Keren Agay-Shay1, Yaron Michael2, Xavier Basagaña3,4,5, Èrica Martínez-Solanas3,4,5, David Broday6, Itamar M Lensky2, Mary Rudolf1, Lisa Rubin7,8, Rafi Kent2, Nadav Levy9, Ziona Haklai10, Itamar Grotto11,12. 1. Department of Population Health, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel. 2. Department of Geography and Environment, Bar Ilan University, Ramat-Gan, Israel. 3. ISGlobal, Barcelona, Spain. 4. Universitat Pompeu Fabra (UPF), Barcelona, Spain. 5. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. 6. Department of Environmental, Water, and Agricultural Engineering, Faculty of Civil and Environmental Engineering, Technion-Israel Institute of Technology, Haifa, Israel. 7. Department of Maternal and Child Health, Public Health Services, Ministry of Health, Jerusalem, Israel. 8. School of Public Health, University of Haifa, Haifa, Israel. 9. Public Transport Unit, Tel Aviv Municipality, Tel Aviv, Israel. 10. Health Information Division, Ministry of Health, Jerusalem, Israel. 11. Ministry of Health, Jerusalem, Israel. 12. School of Public Health, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Abstract
BACKGROUND: Natural environments may have beneficial impacts on pregnancy outcomes. However, longitudinal evidence is limited and the associations with variance in surrounding greenness is unknown. Our objective was to evaluate these associations among 73 221 live births in Tel Aviv, Israel. METHODS: Longitudinal exposure to mean of greenness during pregnancy and trimesters were calculated using satellite-based Moderate Resolution Imaging Spectroradiometer (MODIS) Normalised Difference Vegetation Index (NDVI) data. In addition, exposure to mean and variation of NDVI from high-resolution satellite and percentage of tree cover [Vegetation Continuous Fields (VCF)] at 300-m buffer were evaluated in a cross-sectional approach. Generalized linear models were used to estimate the crude and adjusted associations. We explore the possible mediating role of ambient exposures and distance to 'outdoor gyms' located in parks. RESULTS: Crude beneficial associations between exposure to higher mean NDVI during pregnancy and pregnancy outcomes were observed [for birthweight, 3rd/1st tertile exposure increased the mean by 25.5 g, 95% confidence intervals (CIs): 15.4, 35.5] and decreased the odds of low birthweight, small for gestational age, preterm deliveries (PTD) and very PTD. Adjustment for individual and neighbourhood-level markers of socio-economic status (SES) attenuated all the associations. Strongest associations were observed during the first and second trimesters. Cross-sectional associations for mean greenness were similar with narrower CIs, and associations with NDVI were stronger than with tree cover and stronger for mean compared with variance of greenness. Associations were consistent for term births, different buffer sizes and for further adjustment to maternal education. Stronger associations were observed for lowest SES. Distance to 'outdoor gyms' and variance of greenness had the largest estimates of mediation. CONCLUSION: This study adds to the limited information on when exposure to greenness is most beneficial, on the association with variance of greenness and the possible pathways. These observations require confirmation in other populations.
BACKGROUND: Natural environments may have beneficial impacts on pregnancy outcomes. However, longitudinal evidence is limited and the associations with variance in surrounding greenness is unknown. Our objective was to evaluate these associations among 73 221 live births in Tel Aviv, Israel. METHODS: Longitudinal exposure to mean of greenness during pregnancy and trimesters were calculated using satellite-based Moderate Resolution Imaging Spectroradiometer (MODIS) Normalised Difference Vegetation Index (NDVI) data. In addition, exposure to mean and variation of NDVI from high-resolution satellite and percentage of tree cover [Vegetation Continuous Fields (VCF)] at 300-m buffer were evaluated in a cross-sectional approach. Generalized linear models were used to estimate the crude and adjusted associations. We explore the possible mediating role of ambient exposures and distance to 'outdoor gyms' located in parks. RESULTS: Crude beneficial associations between exposure to higher mean NDVI during pregnancy and pregnancy outcomes were observed [for birthweight, 3rd/1st tertile exposure increased the mean by 25.5 g, 95% confidence intervals (CIs): 15.4, 35.5] and decreased the odds of low birthweight, small for gestational age, preterm deliveries (PTD) and very PTD. Adjustment for individual and neighbourhood-level markers of socio-economic status (SES) attenuated all the associations. Strongest associations were observed during the first and second trimesters. Cross-sectional associations for mean greenness were similar with narrower CIs, and associations with NDVI were stronger than with tree cover and stronger for mean compared with variance of greenness. Associations were consistent for term births, different buffer sizes and for further adjustment to maternal education. Stronger associations were observed for lowest SES. Distance to 'outdoor gyms' and variance of greenness had the largest estimates of mediation. CONCLUSION: This study adds to the limited information on when exposure to greenness is most beneficial, on the association with variance of greenness and the possible pathways. These observations require confirmation in other populations.
Authors: Selin Akaraci; Xiaoqi Feng; Thomas Suesse; Bin Jalaludin; Thomas Astell-Burt Journal: Int J Environ Res Public Health Date: 2020-04-24 Impact factor: 3.390
Authors: Kyung Ju Lee; Hyemi Moon; Hyo Ri Yun; Eun Lyeong Park; Ae Ran Park; Hijeong Choi; Kwan Hong; Juneyoung Lee Journal: Environ Health Date: 2020-08-27 Impact factor: 5.984
Authors: Alessandro Rigolon; Matthew H E M Browning; Olivia McAnirlin; Hyunseo Violet Yoon Journal: Int J Environ Res Public Health Date: 2021-03-04 Impact factor: 3.390