Testing the Multiple Pathways of Residential Greenness to Pregnancy Outcomes Model in a Sample of Pregnant Women in the Metropolitan Area of Donostia-San Sebastián
Abstract
:1. Introduction
1.1. Previous Evidence Supporting the Multiple Pathways of Residential Greenness to Pregnancy Outcomes (MPRGPO) Model
1.2. Blue Spaces and Health: Similarities to Green Spaces
2. Materials and Methods
2.1. Study Sample and Procedure
2.2. Study Instruments and Variables
2.2.1. Residential Greenness
2.2.2. NO2 Exposure Assessment
2.2.3. Physical Activity
2.2.4. Psychological Health
2.2.5. Pregnancy Outcomes
2.2.6. Covariates
2.3. Data Analysis
3. Results
3.1. Testing the Multiple Pathways of Residential Greenness to Pregnancy Outcomes Model in the Study Sample
3.2. Testing the Pathways from Residential Greenness or Blueness to Pregnancy Outcomes in a Study’s Subsample
4. Discussion
4.1. Interpretation of Results in Context of Available Evidence
4.2. Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Whorld Health Organization (WHO). Guías de Calidad del Aire de la OMS Relativas al Material Particulado, el Ozono, el Dióxido de Nitrógeno y el Dióxido de Azufre; WHO: Ginebra, Suiza, 2005. [Google Scholar]
- Markevych, I.; Schoierer, J.; Hartig, T.; Chudnovsky, A.; Hystad, P.; Dzhambov, A.; de Vries, S.; Triguero-Mas, M.; Brauer, M.; Nieuwenhuijsen, M.J.; et al. Exploring pathways linking greenspace to health: Theoretical and methodological guidance. Environ. Res. 2017, 158, 301–317. [Google Scholar] [CrossRef] [PubMed]
- Gascon, M.; Vrijheid, M.; Nieuwenhuijsen, M.J. The Built Environment and Child Health: An Overview of Current Evidence. Curr. Environ. Health Rep. 2016, 3, 250–257. [Google Scholar] [CrossRef] [PubMed]
- O’Callaghan-Gordo, C.; Espinosa, A.; Valentin, A.; Tonne, C.; Pérez-Gómez, B.; Castaño-Vinyals, G.; Dierssen-Sotos, T.; Moreno-Iribas, C.; de Sanjose, S.; Fernandez-Tardón, G.; et al. Green spaces, excess weight and obesity in Spain. Int. J. Hyg. Environ. Health 2019, 223, 45–55. [Google Scholar] [CrossRef] [PubMed]
- Gascon, M.; Triguero-Mas, M.; Martinez, D.; Dadvand, P.; Forns, J.; Plasència, A.; Nieuwenhuijsen, M.J. Mental Health Benefits of Long-Term Exposure to Residential Green and Blue Spaces: A Systematic Review. Int. J. Environ. Res. Public Health 2015, 12, 4354–4379. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Triguero-Mas, M.; Dadvand, P.; Cirach, M.; Martinez, D.; Medina, A.; Mompart, A.; Basagaña, X.; Grazuleviciene, R.; Nieuwenhuijsen, M.J. Natural outdoor environments and mental and physical health: Relationships and mechanisms. Environ. Int. 2015, 77, 35–41. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Weinstein, N.; Balmford, A.; de Haan, C.R.; Gladwell, V.; Bradbury, R.B.; Amano, T. Seeing Community for the Trees: The Links among Contact with Natural Environments, Community Cohesion, and Crime. Bioscience 2015, 65, 1141–1153. [Google Scholar] [CrossRef] [Green Version]
- Capolongo, S.; Rebecchi, A.; Dettori, M.; Appolloni, L.; Azara, A.; Buffoli, M.; Capasso, L.; Casuccio, A.; Conti, G.O.; D’Amico, A.; et al. Healthy Design and Urban Planning Strategies, Actions, and Policy to Achieve Salutogenic Cities. Int. J. Environ. Res. Public Health 2018, 15, 2698. [Google Scholar] [CrossRef] [Green Version]
- Kihal, W.; Padilla, C.; Lalloué, B.; Gelormini, M.; Zmirou-Navier, D.; Deguen, S. Green space and spatial analysis of social inequalities in infant mortality in France. ISEE Conf. Abstr. 2013, 3103. [Google Scholar] [CrossRef]
- Colin, A.A.; McEvoy, C.T.; Castile, R.G. Respiratory morbidity, and lung function in preterm infants of 32 to 36 weeks’ gestational age. Pediatrics 2010, 126, 115–128. [Google Scholar] [CrossRef] [Green Version]
