Associations of residential greenspace exposure and fetal growth across four areas in Spain

Torres Toda, Maria; Estarlich, Marisa; Ballester Díez, Ferran; de Castro, Montserrat; Fernández-Somoano, Ana; Ibarluzea, Jesús; Iñiguez, Carmen; Lertxundi, Aitana; Subiza-Pérez, Mikel; Sunyer Deu, Jordi; Tardón, Adonina; Foraster Pulido, Maria, 1984-; Dadvand, Payam

doi:http://dx.doi.org/10.1016/j.healthplace.2022.102912

Associations of residential greenspace exposure and fetal growth across four areas in Spain

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Torres Toda M, Estarlich M, Ballester F, De Castro M, Fernández-Somoano A, Ibarluzea J, Iñiguez C, Lertxundi A, Subiza-Perez M, Sunyer J, Tardón A, Foraster M, Dadvand P. Associations of residential greenspace exposure and fetal growth across four areas in Spain. Health Place. 2022 Nov;78:102912. DOI: 10.1016/j.healthplace.2022.102912

Abstract

An accumulating body of evidence has associated exposure to greenspace with improved birth outcomes, including higher birth weight and lower risk of low birth weight; however, evidence on such association with in-utero fetal growth is scarce. We explored the influence of maternal exposure to residential greenspace and fetal growth in four INMA (Infancia y Medio Ambiente) Spanish birth cohorts (2003-2008), with 2,465 participants. Residential greenspace was characterised by the Normalised Difference Vegetation Index (NDVI) average across 100 m, 300 m, and 500 m buffers around the residence. Repeated ultrasound measurements of the abdominal circumference (AC), biparietal diameter (BPD), femur length (FL), and estimated fetal weight (EFW) were used. We created customised-generalised least squares models to evaluate associations of residential greenspace exposure on each fetal growth parameter, controlled for the relevant confounders. There were associations between the 500 m buffer and BPD, FL, and AC. We also found associations in the 300 m buffer and FL and AC. The associations in the 100 m buffer were null. Estimates were higher among participants with lower socioeconomic status. Mediation analyses found that air pollution might explain 15-37% of our associations. Mediation by physical activity was not observed. Greenspace exposure may be beneficial for fetal growth.