaki M, Bergström A, Eller E, Lau S, Keil T, Nieuwenhuijsen M, Kogevinas M. The independent role of prenatal and postnatal exposure to active and passive smoking on the development of early wheeze in children. Eur Respir J. 2016; 48(1):115-24.
Popovic M, Pizzi C, Rusconi F, Galassi C, Gagliardi L, De Marco L, Migliore E, Merletti F, Richiardi L. Infant weight trajectories and early childhood wheezing: the NINFEA birth cohort study. Thorax 2016; pii: thoraxjnl-2015-208208.
Birks L, Casas M, Garcia AM, Alexander J, Barros H, Bergström A, Bonde JP, Burdorf A, Costet N, Danileviciute A, Eggesbø M, Fernández MF, González-Galarzo MC, Gražulevičienė R, Hanke W, Jaddoe V, Kogevinas M, Kull I, Lertxundi A, Melaki V, Andersen AN, Olea N, Polanska K, Rusconi F, Santa-Marina L, Santos AC, Vrijkotte T, Zugna D, Nieuwenhuijsen M, Cordier S, Vrijheid M. Occupational Exposure to Endocrine-Disrupting Chemicals and Birth Weight and Length of Gestation: A European Meta-Analysis. Environ Health Perspect. 2016; May 6.
Stratakis N, Roumeliotaki T, Oken E, Barros H, Basterrechea M, Charles MA, Eggesbø M, Forastiere F, Gaillard R, Gehring U, Govarts E, Hanke W, Heude B, Iszatt N, Jaddoe VW, Kelleher C, Mommers M, Murcia M, Oliveira A, Pizzi C, Polanska K, Porta D, Richiardi L, Rifas-Shiman SL, Schoeters G, Sunyer J, Thijs C, Viljoen K, Vrijheid M, Vrijkotte TG, Wijga AH, Zeegers MP, Kogevinas M, Chatzi L. Fish Intake in Pregnancy and Child Growth: A Pooled Analysis of 15 European and US Birth Cohorts. JAMA Pediatr. 2016; 170:381-90.
Popovic M, Rusconi F, Zugna D, Galassi C, Merletti F, Migliore E, Trevisan M, Nannelli T, Gagliardi L, Richiardi L. Prenatal exposure to antibiotics and wheezing in infancy: a birth cohort study. Eur Respir J 2015; Eur Respir J. 2016;47(3):810-7.
Migliore E, Zugna D, Galassi C, Merletti F, Gagliardi L, Rasero L, Trevisan M, Rusconi F, Richiardi L. Prenatal Paracetamol Exposure and Wheezing in Childhood: Causation or Confounding? PLoS One 2015; 10: e0135775.
Firestone R, Cheng S, Pearce N, Douwes J, Merletti F, Pizzi C, Pivetta E, Rusconi F, Richiardi L. Internet-based birth-cohort studies: is this the future for epidemiology? JMIR Res Protoc. 2015; 4: 71.
Casas M, Cordier S, Martínez D, Barros H, Bonde JP, Burdorf A, Costet N, Dos Santos AC, Danileviciute A, Eggesbø M, Fernandez M, Fevotte J, García AM, Gražuleviciene R, Hallner E, Hanke W, Kogevinas M, Kull I, Stemann Larsen P, Melaki V, Monfort C, Nordby KC, Nybo Andersen AM, Patelarou E, Polanska K, Richiardi L, Santa Marina L, Snijder C, Tardón A, van Eijsden M, Vrijkotte TG, Zugna D, Nieuwenhuijsen M, Vrijheid M. Maternal occupation during pregnancy, birth weight, and length of gestation: combined analysis of 13 European birth cohorts Scand J Work Environ Health 2015; 41:384-96.
Richiardi L, Pizzi C, Rusconi F, Merletti F. EPICHANGE: Il progetto NINFEA e le nuove forme di coinvolgimento dei cittadini nella ricerca epidemiologica Epidemiol Prev 2015; 39: 14-8.