- Patton, G.C.; Coffey, C.; Carlin, J.B.; Degenhardt, L.; Lynskey, M.; Hall, W. Cannabis use and mental health in young people: Cohort study. BMJ 2002, 325, 1195–1198. [Google Scholar] [CrossRef] [Green Version]
- Kajantie, E.; Osmond, C.; Barker, D.J.; Forsén, T.; Phillips, D.I.; Eriksson, J.G. Size at birth as a predictor of mortality in adulthood: A follow-up of 350 000 person-years. Int. J. Epidemiol. 2005, 34, 655–663. [Google Scholar] [CrossRef] [PubMed]
- Keren, A.-S.; Peled, A.; Crespo, A.V.; Peretz, C.; Amitai, Y.; Linn, S.; Friger, M.; Nieuwenhuijsen, M.J. Green spaces and adverse pregnancy outcomes. Occup. Environ. Med. 2014, 71, 562–569. [Google Scholar] [CrossRef]
- Banay, R.F.; Bezold, C.P.; James, P.; Hart, J.E.; Laden, F. Residential greenness: Current perspectives on its impact on maternal health and pregnancy outcomes. Int. J. Women’s Health 2017, 9, 133–144. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Dzhambov, A.; Dimitrova, D.; Dimitrakova, E.D. Association between residential greenness and birth weight: Systematic review and meta-analysis. Urban For. Urban Green. 2014, 13, 621–629. [Google Scholar] [CrossRef]
- Dzhambov, A.; Markevych, I.; Lercher, P. Associations of residential greenness, traffic noise, and air pollution with birth outcomes across Alpine areas. Sci. Total Environ. 2019, 678, 399–408. [Google Scholar] [CrossRef]
- Hystad, P.; Davies, H.W.; Frank, L.; van Loon, J.; Gehring, U.; Tamburic, L.; Brauer, M. Residential Greenness and Birth Outcomes: Evaluating the Influence of Spatially Correlated Built-Environment Factors. Environ. Health Perspect. 2014, 122, 1095–1102. [Google Scholar] [CrossRef] [Green Version]
- Laurent, O.; Wu, J.; Li, L.; Milesi, C. Green spaces and pregnancy outcomes in Southern California. Health Place 2013, 24, 190–195. [Google Scholar] [CrossRef] [Green Version]
- Twohig-Bennett, C.; Jones, A. The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes. Environ. Res. 2018, 166, 628–637. [Google Scholar] [CrossRef]
- Eriksson, C.; Lind, T.; Ekström, S.; Gruzieva, O.; Georgelis, A.; Bergström, A.; Lõhmus, M. Neighbourhood greenness and birth outcomes in a Swedish birth cohort—A short communication. Health Place 2019, 57, 200–203. [Google Scholar] [CrossRef]
- Nieuwenhuijsen, M.J.; Agier, L.; Basagaña, X.; Urquiza, J.; Tamayo-Uria, I.; Giorgis-Allemand, L.; Robinson, O.; Siroux, V.; Maitre, L.; de Castro, M.; et al. Influence of the Urban Exposome on Birth Weight. Environ. Health Perspect. 2019, 127, 47007. [Google Scholar] [CrossRef]
- Glazer, K.; Eliot, M.N.; Danilack, V.A.; Carlson, L.; Phipps, M.G.; Dadvand, P.; Savitz, D.A.; Wellenius, G.A. Residential green space and birth outcomes in a coastal setting. Environ. Res. 2018, 163, 97–107. [Google Scholar] [CrossRef]
- Grazuleviciene, R.; Danilevičiūtė, A.; Dėdelė, A.; Vencloviene, J.; Andrusaityte, S.; Uzdanaviciute, I.; Nieuwenhuijsen, M. Surrounding greenness, proximity to city parks and pregnancy outcomes in Kaunas cohort study. Int. J. Hyg. Environ. Health 2015, 218, 358–365. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kumar, P.; Druckman, A.; Gallagher, J.; Gatersleben, B.; Allison, S.; Eisenman, T.S.; Hoang, U.; Hama, S.; Tiwari, A.; Sharma, A.; et al. The nexus between air pollution, green infrastructure, and human health. Environ. Int. 2019, 133, 105181. [Google Scholar] [CrossRef] [PubMed]
- Selmi, W.; Weber, C.; Rivière, E.; Blond, N.; Mehdi, L.; Nowak, D. Air pollution removal by trees in public green spaces in Strasbourg city, France. Urban For. Urban Green. 2016, 17, 192–201. [Google Scholar] [CrossRef] [Green Version]
- Nowak, D.J. The Effects of Urban Trees on Air Quality; USDA Forest Service: Syracuse, NY, USA, 2002. [Google Scholar]
- Cai, L.; Zhuang, M.; Ren, Y. Spatiotemporal characteristics of NO2, PM2.5 and O3 in a coastal region of southeastern China and their removal by green spaces. Int. J. Environ. Health Res. 2020, 1–17. [Google Scholar] [CrossRef] [PubMed]
