绿地类型对先天性异常的差异影响:来自韩国国民健康保险服务的数据(2008 - 2013年)
Differential Effects of Green Space Typologies on Congenital Anomalies: Data from the Korean National Health Insurance Service (2008-2013).
作者信息
Lee Ji-Eun, Lee Kyung-Shin, Lim Youn-Hee, Kim Soontae, Lee Nami, Hong Yun-Chul
机构信息
Department of Human Systems Medicine, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea.
Center for Public Healthcare Policy, National Medical Center, Seoul 04564, Republic of Korea.
出版信息
Healthcare (Basel). 2025 Aug 1;13(15):1886. doi: 10.3390/healthcare13151886.
: Urban green space has been increasingly recognized as a determinant of maternal and child health. This study investigated the association between prenatal exposure to different types of green space and the risk of congenital anomalies in South Korea. : We analyzed data from the National Health Insurance Service (N = 142,422). Green space exposure was measured at the area level and categorized into grassland and forest; statistical analysis was performed using generalized estimating equations and generalized additive models to analyze the associations. Additionally, subgroup and sensitivity analyses were performed. : GEE analysis showed that a 10% increase in the proportion of grassland in a residential district was associated with a reduced risk of nervous system (adjusted odds ratio [aOR]: 0.77, 95% confidence interval [CI]: 0.63-0.94) and genitourinary system anomalies (aOR: 0.83, 95% CI: 0.71-0.97). The subgroup analysis results showed significance only for male infants, but the difference between the sexes was not significant. In the quartile-based analysis, we found a slightly significant -value for trend for the effect of forests on digestive system anomalies, but the trend was toward increasing risk. In a sensitivity analysis with different exposure classifications, the overall and nervous system anomalies in built green space showed that the risk decreased as green space increased compared to that in the lowest quartile. : Our results highlight the importance of spatial environmental factors during pregnancy and suggest that different types of green spaces differentially impact the offspring's early health outcomes. This study suggests the need for built environment planning as part of preventive maternal and child health strategies.
城市绿地已越来越被视为母婴健康的一个决定因素。本研究调查了韩国产前暴露于不同类型绿地与先天性异常风险之间的关联。
我们分析了来自国民健康保险服务的数据(N = 142,422)。在区域层面测量绿地暴露情况,并将其分为草地和森林;使用广义估计方程和广义相加模型进行统计分析以分析关联。此外,还进行了亚组分析和敏感性分析。
广义估计方程分析表明,居民区草地比例增加10%与神经系统异常风险降低相关(调整后的优势比[aOR]:0.77,95%置信区间[CI]:0.63 - 0.94)以及泌尿生殖系统异常风险降低相关(aOR:0.83,95% CI:0.71 - 0.97)。亚组分析结果仅对男婴有统计学意义,但性别差异不显著。在基于四分位数的分析中,我们发现森林对消化系统异常影响的趋势值略有统计学意义,但趋势是风险增加。在不同暴露分类的敏感性分析中,建成绿地中的总体异常和神经系统异常表明,与最低四分位数相比,随着绿地增加风险降低。
我们的结果强调了孕期空间环境因素的重要性,并表明不同类型的绿地对后代早期健康结果有不同影响。本研究表明需要将建成环境规划作为母婴预防保健策略的一部分。
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