Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI (Dr Tvina, MS Visser, and Dr Palatnik).
Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI (Ms Walker and Dr Palatnik); Institute of Health and Equity, Department of Public and Community Health, Medical College of Wisconsin, Milwaukee, WI (Ms Walker and Drs Zhou and Beyer).
Am J Obstet Gynecol MFM. 2021 Sep;3(5):100391. doi: 10.1016/j.ajogmf.2021.100391. Epub 2021 May 11.
There are marked racial disparities in obstetrical outcomes, with the incidence of preterm birth being the highest among non-Hispanic Black women. The presence of green space, such as forests and parks, is now widely viewed as a health-promoting characteristic of residential environments.
This study aimed to examine the association between the proximity of tree canopies to a prenatal residential address and the rates of preterm birth among non-Hispanic Black women in Milwaukee, Wisconsin.
This was a retrospective, case-control study utilizing hospital pregnancy records of self-identified non-Hispanic Black women. The addresses of the women, who delivered from 2011 to 2019, were geocoded to characterize the percentage of tree canopy surrounding the prenatal address using the National Land Cover Database. Circular residential buffers of 100, 150, 250, and 500 m were used to assess the exposure to tree canopy coverage in proximity to a prenatal address. Univariable and multivariable analyses were conducted to determine whether tree canopy percentage at 4 different proximity buffers, examined both in means and quartiles, was associated with preterm birth (birth at <37 weeks' gestation).
Of the 2771 non-Hispanic Black women included in the study, 333 (12.0%) experienced preterm births. Less tree canopy coverage was significantly (P < .05) associated with preterm birth, irrespective of whether the coverage was quantified as a mean or by quartile. In the unadjusted and adjusted models, which adjusted for sociodemographic and clinical risk factors for preterm birth, a 10% increase in tree canopy coverage was associated with lower odds of preterm birth at all 4 buffers examined. When examining the green space by quartile, higher quartiles were associated with lower odds of preterm birth at the 100-, 150-, and 250 m buffers, but not at the 500 m buffer.
A higher percentage of tree canopy coverage in close proximity to the prenatal residential address is associated with lower odds of preterm birth among non-Hispanic Black women. These findings suggest that access to neighborhood green space is an important factor associated with preterm birth.
在产科结局方面存在明显的种族差异，非西班牙裔黑人女性的早产发生率最高。现在，绿地（如森林和公园）的存在被广泛认为是居住环境促进健康的特征。
本研究旨在探讨密尔沃基威斯康星州非西班牙裔黑人孕妇产前居住地址附近树冠的接近程度与早产率之间的关系。
这是一项回顾性病例对照研究，利用医院妊娠记录对自我认定的非西班牙裔黑人女性进行研究。这些女性的地址在 2011 年至 2019 年分娩，使用国家土地覆盖数据库对其进行地理编码，以描述产前地址周围树冠的百分比。使用 100、150、250 和 500 m 的圆形居住缓冲区来评估接近产前地址的树冠覆盖的暴露程度。进行单变量和多变量分析，以确定 4 种不同接近缓冲区的树冠百分比（以平均值和四分位数表示）是否与早产（妊娠 37 周前分娩）相关。
在纳入研究的 2771 名非西班牙裔黑人女性中，333 名（12.0%）经历了早产。无论覆盖率是用平均值还是四分位数来量化，树冠覆盖率较低与早产显著相关（P <.05）。在未调整和调整模型中，这些模型调整了早产的社会人口学和临床风险因素，在所有 4 个检查的缓冲区中，树冠覆盖率增加 10%与早产的几率降低相关。当按四分位数检查绿地时，较高的四分位数与 100、150 和 250 m 缓冲区的早产几率降低相关，但在 500 m 缓冲区则没有。
产前居住地址附近较高的树冠覆盖率与非西班牙裔黑人女性的早产几率降低相关。这些发现表明，获得邻里绿地是与早产相关的一个重要因素。