- Kaplan, R.; Kaplan, S. The Experience of Nature: A Psychological Perspective; Cambridge University Press: Cambridge, UK, 1989. [Google Scholar]
- Ulrich, R.S.; Biophilia, B. Natural Landscapes. In The Biophilia Hypothesis; Kellert, S.E., Wilson, E., Eds.; Island Press: Washington, DC, USA, 1993; pp. 73–137. [Google Scholar]
- Dadvand, P.; Bartoll, X.; Basagaña, X.; Dalmau-Bueno, A.; Martínez, D.; Ambros, A.; Cirach, M.; Triguero-Mas, M.; Gascon, M.; Borrell, C.; et al. Green spaces and General Health: Roles of mental health status, social support, and physical activity. Environ. Int. 2016, 91, 161–167. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- McEachan, R.; Prady, S.L.; Smith, L.; Fairley, L.; Cabieses, B.; Gidlow, C.J.; Wright, J.; Dadvand, P.; van Gent, D.; Nieuwenhuijsen, M.J. The association between green space and depressive symptoms in pregnant women: Moderating roles of socioeconomic status and physical activity. J. Epidemiol. Comm. Health 2015, 70, 253–259. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Pietilä, M.; Neuvonen, M.; Borodulin, K.; Korpela, K.; Sievänen, T.; Tyrväinen, L. Relationships between exposure to urban green spaces, physical activity, and self-rated health. J. Outdoor Recreat. Tour. 2015, 10, 44–54. [Google Scholar] [CrossRef]
- Hartig, T.; Mitchell, R.; de Vries, S.; Frumkin, H. Nature and Health. Annu. Rev. Public Health 2014, 35, 207–228. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Guo, L.-Q.; Chen, Y.; Mi, B.-B.; Dang, S.-N.; Zhao, D.-D.; Liu, R.; Wang, H.-L.; Yan, H. Ambient air pollution and adverse birth outcomes: A systematic review and meta-analysis. J. Zhejiang Univ. Sci. B 2019, 20, 238–252. [Google Scholar] [CrossRef]
- Klepac, P.; Locatelli, I.; Korošec, S.; Künzli, N.; Kukec, A. Ambient air pollution and pregnancy outcomes: A comprehensive review and identification of environmental public health challenges. Environ. Res. 2018, 167, 144–159. [Google Scholar] [CrossRef]
- Bennett, H.A.; Einarson, A.; Taddio, A.; Koren, G.; Einarson, T.R. Prevalence of Depression During Pregnancy: Systematic Review. Obstet. Gynecol. 2004, 103, 698–709. [Google Scholar] [CrossRef] [PubMed]
- Couto, T.C.E.; Cardoso, M.N.; Brancaglion, M.M.; Faria, G.C.; Garcia, F.D.; Nicolato, R.; Miranda, D.M.; Corrêa, H. Antenatal depression: Prevalence and risk factor patterns across the gestational period. J. Affect. Disord. 2016, 192, 70–75. [Google Scholar] [CrossRef] [PubMed]
- Lee, A.M.; Lam, S.K.; Lau, S.M.S.M.; Chong, C.; Chui, H.W.; Fong, D.-T. Prevalence, Course, and Risk Factors for Antenatal Anxiety and Depression. Obstet. Gynecol. 2007, 110, 1102–1112. [Google Scholar] [CrossRef] [PubMed]
- de Tychey, C.; Spitz, E.; Briançon, S.; Lighezzolo-Alnot, J.; Girvan, F.; Rosati, A.; Thockler, A.; Vincent, S. Pre- and postnatal depression, and coping: A comparative approach. J. Affect. Disord. 2005, 85, 323–326. [Google Scholar] [CrossRef]
- van Bussel, J.C.H.; Spitz, B.; Demyttenaere, K. Women’s Mental Health Before, During, and After Pregnancy: A Population-Based Controlled Cohort Study. Birth 2006, 33, 297–302. [Google Scholar] [CrossRef] [PubMed]
- Lima, S.A.M.; el Dib, R.P.; Rodrigues, M.R.K.; Ferraz, G.A.R.; Molina, A.C.; Neto, C.A.P.; de Lima, M.A.F.; Rudge, M.V.C. Is the risk of low birth weight or preterm labor greater when maternal stress is experienced during pregnancy? A systematic review and meta-analysis of cohort studies. PLoS ONE 2018, 13, e0200594. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Rethorst, C.; Wipfli, B.M.; Landers, D.M. The Antidepressive Effects of Exercise. Sports Med. 2009, 39, 491–511. [Google Scholar] [CrossRef]
- Wipfli, B.M.; Rethorst, C.; Landers, D.M. The anxiolytic effects of exercise: A meta-analysis of randomized trials and dose-response analysis. J. Sport Exerc. Psychol. 2008, 30, 392–410. [Google Scholar] [CrossRef] [Green Version]
