Khalaf Rukun K S, Akaraci Selin, Baldwin Faye D, Geary Rebecca S, Kolamunnage-Dona Ruwanti, Hunter Ruth F, Rodgers Sarah E
Institute of Population Health, University of Liverpool, Liverpool, UK
Centre for Public Health, Queen's University Belfast, Belfast, UK.
BMJ Open. 2024 Aug 7;14(8):e082413. doi: 10.1136/bmjopen-2023-082413.
Previous systematic reviews investigating the effects of green and blue space (GBS) on maternal and neonatal health have mainly focused on cross-sectional evidence, limiting potential causal inferences. The last review on the topic was published in January 2024. This review focused on residential greenness effects and neonatal health only but did not include other green/blue space measures, or maternal health outcomes. This review also only included papers published up to June 2023; discounting the 15 studies that have been published since. Thus, this study will capture the growing number of studies that generate causal evidence and aims to investigate the association between GBS and maternal and/or neonatal health.
The study protocol was developed with reference to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This review will include study designs such as experiments, quasi-experiments, longitudinal studies and more. The study independent variable must be a GBS, green space and/or blue space measure. Eligible maternal health outcomes are those reported during pregnancy and up to 1 year after pregnancy. Neonatal health outcomes are limited to neonates no older than 28 days. A total of seven online databases will be searched: Medline, Scopus, Web of Science, PsycInfo, Embase, Environment Complete, and Maternity and Infant Care Database. Abstract and full-text screenings will be undertaken by three reviewers. Risk of bias assessment will be conducted based on the Risk of Bias in Non-randomized Studies-of Exposure framework.A narrative synthesis will be undertaken. If sufficiently comparable studies are identified, meta-analyses using random effects models will be conducted. We will explore heterogeneity using the I test.
Ethical approval is not required as all the data will be derived from published primary studies that have already obtained ethical permissions. The findings will be disseminated through relevant conferences and peer-reviewed publications.
CRD42023396372.
以往关于绿色和蓝色空间（GBS）对孕产妇和新生儿健康影响的系统评价主要集中在横断面证据上，限制了潜在的因果推断。关于该主题的上一次综述于2024年1月发表。该综述仅关注居住绿地与新生儿健康的影响，但未纳入其他绿色/蓝色空间指标或孕产妇健康结局。该综述也仅纳入了截至2023年6月发表的论文，未包括自那以后发表的15项研究。因此，本研究将纳入越来越多产生因果证据的研究，并旨在调查GBS与孕产妇和/或新生儿健康之间的关联。
本研究方案是参照系统评价与Meta分析的首选报告项目指南制定的。本综述将纳入实验、准实验、纵向研究等研究设计。研究的自变量必须是GBS、绿色空间和/或蓝色空间指标。符合条件的孕产妇健康结局是在孕期及产后1年内报告的结局。新生儿健康结局仅限于28日龄及以内的新生儿。总共将检索7个在线数据库：医学期刊数据库（Medline）、Scopus数据库、科学引文索引（Web of Science）、心理学文摘数据库（PsycInfo）、荷兰医学文摘数据库（Embase）、环境全文数据库（Environment Complete）以及母婴护理数据库（Maternity and Infant Care Database）。将由三名评审员进行摘要和全文筛选。将基于非随机暴露研究中的偏倚风险框架进行偏倚风险评估。将进行叙述性综合分析。如果识别出足够可比的研究，将使用随机效应模型进行Meta分析。我们将使用I²检验探索异质性。
由于所有数据都将来自已获得伦理许可的已发表的原始研究，因此无需伦理批准。研究结果将通过相关会议和同行评审出版物进行传播。
国际前瞻性系统评价注册库（PROSPERO）注册号：CRD42023396372。
