Association between residential greenness and birth weight: Systematic review and meta-analysis |
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| Authors: | Angel M Dzhambov Donka D Dimitrova Elena D Dimitrakova |
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| Institution: | 1. Faculty of Medicine, Medical University of Plovdiv, 15-A Vasil Aprilov Blvd., 4002 Plovdiv, Bulgaria;2. Department of Health Care Management, Health Economics and Primary Care, Medical University of Plovdiv, 15-A Vasil Aprilov Blvd., 4002 Plovdiv, Bulgaria;3. Department of Obstetrics and Gynaecology, Medical University of Plovdiv, 15-A Vasil Aprilov Blvd., 4002 Plovdiv, Bulgaria;1. Program in Public Health, Anteater Instruction & Research Bldg (AIRB), 653 East Peltason Drive University of California, Irvine, CA 92697-3957, United States;2. Department of Science and Environmental Policy, California State University Monterey Bay/NASA Ames Research Center, Moffett Field, CA 94035, United States;1. Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany;2. Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children''s Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany;3. IUF – Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany;4. Institute of Health Economics and Health Care Management, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany;5. Research Institute, Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany;6. Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich (LMU), Munich, Germany;1. College of Public Health and Human Sciences, School of Biological and Population Health Sciences, 20a Milam Hall, Corvallis, OR 97331, USA;1. Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, Canada K1S 5B6;2. School of Public Health, University of California, 50 University Hall, Berkeley, CA 94720-7360, United States;1. School of Psychology and Public Health, La Trobe University, Melbourne, Australia;2. Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia;3. Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia;4. Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Center, Ludwig Maximilians University, Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany;5. School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia |
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| Abstract: | Birth weight is extensively investigated as an outcome of interacting with greenery in mothers’ living environment, because it is one of the major causes for neonatal and infant mortality, as well as a correlate of some adverse effects in childhood and beyond. Conversely, in modern urban-ecological systems the access to greenery is limited. The aim of this study was to answer the question whether green spaces and generally greenery in the living environment of pregnant women are associated with the birth weight of their infants and what the direction of that effect is. MEDLINE, EMBASE and the Internet were searched for relevant publications in English and Spanish. Eight studies were identified and included in the analyses (total n = 214 940). We report quality effects meta-analyses based on correlation and standardized regression coefficients as estimates of effect size. Neighbourhood greenness within 100-m buffer was weakly and positively associated with birth weight. The pooled correlation coefficient was 0.049 (95% CI: 0.039, 0.059) and the pooled standardized regression coefficient was 0.001 (95% CI: ?0.001, 0.003). There was, however, considerable heterogeneity between the studies. Using more sensitive measures for greenness and taking into account green space functionality and quality, adjusting for environmental exposures, and assessing individual attitudes towards nature, might yield clearer picture, higher statistical power and more precise results in future research. Our findings endorse the emphasis put on urban forestry and landscape management as closely related to public health and propose a more naturalistic, humanitarian and person-centered approach in future studies. |
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| Keywords: | Birth weight Birth outcomes Green spaces Greenness Meta-analysis Pregnancy |
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