- Schlüssel, M.M.; de Souza, E.B.; Reichenheim, M.E.; Kac, G. Physical activity during pregnancy and maternal-child health outcomes: A systematic literature review. Cad. Saúde Pública 2008, 24, s531–s544. [Google Scholar] [CrossRef]
- Davenport, M.H.; Meah, V.L.; Ruchat, S.-M.; Davies, G.A.; Skow, R.J.; Barrowman, N.; Adamo, K.B.; Poitras, V.J.; Gray, C.; Garcia, A.J.; et al. Impact of prenatal exercise on neonatal and childhood outcomes: A systematic review and meta-analysis. Br. J. Sports Med. 2018, 52, 1386–1396. [Google Scholar] [CrossRef]
- da Silva, S.G.; Ricardo, L.I.C.; Evenson, K.R.; Hallal, P.C. Leisure-Time Physical Activity in Pregnancy and Maternal-Child Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Cohort Studies. Sports Med. 2016, 47, 295–317. [Google Scholar] [CrossRef] [PubMed]
- Fieril, K.; Glantz, A.; Olsén, M.F. The efficacy of moderate-to-vigorous resistance exercise during pregnancy: A randomized controlled trial. Acta Obstet. Gynecol. Scand. 2014, 94, 35–42. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Takami, M.; Tsuchida, A.; Takamori, A.; Aoki, S.; Ito, M.; Kigawa, M.; Kawakami, C.; Hirahara, F.; Hamazaki, K.; Inadera, H.; et al. Effects of physical activity during pregnancy on preterm delivery and mode of delivery: The Japan Environment and Children’s Study, birth cohort study. PLoS ONE 2018, 13, e0206160. [Google Scholar] [CrossRef] [Green Version]
- Foley, R.; Kistemann, T. Blue space geographies: Enabling health in place. Health Place 2015, 35, 157–165. [Google Scholar] [CrossRef] [Green Version]
- Ballesteros-Olza, M.; Gracia-de-Rentería, P.; Pérez-Zabaleta, A. Effects on general health associated with beach proximity in Barcelona (Spain). Health Promot. Int. 2020, 1–9. [Google Scholar] [CrossRef] [PubMed]
- Gascon, M.; Zijlema, W.L.; Vert, C.; White, M.P.; Nieuwenhuijsen, M.J. Outdoor blue spaces, human health, and well-being: A systematic review of quantitative studies. Int. J. Hyg. Environ. Health 2017, 220, 1207–1221. [Google Scholar] [CrossRef]
- White, M.; Alcock, I.; Wheeler, B.; Depledge, M.H. Coastal proximity, health, and well-being: Results from a longitudinal panel survey. Health Place 2013, 23, 97–103. [Google Scholar] [CrossRef] [Green Version]
- Edwards, N.; Giles-Corti, B.; Larson, A.; Beesley, B. The Effect of Proximity on Park and Beach Use and Physical Activity Among Rural Adolescents. J. Phys. Act. Health 2014, 11, 977–984. [Google Scholar] [CrossRef]
- James, P.; Banay, R.F.; Hart, J.E.; Laden, F. A Review of the Health Benefits of Greenness. Curr. Epidemiol. Rep. 2015, 2, 131–142. [Google Scholar] [CrossRef] [Green Version]
- Rugel, E.J.; Henderson, S.B.; Carpiano, R.M.; Brauer, M. Beyond the Normalized Difference Vegetation Index (NDVI): Developing a natural space index for population-level health research. Environ. Res. 2017, 159, 474–483. [Google Scholar] [CrossRef] [PubMed]
- Beelen, R.; Hoek, G.; Vienneau, D.; Eeftens, M.; Dimakopoulou, K.; Pedeli, X.; Tsai, M.-Y.; Künzli, N.; Schikowski, T.; Marcon, A.; et al. Development of NO2 and NOx land use regression models for estimating air pollution exposure in 36 study areas in Europe—The ESCAPE project. Atmos. Environ. 2013, 72, 10–23. [Google Scholar] [CrossRef]
- Guxens, M.; Ballester, F.; Espada, M.; Fernández, M.F.; Grimalt, J.O.; Ibarluzea, J.; Olea, N.; Rebagliato, M.; Tardon, A.; Torrent, M.; et al. Cohort Profile: The INMA—INfancia y Medio Ambiente—(Environment and Childhood) Project. Int. J. Epidemiol. 2011, 41, 930–940. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Larrañaga, I.; Marina, L.S.; Begiristain, H.; Machón, M.; Vrijheid, M.; Casas, M.; Tardon, A.; Fernández-Somoano, A.; Llop, S.; Rodríguez-Bernal, C.L.; et al. Socio-Economic Inequalities in Health, Habits and Self-Care During Pregnancy in Spain. Matern. Child Health J. 2012, 17, 1315–1324. [Google Scholar] [CrossRef] [PubMed]
