Weber Kari A, Lyons Evan, Yang Wei, Stevenson Charlotte, Stevenson David K, Shaw Gary M
Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, California.
Department of Earth System Science, Stanford University, Stanford, California; and.
Environ Epidemiol. 2020 Oct 21;4(6):e120. doi: 10.1097/EE9.0000000000000120. eCollection 2020 Dec.
We investigated whether residing near more green space might reduce the risk of preeclampsia.
Participants were women who delivered a live, singleton birth between 1998 and 2011 in eight counties of the San Joaquin Valley in California. There were 7276 cases of preeclampsia divided into mild, severe, or superimposed on preexisting hypertension. Controls were 197,345 women who did not have a hypertensive disorder and delivered between 37 and 41 weeks. Green space was estimated from satellite data using Normalized Difference Vegetation Index (NDVI), an index calculated from surface reflectance at the visible and near-infrared wavelengths. Values closer to 1 denote a higher density of green vegetation. Average NDVI was calculated within a 50 m, 100 m, and 500 m buffer around each woman's residence. Odds ratios and 95% confidence intervals were estimated comparing the lowest and highest quartiles of mean NDVI to the interquartile range comparing each preeclampsia phenotype, divided into early (20-31 weeks) and late (32-36 weeks) preterm birth, to full-term controls.
We observed an inverse association in the 500 m buffer for women in the top quartile of NDVI and a positive association for women in the lowest quartile of NDVI for women with superimposed preeclampsia. There were no associations in the 50 and 100 m buffers.
Within a 500 m buffer, more green space was inversely associated with superimposed preeclampsia. Future work should explore the mechanism by which green space may protect against preeclampsia.
我们调查了居住在绿地较多的地方是否可能降低先兆子痫的风险。
研究对象为1998年至2011年在加利福尼亚州圣华金谷八个县分娩单胎活婴的女性。共有7276例先兆子痫病例，分为轻度、重度或合并既往高血压。对照组为197345名未患高血压疾病且在37至41周分娩的女性。利用归一化植被指数（NDVI）从卫星数据估算绿地面积，该指数由可见光和近红外波段的地表反射率计算得出。数值越接近1表示绿色植被密度越高。计算每位女性住所周围50米、100米和500米缓冲区内的平均NDVI。比较平均NDVI的最低和最高四分位数与四分位间距，估算比值比和95%置信区间，将每种先兆子痫表型分为早产（20 - 31周）和晚期早产（32 - 36周），并与足月对照组进行比较。
我们观察到，对于合并先兆子痫的女性，在500米缓冲区内，NDVI最高四分位数的女性存在负相关，而NDVI最低四分位数的女性存在正相关。在50米和100米缓冲区内无相关性。
在500米缓冲区内，绿地较多与合并先兆子痫呈负相关。未来的研究应探索绿地可能预防先兆子痫的机制。
