Psychology and Neuroscience, University of Glasgow, Glasgow, UK
University College London Institute of Education, London, UK.
Arch Dis Child. 2024 Nov 19;109(12):1017-1024. doi: 10.1136/archdischild-2024-327349.
The relationship between low income and adverse perinatal outcomes, such as low birth weight and developmental delays, is well established making the search for protective factors important. One such factor may be neighbourhood greenspace. This study elucidates the role of urban neighbourhood greenspace in the relationship between income and perinatal outcomes in a nationally representative birth cohort from the UK.
Data on 14 050 infants participating in the initial wave at age 9 months of the Millennium Cohort Study were used (51% male, 20% non-white, 52% living in disadvantaged areas). We tested whether the association between income and perinatal outcomes is moderated by urban greenspace (measured in deciles) before and after adjustments for confounding. The perinatal outcomes included birth weight, gestational age (in days), communication and motor delays. The models were adjusted for the infant's sex and ethnicity, mother's age, education, substance use and mental health as well as area disadvantage and air pollution.
Neighbourhood greenspace moderated the association between income and gestational age, even after adjustment for all confounders, b=-0.11, 95% CI (-0.215, -0.004). For births in low-income households, in particular, it was associated with an increase in gestational age by an average of approximately 3 days. However, after adjustment, greenspace was not found to influence birth weight, communication or motor delays at age 9 months.
The biophilic design of urban environments is a modifiable factor for improving perinatal outcomes in the UK as urban greenspaces appear to be mitigating the risk of preterm birth associated with family poverty.
低收入与不良围产期结局（如低出生体重和发育迟缓）之间的关系已得到充分证实，因此寻找保护因素尤为重要。其中一个因素可能是社区绿地。本研究阐明了城市社区绿地在英国全国代表性出生队列中，在收入与围产期结局之间的关系中的作用。
本研究使用了参与千禧年队列研究初始 9 个月时的 14050 名婴儿的数据（51%为男性，20%为非白人，52%生活在贫困地区）。我们检验了在调整混杂因素前后，城市绿地（用十分位数衡量）是否调节了收入与围产期结局之间的关联。围产期结局包括出生体重、胎龄（以天数计）、语言和运动发育迟缓。这些模型调整了婴儿的性别和种族、母亲的年龄、教育、物质使用和心理健康以及地区劣势和空气污染。
即使在调整了所有混杂因素后，社区绿地仍调节了收入与胎龄之间的关联，b=-0.11，95%置信区间（-0.215，-0.004）。对于低收入家庭的分娩而言，与胎龄增加平均约 3 天有关。然而，调整后，绿地并未发现对 9 个月时的出生体重、语言或运动发育迟缓产生影响。
城市环境的亲生物设计是改善英国围产期结局的可调节因素，因为城市绿地似乎减轻了与家庭贫困相关的早产风险。