- Rocha, K.B.; Pérez, K.; Rodríguez-Sanz, M.; Borrell, C.; Obiols, J.E. Propiedades psicométricas y valores normativos del General Health Questionnaire (GHQ-12) en población general española TT—Psychometric properties and normative values of General Health Questionnaire (GHQ-12) in Spanish population. Int. J. Clin. Health Psychol. 2011, 11, 125–139. [Google Scholar]
- Tao, W.; Lagergren, J. Clinical management of obese patients with cancer. Nature Rev. Clin. Oncol. 2013, 10, 519. [Google Scholar] [CrossRef]
- Hyndman, R.J.; Fan, Y. Sample Quantiles in Statistical Packages. Am. Stat. 1996, 50, 361–365. [Google Scholar] [CrossRef]
- Core, T.R. A Language and Environment for Statistical Computing; RC Team: Vienna, Austria, 2019. [Google Scholar]
- MacKinnon, D.P. Introduction to Statistical Mediation Analysis; Multivariate Applications Series; Taylor & Francis Group/Lawrence Erlbaum Associates: New York, NY, USA, 2008; ISBN 0-8058-6429-6. (Paperback). [Google Scholar]
- Robins, J.M.; Greenland, S. Identifiability and Exchangeability for Direct and Indirect Effects. Epidemiology 1992, 3, 143–155. [Google Scholar] [CrossRef] [Green Version]
- Pearl, J. Direct and Indirect Effects. In Proceedings of the 17th Conference in Uncertainty in Artificial Intelligence; Morgan Kaufmann Publishers Inc.: San Francisco, CA, USA, 2001; pp. 411–420. [Google Scholar]
- Steen, J.; Loeys, T.; Moerkerke, B.; Vansteelandt, S. Medflex: An R Package for Flexible Mediation Analysis using Natural Effect Models. J. Stat. Softw. 2017, 76, 1–46. [Google Scholar] [CrossRef] [Green Version]
- Loeys, T.; Moerkerke, B.; de Smet, O.; Buysse, A.; Steen, J.; Vansteelandt, S. Flexible Mediation Analysis in the Presence of Nonlinear Relations: Beyond the Mediation Formula. Multivar. Behav. Res. 2013, 48, 871–894. [Google Scholar] [CrossRef]
- Vander-Weele, T.J.; Vansteelandt, S. Odds ratios for mediation analysis for a dichotomous outcome. Am. J. Epidemiol. 2010, 172, 1339–1348. [Google Scholar] [CrossRef] [PubMed]
- Vansteelandt, S.; Bekaert, M.A.; Lange, T. Imputation Strategies for the Estimation of Natural Direct and Indirect Effects. Epidemiol. Methods 2012, 1, 130–158. [Google Scholar] [CrossRef]
- Lange, T.; Vansteelandt, S.; Bekaert, M. A Simple Unified Approach for Estimating Natural Direct and Indirect Effects. Am. J. Epidemiol. 2012, 176, 190–195. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Mendinueta, A.; Esnal, H.; Arrieta, H.; Arrue, M.; Urbieta, N.; Ubillos, I.; Whitworth, K.W.; Delclòs-Alió, X.; Vich, G.; Ibarluzea, J. What Accounts for Physical Activity during Pregnancy? A Study on the Sociodemographic Predictors of Self-Reported and Objectively Assessed Physical Activity during the 1st and 2nd Trimesters of Pregnancy. Int. J. Environ. Res. Public Health 2020, 17, 2517. [Google Scholar] [CrossRef] [PubMed]
- Robinson, O.; Tamayo, I.; de Castro, M.; Valentin, A.; Giorgis-Allemand, L.; Krog, N.H.; Aasvang, G.M.; Ambros, A.; Ballester, F.; Bird, P.; et al. The Urban Exposome during Pregnancy and Its Socioeconomic Determinants. Environ. Health Perspect. 2018, 126, 077005. [Google Scholar] [CrossRef]
- Dadvand, P.; Sunyer, J.; Basagaña, X.; Ballester, F.; Lertxundi, A.; Fernández-Somoano, A.; Estarlich, M.; García-Esteban, R.; Méndez, M.A.; Nieuwenhuijsen, M.J. Surrounding Greenness and Pregnancy Outcomes in Four Spanish Birth Cohorts. Environ. Health Perspect. 2012, 120, 1481–1487. [Google Scholar] [CrossRef]
- Gobierno Vasco Informe Anual de la Calidad del Aire de la CAPV. 2018. Available online: https://www.euskadi.eus/contenidos/documentacion/informes_anuales_calidad_aire/es_def/Informe 2018.pdf (accessed on 24 April 2020).
