TitleResidential green space and pathways to term birth weight in the Canadian Healthy Infant Longitudinal Development (CHILD) Study.
Publication TypeJournal Article
Year of Publication2018
AuthorsCusack, L, Sbihi, H, Larkin, A, Chow, A, Brook, JR, Moraes, T, Mandhane, PJ, Becker, AB, Azad, MB, Subbarao, P, Kozyrskyj, A, Takaro, TK, Sears, MR, Turvey, SE, Hystad, P
Corporate AuthorsCHILD Study Investigators
JournalInt J Health Geogr
Volume17
Issue1
Pagination43
Date Published12/2018
ISSN1476-072X
Abstract
 

BACKGROUND: A growing number of studies observe associations between the amount of green space around a mother's home and positive birth outcomes; however, the robustness of this association and potential pathways of action remain unclear.

OBJECTIVES: To examine associations between mother's residential green space and term birth weight within the Canadian Healthy Infant Longitudinal Development (CHILD) study and examine specific hypothesized pathways.

METHODS: We examined 2510 births located in Vancouver, Edmonton, Winnipeg, and Toronto Canada. Green space was estimated around mother's residences during pregnancy using Landsat 30 m normalized difference vegetation index (NDVI). We examined hypothesized pathways of: (1) reduction of environmental exposure; (2) built environment features promoting physical activity; (3) psychosocial conditions; and (4) psychological influences. Linear regression was used to assess associations between green space and term birth weight adjusting first for a comprehensive set of confounding factors and then incrementally for pathway variables.

RESULTS: Fully adjusted models showed non-statistically significant increases in term birth weight with increasing green space. For example, a 0.1 increase in NDVI within 500 m was associated with a 21.5 g (95% CI - 4.6, 47.7) increase in term birth weight. Associations varied by city and were most robust for high-density locations. For the two largest cities (Vancouver and Toronto), we observed an increase in birth weight of 41.2 g (95% CI 7.8, 74.6) for a 0.1 increase in NDVI within 500 m. We did not observe substantial reductions in the green space effect on birth weight when adjusting for pathway variables.

CONCLUSION: Our results highlight the need to further characterize the interactions between green space, urban density and climate related factors as well as the pathways linking residential green space to birth outcomes.

DOI10.1186/s12942-018-0160-x
Alternate JournalInt J Health Geogr
PubMed ID30514315
PubMed Central IDPMC6280529
Grant List / / CIHR / Canada