Poulsen G, Strandberg-Larsen K, Mortensen L, Barros H, Cordier S, Correia S, Danileviciute A, van Eijsden M, Fernández-Somoano A, Gehring U, Grazuleviciene R, Hafkamp-de Groen E, Henriksen TB, Jensen MS, Larrañaga I, Magnus P, Pickett K, Raat H, Richiardi L, Rouget F, Rusconi F, Stoltenberg C, Uphoff EP, Vrijkotte TG, Wijga AH, Vrijheid M, Osler M, Andersen AM. Exploring educational disparities in risk of preterm delivery: a comparative study of 12 European birth cohorts. Paediatr Perinat Epidemiol 2015; 29: 157-83.
Zugna D, Galassi C, Annesi-Maesano I, Baïz N, Barros H, Basterrechea M, Correia S, Duijts L, Esplugues A, Fantini MP, Forastiere F, Gascon M, Gori D, Inskip H, Larsen PS, Mommers M, Nybo Andersen AM, Penders J, Petersen MS, Pike K, Porta D, Sonnenschein-van der Voort A, Steuerwald U, Sunyer J, Torrent M, Vrijheid M, Richiardi L, Rusconi F. Maternal complications in pregnancy and wheezing in early childhood: a pooled analysis of 14 birth cohorts. Int J Epidemiol 2015; 44: 199-208.
Popovic M, Pizzi C, Rusconi F, Galassi C, Merletti F, Richiardi L. Infant weight trajectories and early childhood wheezing: the NINFEA birth cohort study 2015; ERS International Congress.
Pizzi C, Pearce N, Richiardi L. Noncollapsibility in studies based on nonrepresentative samples. Annals of Epidemiology 2015; 25: 955e958.
Pizzi C, Popovic M, Rusconi F, Merletti F, Richiardi L. Crescita antropometrica durante l'infanzia e salute del bambino 2014; XXXVIII Congresso AIE - Associazione Italiana di Epidemiologia.
Popovic M, Rusconi F, Zugna D, Galassi C, Gagliardi L, Merletti F, Migliore E, Richiardi L. Uso di antibiotici in gravidanza e wheezing nell'infanzia 2014; XXXVIII Congresso AIE - Associazione Italiana di Epidemiologia.
Bajardi P, Paolotti D, Vespignani A, Eames K, Funk S, Edmunds WJ, Turbelin C, Debin M, Colizza V, Smallenburg R, Koppeschaar C, Franco AO, Faustino V, Carnahan A, Rehn M, Merletti F, Douwes J, Firestone R, Richiardi L. Association between recruitment methods and attrition in internet-based studies. PLoS One 2014; 9: e0114925.
Sonnenschein-van der Voort AM, Arends LR, de Jongste JC, Annesi-Maesano I, Arshad SH, Barros H, Basterrechea M, Bisgaard H, Chatzi L, Corpeleijn E, Correia S, Craig LC, Devereux G, Dogaru C, Dostal M, Duchen K, Eggesbø M, van der Ent CK, Fantini MP, Forastiere F, Frey U, Gehring U, Gori D, van der Gugten AC, Hanke W, Henderson AJ, Heude B, Iñiguez C, Inskip HM, Keil T, Kelleher CC, Kogevinas M, Kreiner-Møller E, Kuehni CE, Küpers LK, Lancz K, Larsen PS, Lau S, Ludvigsson J, Mommers M, Nybo Andersen AM, Palkovicova L, Pike KC, Pizzi C, Polanska K, Porta D, Richiardi L, Roberts G, Schmidt A, Sram RJ, Sunyer J, Thijs C, Torrent M, Viljoen K, Wijga AH, Vrijheid M, Jaddoe VW, Duijts L. Preterm birth, infant weight gain, and childhood asthma risk: a meta-analysis of 147,000 European children. J Allergy Clin Immunol 2014; 133:1317-29.
Pizzi C, Cole T.J, Richiardi L, dos-Santos-Silvia I, Corvalan C, De Stavola B. Prenatal influences on size, velocity and tempo of infant growth: findings from three contemporary cohorts. PLoS One 2014; 9, e90291.
Leventakou V, Roumeliotaki T, Martinez D, Barros H, Brantsaeter AL, Casas M, Charles MA, Cordier S, Eggesbø M, van Eijsden M, Forastiere F, Gehring U, Govarts E, Halldórsson TI, Hanke W, Haugen M, Heppe DH, Heude B, Inskip HM, Jaddoe VW, Jansen M, Kelleher C, Meltzer HM, Merletti F, Moltó-Puigmartí C, Mommers M, Murcia M, Oliveira A, Olsen SF, Pele F, Polanska K, Porta D, Richiardi L, Robinson SM, Stigum H, Strøm M, Sunyer J, Thijs C, Viljoen K, Vrijkotte TG, Wijga AH, Kogevinas M, Vrijheid M, Chatzi L. Fish intake during pregnancy, fetal growth, and gestational length in 19 European birth cohort studies. Am J Clin Nutr 2014; 99: 506-16.