- Tabatabaie, S.; Litt, J.S.; Carrico, A.R. A Study of Perceived Nature, Shade and Trees and Self-Reported Physical Activity in Denver. Int. J. Environ. Res. Public Health 2019, 16, 3604. [Google Scholar] [CrossRef] [Green Version]
- Colley, R.C.; Butler, G.; Garriguet, D.; Prince, S.A.; Roberts, K.C. Comparison of self-reported and accelerometer-measured physical activity among Canadian youth. Health Reports 2019, 30, 3–12. [Google Scholar]
- Skender, S.; Ose, J.; Chang-Claude, J.; Paskow, M.; Brühmann, B.; Siegel, E.M.; Steindorf, K.; Ulrich, C.M. Accelerometry and physical activity Questionnaires—A systematic review. BMC Public Health 2016, 16, 515. [Google Scholar] [CrossRef] [Green Version]
- Gidlow, C.J.; van Kempen, E.; Smith, G.; Triguero-Mas, M.; Kruize, H.; Grazuleviciene, R.; Ellis, N.; Hurst, G.; Masterson, D.; Cirach, M.; et al. Development of the natural environment scoring tool (NEST). Urban For. Urban Green. 2018, 29, 322–333. [Google Scholar] [CrossRef]
- Vansteelandt, S. Understanding counterfactual-based mediation analysis approaches and their differences. Epidemiology 2012, 23, 889–891. [Google Scholar] [CrossRef] [PubMed]
- Casella, G.; Berger, R.L. Statistical Inference; Duxbury: Pacific Grove, USA, 2002; 660p. [Google Scholar]
- Loeys, T.; Moerkerke, B.; Vansteelandt, S. A cautionary note on the power of the test for the indirect effect in mediation analysis. Front. Psychol. 2015, 5. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lange, T.; Starkopf, L. Commentary: Mediation analyses in the real world. Epidemiology 2016, 27, 677–681. [Google Scholar] [CrossRef] [PubMed]
- da Silva, A.M.C.; Moi, G.P.; Mattos, I.E.; Hacon, S.D.S. Low birth weight at term and the presence of fine particulate matter and carbon monoxide in the Brazilian Amazon: A population-based retrospective cohort study. BMC Pregnancy Childbirth 2014, 14, 309. [Google Scholar] [CrossRef] [Green Version]
- Kumar, N. The Exposure Uncertainty Analysis: The Association between Birth Weight and Trimester Specific Exposure to Particulate Matter (PM2.5 vs. PM10). Int. J. Environ. Res. Public Health 2016, 13, 906. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lavigne, E.; Yasseen, A.S.; Stieb, D.M.; Hystad, P.; van Donkelaar, A.; Martin, R.V.; Brook, J.R.; Crouse, D.L.; Burnett, R.T.; Chen, H.; et al. Ambient air pollution and adverse birth outcomes: Differences by maternal comorbidities. Environ. Res. 2016, 148, 457–466. [Google Scholar] [CrossRef] [Green Version]
- Ng, C.; Malig, B.; Hasheminassab, S.; Sioutas, C.; Basu, R.; Ebisu, K. Source apportionment of fine particulate matter and risk of term low birth weight in California: Exploring modification by region and maternal characteristics. Sci. Total Environ. 2017, 605, 647–654. [Google Scholar] [CrossRef]
- Nieuwenhuijsen, M.J.; Ristovska, G.; Dadvand, P. WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Adverse Birth Outcomes. Int. J. Environ. Res. Public Health 2017, 14, 1252. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Stieb, D.M.; Chen, L.; Beckerman, B.S.; Jerrett, M.; Crouse, D.L.; Omariba, D.W.R.; Peters, P.A.; van Donkelaar, A.; Martin, R.V.; Burnett, R.T.; et al. Associations of Pregnancy Outcomes and PM2.5 in a National Canadian Study. Environ. Health Perspect. 2015, 124, 243–249. [Google Scholar] [CrossRef] [Green Version]
