Surrounding greenness, proximity to city parks and pregnancy outcomes in Kaunas cohort study

Abstract

There is increasing evidence that green space can improve the health and well-being of urban residents. However, there has been no consistent evidence of the effect of city parks on reproductive health. We investigated whether surrounding greenness levels and/or distance to city parks affect birth outcomes. This study was based on 3292 singleton live-births from the Kaunas birth cohort, Lithuania (2007–2009), who were enrolled in the FP7 PHENOTYPE project study. Residential surrounding greenness level was ascertained as average of satellite-based normalized difference vegetation index (NDVI) within buffers of 100 m, 300 m, and 500 m of each maternal home and distance to a city park was defined as distance to boundaries of the nearest city park. For each indicator of green space exposure, linear or logistic regression models were constructed to estimate change in birth outcomes adjusted for relevant covariates. An increase in distance to a city parks was associated with an increase in risk of preterm birth and decrease of gestational age. We found a statistically significant association between low surrounding greenness and term low birth weight. After assessing effect modification based on the low surrounding greenness (NDVI-500 < median) and the distance to city parks (>1000 m), we found increased risks for low birth weight (OR 2.23, 1.20–4.15), term low birth weight (OR 2.97, 1.04–8.45) and preterm birth (OR 1.77, 1.10–2.81) for subjects with low surrounding greenness and farther distance from a park. Both higher surrounding greenness level and proximity to park have beneficial effects on pregnancy outcomes. A beneficial park effect on foetal growth is most apparent in the environment with low surrounding greenness level. Further investigation is needed to confirm this association.

A Review of Epidemiologic Studies on Greenness and Health: Updated Literature Through 2017

“…Other studies have assessed the road network distance between a participant’s home address and green spaces such as parks, forests, agricultural land, and others [10,14,16,25–28]. Researchers have also used subjective perceptions of nature to assess greenness exposure.…”

Green Infrastructure, Green Stormwater Infrastructure, and Human Health: A Review

“…Residential proximity to GI is associated with higher term birth weight in three studies [23][24][25], larger head circumference [24], lower risk of the baby being too small for its gestational age [23,26], and healthier blood pressure in pregnant women [16]. These relationships persist even after air pollution, noise, and accessibility by walking are taken into account [23].…”

“…Tree density is positively associated with lower crime rates [43,44,47,48,50], more optimal cortisol patterns [19][20][21]75], lower blood pressure [16,17], lower rates of obesity [62], lower allergy rates [27], higher cognitive development and performance [37,38], lower prescription rates of antidepression medication [40], and better pregnancy outcomes [23][24][25][26].…”

“…These outcomes came from studies of pregnant women [42], newborn children [16], school-aged children [31,42], and adults [29,39]. The health outcomes associated with the proximity to green spaces include mental health [39,42], pregnancy outcomes [25], blood pressure [16], lower rates of obesity [31], and lower mortality rates [29].…”

Effects of Urban Green Space on Environmental Health, Equity and Resilience

“…More recent studies (AgayShay et al 2014;Markevych et al 2014;Dadvand et al 2014b) provided further evidence of beneficial effects of green space on birth weight. A larger distance to a city park was also linked with increased risk of preterm birth and with reduced gestational age at birth (Grazuleviciene et al 2015a), while improved availability of green space was linked with reduced risk of preterm births (Laurent et al 2013). …”