Establishing a Multifaceted Comprehensive Maternity Cohort Facilitates Understanding of How Environmental Exposures Impact Perinatal Health

China’s “three-child policy”, implemented in response to population aging, has made the protection of maternal and infant health an urgent priority. In this environmental and medical big-data era, the Zhejiang Environmental and Birth Health Research Alliance (ZEBRA) maternity cohort was established with the aim of identifying risk factors for perinatal morbidity and mortality from the perspectives of both observational epidemiology and experimental etiology. Compared with conventional birth cohorts, the inclusion of a maternity cohort allows greater scope for research and places an emphasis on maternal health. In particular, it allows us to focus on pregnant women with a history of pregnancy-related illnesses and those planning to have a second or third child. There are currently many pressing issues in perinatal health, including the risk associations between exogenous together with endogenous factors and the occurrence of perinatal abnormalities, pregnancy complications, and adverse pregnancy outcomes. It is crucial to explore the interaction between environmental exposures and genetic factors affecting perinatal health if we are to improve it. It is also worthwhile to assess the feasibility of the early stage prediction of major perinatal abnormalities. We hope to study this in the ZEBRA cohort and also seek nationwide and international collaborations to establish a multicenter cohort consortium, with the ultimate goal of contributing epidemiological evidence to literature and providing evidence-based insights for global maternal and child healthcare.