- Cusack, L.; Sbihi, H.; Larkin, A.; Chow, A.; Brook, J.R.; Moraes, T.J.; Mandhane, P.J.; Becker, A.B.; Azad, M.B.; Subbarao, P.; et al. Residential green space and pathways to term birth weight in the Canadian Healthy Infant Longitudinal Development (CHILD) Study. Int. J. Health Geogr. 2018, 17, 43. [Google Scholar] [CrossRef]
- Government of Basque Country. Gobierno Vasco Programa de Cribado Neonatal de la CAPV. In Memoria; Government of Basque Country: Basque Country, Spain, 2018; pp. 1–17. [Google Scholar]
- Vallée, J.; le Roux, G.; Kestens, Y.; Chaix, B.; Chauvin, P. The ‘constant size neighbourhood trap’ in accessibility and health studies. Urban Stud. 2014, 52, 338–357. [Google Scholar] [CrossRef]
- Donaire-Gonzalez, D.; Curto, A.; Valentín, A.; Andrusaityte, S.; Basagaña, X.; Casas, M.; Chatzi, L.; de Bont, J.; de Castro, M.; Dedele, A.; et al. Personal assessment of the external exposome during pregnancy and childhood in Europe. Environ. Res. 2019, 174, 95–104. [Google Scholar] [CrossRef] [PubMed]
Role in the Analyses | Variable | Type | n | n Missing | Condition Is Met | Minimum | Maximum | Mean | SD | Median | Q1 | Q2 | IQR |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Exposure | Green space availability within 300 m | Binary | 435 | 1 | 325 (74.7%) | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
Green space availability within 500 m | Binary | 435 | 1 | 384 (88.3%) | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | |
Neighborhood greenness (NDVI) within 300 m | Quantitative continuous | 435 | 1 | N/A | 0.07 | 0.5 | 0.21 | 0.09 | 0.2 | 0.14 | 0.26 | 0.11 | |
Mediator | Mental health | Quantitative discrete | 373 | 63 | N/A | 0 | 29 | 10.8 | 4.07 | 10 | 8 | 13 | 5 |
Average NO2 during the whole pregnancy | Quantitative continuous | 400 | 36 | N/A | 11.3 | 226 | 46.7 | 22.36 | 40.2 | 33 | 56 | 23 | |
MVPA during the first trimester | Quantitative continuous | 338 | 98 | N/A | 4 | 124 | 39.9 | 21.65 | 36.3 | 24.1 | 53.4 | 29.35 | |
Response | Birth Weight | Quantitative continuous | 400 | 36 | N/A | 1600 | 4900 | 3350 | 488.62 | 3340 | 3060 | 3640 | 580 |
Prematurity | Binary | 398 | 38 | 13 (3.3%) | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | |
SGA (small for gestational age) | Binary | 397 | 39 | 37 (9.3%) | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | |
LGA (large for gestational age) | Binary | 397 | 39 | 58 (14.6%) | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | |
LBW (low birth weight) | Binary | 400 | 36 | 19 (4.8%) | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | |
Covariate | Parity | Quantitative discrete | 400 | 36 | N/A | 0.00 | 10.00 | 0.71 | 0.89 | 1.00 | 0.00 | 1.00 | 1.00 |
Privation Index | Quantitative discrete | 435 | 1 | N/A | 1.00 | 5.00 | 2.42 | 1.28 | 2.00 | 1.00 | 3.00 | 2.00 | |
Spring | Summer | Autumn | Winter | N/A | N/A | N/A | |||||||
Sex | Binary | 401 | 35 | 196 (48.9%) | 205 (51.1%) | N/A | N/A | N/A | N/A | N/A | N/A | N/A | |
Season | Nominal | 398 | 38 | N/A | N/A | 82 (20.6%) | 135 (33.9%) | 127 (31.9%) | 54 (13.6%) | N/A | N/A | N/A |
Exposure | Prematurity | SGA | LGA | LBW | BW | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
NO2 | GHQ | MVPA | NO2 | GHQ | MVPA | NO2 | GHQ | MVPA | NO2 | GHQ | MVPA | NO2 | GHQ | MVPA | |
Green availability 300 m | |||||||||||||||
