Department of Forestry, Michigan State University, East Lansing, MI 48824, USA.
Department of Public Health, Michigan State University, Flint, MI 48502, USA.
Int J Environ Res Public Health. 2023 Sep 21;20(18):6790. doi: 10.3390/ijerph20186790.
Growing research investigates the perinatal health benefits of greenspace in a mother's prenatal environment. However, evidence of associations between residential greenspace and birth outcomes remains mixed, limiting the relevance this work holds for urban policy and greening interventions. Past research relies predominantly on cross-sectional designs that are vulnerable to residential selection bias, and rarely tests effect modification by maternal race/ethnicity, which may contribute to heterogeneous findings. This study uses a rigorous, longitudinal sibling comparison design and maternal fixed effect analyses to test whether increases in maternal exposure to residential greenspace between pregnancies precede improved birth outcomes among non-Hispanic (NH) white ( = 247,285) and Black ( = 54,995) mothers (mean age = 28 years) who had at least two consecutive live births in California between 2005 and 2015. Results show that increases in residential greenspace correspond with higher birthweight (coef. = 75.49, 95% CI: 23.48, 127.50) among Black, but not white (coef. = -0.51, 95% CI: -22.90, 21.90), infants. Additional analyses suggest that prior evidence of perinatal benefits associated with residential greenspace among white mothers may arise from residential selection; no such bias is observed for Black mothers. Taken together, these findings support urban greening initiatives in historically under-resourced neighborhoods. Efforts to evenly distribute residential greenspace may reduce persistent racial disparities in birth outcomes, an important step towards promoting health equity across the life course.
越来越多的研究调查了母亲产前环境中绿地对围产期健康的益处。然而，居住绿地与出生结果之间的关联证据仍然存在分歧，这限制了这项工作对城市政策和绿化干预的相关性。过去的研究主要依赖于横断面设计，容易受到居住选择偏差的影响，而且很少测试母亲种族/民族对效应的修饰作用，这可能导致研究结果存在异质性。本研究使用严格的纵向同胞比较设计和母亲固定效应分析，来检验母亲在两次怀孕之间接触居住绿地的增加是否会改善非西班牙裔（NH）白人（n = 247285）和黑人（n = 54995）母亲的出生结果（平均年龄为 28 岁），这些母亲在 2005 年至 2015 年期间在加利福尼亚至少有两次连续的活产。结果表明，居住绿地的增加与黑人婴儿的出生体重增加（系数=75.49，95%置信区间：23.48，127.50）相关，但与白人婴儿（系数=-0.51，95%置信区间：-22.90，21.90）无关。进一步的分析表明，先前关于居住绿地与白人母亲围产期益处相关的证据可能源于居住选择；对于黑人母亲来说，没有观察到这种偏差。综上所述，这些发现支持在历史上资源匮乏的社区开展城市绿化计划。努力均匀分配居住绿地可能会减少出生结果中持续存在的种族差异，这是在整个生命周期中促进健康公平的重要一步。
