Background and Objective: Gestational and perinatal environmental exposure has been associated with different pregnancy, birth, and early life outcomes, but the processes and timing are still unclear. Historically, applied models neglect the acute and short-term effects of environmental exposure, even more on respiratory and allergic Emergency Department (ED) admission during early life stages. We examined 3-years (2015–2017) newborns in Turin (Italy) with, at least, one respiratory/allergic pediatric ED admission during their first year of life, focusing on the relationship with air pollution (PM2.5, O3, NO2, aeroallergens) and greenness (NDVI) exposure, in the narrow window of a week before delivery and ED admission, and on the causal mediation analysis of other risk factors, elucidating causal mechanisms or effect pathways. Methods: A tailored Logistic Regression Model, adjusted for seasonality and other possible confounding variables (mothers health and personal conditions, gestational age of birth, meteorological/non-meteorological factors), was applied. Relative Risk (RR) associated with birth outcomes and respiratory/allergic ED admission was assessed at a time lag between 0 and 7 days prior these events. Results: We analyzed 1177 newborns (56.9%male/43.1%female), with at least one respiratory/allergic pediatric ED admission during their first year of life. We modeled air pollution and greenness exposure in relationship with some birth outcomes (i.e Apgar score, weight) and severity of ED admissions. Preliminary analyses showed direct correlations between increased air pollutant levels and birth outcomes (p=0.04) and the severity of ED admissions (p=0.002). The spatial and causal mediation analyses are still undergoing. Conclusions: Environmental exposure may represent adverse or protective pathophysiological connection with birth and early life outcomes, as testified by the effects reported. Further studies are needed to better elucidate such relationship, estimating casual direct/indirect effects on these crucial perinatal outcomes.