Association of residential greenness, air pollution with adverse birth outcomes: Results from 61,762 mother‑neonatal pairs in project ELEFANT (2011-2021)

Yuanyuan Yu; Huishu Lin; Qisijing Liu; Yuxuan Ma; Lei Zhao; Weixia Li; Yan Zhou; Hyang-Min Byun; Penghui Li; Chen Li; Congcong Sun; Xuemei Chen; Ziquan Liu; Wenlong Dong; Liqun Chen; Furong Deng; Shaowei Wu; Shike Hou; Liqiong Guo

doi:10.1016/j.scitotenv.2023.169549

Association of residential greenness, air pollution with adverse birth outcomes: Results from 61,762 mother‑neonatal pairs in project ELEFANT (2011-2021)

Sci Total Environ. 2024 Feb 20:912:169549. doi: 10.1016/j.scitotenv.2023.169549. Epub 2023 Dec 23.

Authors

Yuanyuan Yu¹, Huishu Lin¹, Qisijing Liu², Yuxuan Ma¹, Lei Zhao¹, Weixia Li¹, Yan Zhou³, Hyang-Min Byun⁴, Penghui Li⁵, Chen Li⁶, Congcong Sun⁷, Xuemei Chen¹, Ziquan Liu¹, Wenlong Dong⁸, Liqun Chen⁹, Furong Deng¹⁰, Shaowei Wu¹¹, Shike Hou¹², Liqiong Guo¹³

Affiliations

¹ Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China.
² Research Institute of Public Health, School of Medicine, Nankai University, Tianjin, China.
³ School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, China.
⁴ Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle Upon Tyne NE4 5PL, UK.
⁵ Department of Environmental Science, School of Environmental Science and Safety Engineering, Tianjin University of Technology, Tianjin, China.
⁶ Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China.
⁷ Department of Scientific Research Center, The Third Clinical Institute Affiliated of Wenzhou Medical University, The Third Affiliated of Shanghai University, Wenzhou People's Hospital, Wenzhou Maternal and Child Health Care Hospital, Wenzhou, China.
⁸ Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China.
⁹ Academy of Medical Engineering and Translational Medicine, Medical College, Tianjin University, Tianjin 300072, China.
¹⁰ Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China.
¹¹ Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.
¹² Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China. Electronic address: houshike@tju.edu.cn.
¹³ Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China. Electronic address: yingqidao@163.com.

PMID: 38145684
DOI: 10.1016/j.scitotenv.2023.169549

Abstract

Background: Emerging evidence has demonstrated the benefits of greenness exposure on human health, while conflicts remain unsolved in issue of adverse birth outcomes.

Methods: Utilizing data from project ELEFANT spanning the years 2011 to 2021, we assessed residential greenness using the NDVI from MODIS data and residential PM_2.5 exposure level from CHAP data. Our primary concerns were PTD, LBW, LGA, and SGA. Cox proportional hazard regression model was used to examine the association of residential greenness and air pollution exposure with risk of adverse birth outcomes. We performed mediation and modification effect analyses between greenness and air pollutant.

Results: We identified 61,762 mother‑neonatal pairs in final analysis. For per 10 μg/m³ increase in PM_2.5 concentration during entire pregnancy was associated with 19.8 % and 20.7 % increased risk of PTD and LGA. In contrast, we identified that an 0.1 unit increment in NDVI were associated with 24 %, 43 %, 26.5 %, and 39.5 % lower risk for PTD, LBW, LGA, and SGA, respectively. According to mediation analysis, NDVI mediated 7.70 % and 7.89 % of the associations between PM_2.5 and PTD and LGA. Residential greenness could reduce the risk of PTD among mothers under 35 years old, living in rural areas, primigravidae and primiparity..

Conclusions: In summary, our results highlighted the potential of residential greenness to mitigate the risk of adverse birth outcomes, while also pointing to the adverse impact of PM_2.5 on increased risk of multiple adverse birth outcomes (PTD and LGA). The significant mediation effect of NDVI emphasizes its potential as an important protective factor of PM_2.5 exposure. Additionally, the identification of susceptible subgroups can inform targeted interventions to reduce adverse birth outcomes related to air pollution and lack of green spaces. Further research and understanding of these associations can contribute to better public health strategies aimed at promoting healthier pregnancies and birth outcomes.

Keywords: Air pollution; Large for gestational age; Low birth weight; Preterm delivery; Residential greenness; Small for gestational age.

MeSH terms

Adult
Air Pollutants*
Air Pollution*
Environmental Exposure
Female
Humans
Infant, Newborn
Mothers
Particulate Matter
Pregnancy
Pregnancy Complications*

Substances

Air Pollutants
Particulate Matter