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Residential greenness: current perspectives on its impact on maternal health and pregnancy outcomes

Authors Banay RF, Bezold CP, James P, Hart JE, Laden F

Received 21 October 2016

Accepted for publication 18 January 2017

Published 28 February 2017 Volume 2017:9 Pages 133—144

DOI https://doi.org/10.2147/IJWH.S125358

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Leyla Bahar

Peer reviewer comments 2

Editor who approved publication: Professor Elie Al-Chaer


Rachel F Banay,1,* Carla P Bezold,2,* Peter James,1–3 Jaime E Hart,1,3 Francine Laden1–3

1Department of Environmental Health, 2Department of Epidemiology, Harvard T.H. Chan School of Public Health, 3Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

*These authors contributed equally to this work

Abstract:
Recent research in environmental epidemiology has attempted to estimate the effects of exposure to nature, often operationalized as vegetation, on health. Although many analyses have focused on vegetation or greenness with regard to physical activity and weight status, an incipient area of interest concerns maternal health and birth outcomes. This paper reviews 14 studies that examined the association between greenness and maternal or infant health. Most studies were cross-sectional and conducted in birth cohorts. Several studies found evidence for positive associations between greenness and birth weight and maternal peripartum depression. Few studies found evidence for an association between greenness and gestational age or other birth outcomes, or between greenness and preeclampsia or gestational diabetes. Several assessed effect modification by individual or area-level socioeconomic status and found that effects were stronger among those of lower socioeconomic status. Few studies conducted mediation analyses of any kind. Future research should include more diverse birth outcomes and focus on maternal health (especially mental health) and capitalize on richer exposure information during pregnancy rather than cross-sectional assessment at birth.

Keywords: greenness, green space, birth outcomes, prenatal health, infant health

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