Larsen PS, Kamper-Jørgensen M, Adamson A, Barros H, Bonde JP, Brescianini S,Brophy S, Casas M, Charles MA, Devereux G, Eggesbø M, Fantini MP, Frey U, Gehring U, Grazuleviciene R, Henriksen TB, Hertz-Picciotto I, Heude B, Hryhorczuk DO, Inskip H, Jaddoe VW, Lawlor DA, Ludvigsson J, Kelleher C, Kiess W, Koletzko B, Kuehni CE, Kull I, Kyhl HB, Magnus P, Momas I, Murray D, Pekkanen J, Polanska K, Porta D, Poulsen G, Richiardi L, Roeleveld N, Skovgaard AM, Sram RJ, Strandberg-Larsen K, Thijs C, Van Eijsden M, Wright J, Vrijheid M, Andersen AM. Pregnancy and birth cohort resources in Europe: a large opportunity for aetiological child health research. Paediatr Perinat Epidemiol 2013; 27: 393-414.
Nannelli T, Rasero L, Montelatici V, Poggesi G, Richiardi L, Rusconi F. Il progetto Ninfea: l'esperienza in Toscana di uno studio di coorte nati con reclutamento on-line. L'infermiere. Notiziario Aggiornamenti Professionali. 2013; 1.
Richiardi L, Pivetta E, Merletti F. Recruiting study participants through Facebook. Epidemiology 2012; 23:175.
Pizzi C, De Stavola BL, Pearce N, Lazzarato F, Ghiotti P, Merletti F, Richiardi L. Selection bias and patterns of confounding in cohort studies: the case of the NINFEA web-based birth cohort. J Epidemiol Community Health 2012; 66: 976-81.
Vrijheid M, Casas M, Bergström A, Carmichael A, Cordier S, Eggesbø M, Eller E, Fantini MP, Fernández MF, Fernández-Somoano A, Gehring U, Grazuleviciene R, Hohmann C, Karvonen AM, Keil T, Kogevinas M, Koppen G, Krämer U, Kuehni C, Magnus P, Majewska R, Andersen AM, Patelarou E, Petersen MS, Pierik FH, Polanska K, Porta D, Richiardi L, Santos AC, Slama R, Sram RJ, Thijs C, Tischer C, Toft G, Trnovec T, Vandentorren S, Vrijkotte TG, Wilhelm M, Wright J, Nieuwenhuijsen M. European birth cohorts for environmental health research. Environ Health Perspect 2012; 120: 29-37.
Costanza Pizzi Validation of NINFEA birth data 2012.
Pizzi C, De Stavola B, Merletti F, Bellocco R, Dos Santos Silva I, Pearce N, Richiardi L. Sample selection and validity of exposure-disease association estimates in cohort studies. J Epidemiol Community Health 2011; 65: 407-11.
Richiardi L, Merletti F. Il progetto NINFEA, studio di coorte di nuovi nati in Italia: finalità, metodi e divulgazione. Donna & Donna, il Giornale delle Ostetriche 2008; 62:62.
Richiardi L, Baussano I, Vizzini L, Douwes J, Pearce N, Merletti F. NINFEA cohort. Feasibility of recruiting a birth cohort through the Internet: the experience of the NINFEA cohort. Eur J Epidemiol 2007; 22: 831-7.
Richiardi L, Baussano I, Merletti F. Coorte di nuovi nati basata su Internet: il progetto NINFEA 2006; XXX Congresso Italiano di Epidemiologia - AIE.
Baussano I, Merletti F, Sassu O, Saccona F, Michelis M, Stralla S, Richiardi L. Web-based birth cohorts Eur J Epidemiol 2006; 21: S124.
Richiardi L, Baussano I, Merletti F. Newborn cohort studies: shall we use the Web? Epidemiol Prev 2005; 29: 56.

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NINFEA study protocol: (version 17th April, 2008 EN)