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A Systematic Review and Meta-Analysis of Associations between Green and Blue Spaces and Birth Outcomes

1
Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
2
School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
3
Menzies Centre for Health Policy, University of Sydney, Sydney, NSW 2006, Australia
4
National Institute of Environmental Health, Chinese Center for Disease Control and Prevention (China CDC), Beijing 102206, China
5
NIASRA, National Institute for Applied Statistics Research Australia School of Mathematics and Applied Statistics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
6
Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, NSW 2170, Australia
7
School of Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing 100730, China
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(8), 2949; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17082949
Received: 22 March 2020 / Revised: 13 April 2020 / Accepted: 21 April 2020 / Published: 24 April 2020
(This article belongs to the Special Issue Greenspaces and Health: Measures and Methods)
Previous studies suggest that green and blue spaces may promote several health outcomes including birth outcomes. However, no synthesis of previous work has specifically asked policy-relevant questions of how much and what type is needed in every neighborhood to elicit these benefits at the population level. A systematic review and meta-analyses were conducted to synthesize thirty-seven studies on the association between residential green and blue spaces and pregnancy outcomes. Meta-analyses were performed for birth weight (BW), small for gestational age (SGA), low birth weight (LBW) and preterm birth (PTB). Increase in residential greenness was statistically significantly associated with higher BW [β = 0.001, 95%CI: (<0.001, 0.002)] and lower odds of SGA [OR = 0.95, 95%CI: (0.92, 0.97)]. Associations between green space and LBW and PTB were as hypothesized but not statistically significant. Associations between blue spaces and pregnancy outcomes were not evident. No study explicitly examined questions of threshold, though some evidence of nonlinearity indicated that moderate amounts of green space may support more favorable pregnancy outcomes. Policy-relevant green and blue space exposures involving theory-driven thresholds warrant testing to ensure future investments in urban greening promote healthier pregnancy outcomes. View Full-Text
Keywords: green space; blue space; pregnancy outcomes; health benefits; urban planning green space; blue space; pregnancy outcomes; health benefits; urban planning
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MDPI and ACS Style

Akaraci, S.; Feng, X.; Suesse, T.; Jalaludin, B.; Astell-Burt, T. A Systematic Review and Meta-Analysis of Associations between Green and Blue Spaces and Birth Outcomes. Int. J. Environ. Res. Public Health 2020, 17, 2949. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17082949

AMA Style

Akaraci S, Feng X, Suesse T, Jalaludin B, Astell-Burt T. A Systematic Review and Meta-Analysis of Associations between Green and Blue Spaces and Birth Outcomes. International Journal of Environmental Research and Public Health. 2020; 17(8):2949. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17082949

Chicago/Turabian Style

Akaraci, Selin, Xiaoqi Feng, Thomas Suesse, Bin Jalaludin, and Thomas Astell-Burt. 2020. "A Systematic Review and Meta-Analysis of Associations between Green and Blue Spaces and Birth Outcomes" International Journal of Environmental Research and Public Health 17, no. 8: 2949. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17082949

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