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Abstract
Objective 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.
Methods 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.
Results 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.
Conclusion 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.
- Child Development
- Neonatology
Data availability statement
Data are available in a public, open access repository. UK Data Service. University of London, Institute of Education, Centre for Longitudinal Studies. (2022). Millennium Cohort Study: First Survey, 2001-2003. 14th Edition. SN: 4683, DOI: http://doi.org/10.5255/UKDA-SN-4683-6.
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Data availability statement
Data are available in a public, open access repository. UK Data Service. University of London, Institute of Education, Centre for Longitudinal Studies. (2022). Millennium Cohort Study: First Survey, 2001-2003. 14th Edition. SN: 4683, DOI: http://doi.org/10.5255/UKDA-SN-4683-6.
Footnotes
DR and EF are joint senior authors.
Correction notice This paper has been corrected since it was first published. A typo was corrected in the Abstract, under the Results subsection, on the first paragraph: ‘Neighbourhood greenspace moderated the association between income and gestational age, even after adjustment for all confounders, b=0.37, 95% CI (0.01, 0.72).’
Contributors Substantial contributions to the conception or design of the work: DIT, EP, DR and EF. Data acquisition: DIT, EP, DR and EF. Analysis: DIT, EP, DR and EF. Interpretation: DIT, EP, DR and EF. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. Guarantor: EF. The guarantor, EF, accepts full responsibility for the finished work and/or the conduct of the study, had access to the data and controlled the decision to publish.
Funding DIT was supported by Alphablocks Nursery School.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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