Direct effect | −0.1 (2.69) | −0.71 (3.10) | −0.32 (2.61) | 0.68 (0.55) | 0.46 (0.56) | 0.42 (0.79) | −0.52 (0.32) | −0.64 † (0.38) | −0.48 (0.37) | 0.39 (2.35) | −0.20 (2.48) | 0.06 (2.31) | −138.65 * (60.35) | −107.87 † (65.39) | −110.63 † (66.90) |
Indirect effect | −0.17 (0.15) | 0.06 (0.23) | 0.01 (0.17) | −0.02 (0.06) | <0.01 (0.03) | <0.01 (0.04) | 0.03 (0.04) | 0.01 (0.03) | −0.012 (0.04) | −0.12 (0.11) | 0.05 (0.08) | −0.016 (0.12) | 6.62 (5.26) | −1.24 (4.54) | −2.06 (6.23) |
Green availability 500 m | |||||||||||||||
Direct effect | 0.99 (8.27) | 0.02 (8.49) | 0.27 (8.28) | 1.12 (5.10) | 1.01 (5.19) | 0.95 (4.89) | −0.11 (0.54) | −0.20 (1.59) | −0.25 (0.77) | 0.46 (5.76) | −0.26 (5.80) | −0.10 (6.03) | −137.35† (81.96) | −123.87 (86.26) | −133.9 (86.98) |
Indirect effect | −0.50 (0.38) | 0.11 (0.19) | 0.01 (0.26) | −0.05 (0.14) | <0.01 (0.04) | <0.01 (0.07) | 0.05 (0.08) | 0.03 (0.05) | −0.02 (0.07) | −0.31 (0.25) | 0.04 (0.09) | −0.01 (0.15) | 15.39 (12.95) | −2.44 (5.43) | −3.97 (9.20) |
NDVI 300 m | |||||||||||||||
Direct effect | −0.34 (0.38) | −0.5 (0.70) | −0.14 (0.49) | 0.14 (0.18) | 0.01 (0.19) | 0.12 (0.20) | −0.05 (0.15) | 0.02 (0.18) | −0.03 (0.17) | −0.07 (0.20) | −0.11 (0.25) | −0.12 (0.25) | −6.15 (22.28) | 4.26 (23.12) | −4.75 (23.88) |
Indirect effect | 0.19 (0.14) | 0.01 (0.07) | 0.02 (0.08) | >−0.001 (0.02) | <0.01 (0.01) | <0.01 (0.05) | <0.01 (0.02) | <0.01 (0.01) | −0.01 (0.03) | 0.08 (0.09) | <0.01 (0.03) | 0.08 (0.06) | 0.42 (0.60) | 0.85 (2.14) | −3.46 (4.73) |
Prematurity | SGA | LGA | LBW | BW | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
NO2 | GHQ | MVPA | NO2 | GHQ | MVPA | NO2 | GHQ | MVPA | NO2 | GHQ | MVPA | NO2 | GHQ | MVPA | |
Green/blue availability 300 m | |||||||||||||||
Direct effect | −0.28 (5.10) | −0.48 (9.06) | −0.72 (6.42) | 0.12 (1.48) | 0.12 (0.89) | 0.39 (1.71) | −0.20 (0.45) | −0.01 (0.54) | −0.35 (0.50) | −1.34 (6.81) | −1.58 (7.26) | −1.45 (6.52) | 51.47 (68.73) | 107.19 (72.73) | 80.41 (81.38) |
Indirect effect | −0.07 (2.70) | 0.04 (9.77) | −0.01 (1.93) | −0.03 (0.11) | <0.01 (0.07) | −0.05 (0.13) | −0.02 (0.07) | >−0.001 (0.06) | 0.06 (0.10) | −0.14 (0.45) | 0.01 (1.22) | −0.10 (0.83) | 21.81 (14.60) | −3.02 (12.05) | 9.62 (13.91) |
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Anabitarte, A.; Subiza-Pérez, M.; Ibarluzea, J.; Azkona, K.; García-Baquero, G.; Miralles-Guasch, C.; Irazusta, J.; Whitworth, K.W.; Vich, G.; Lertxundi, A. Testing the Multiple Pathways of Residential Greenness to Pregnancy Outcomes Model in a Sample of Pregnant Women in the Metropolitan Area of Donostia-San Sebastián. Int. J. Environ. Res. Public Health 2020, 17, 4520. https://doi.org/10.3390/ijerph17124520
Anabitarte A, Subiza-Pérez M, Ibarluzea J, Azkona K, García-Baquero G, Miralles-Guasch C, Irazusta J, Whitworth KW, Vich G, Lertxundi A. Testing the Multiple Pathways of Residential Greenness to Pregnancy Outcomes Model in a Sample of Pregnant Women in the Metropolitan Area of Donostia-San Sebastián. International Journal of Environmental Research and Public Health. 2020; 17(12):4520. https://doi.org/10.3390/ijerph17124520
Chicago/Turabian StyleAnabitarte, Asier, Mikel Subiza-Pérez, Jesús Ibarluzea, Kepa Azkona, Gonzalo García-Baquero, Carme Miralles-Guasch, Jon Irazusta, Kristina W. Whitworth, Guillem Vich, and Aitana Lertxundi. 2020. "Testing the Multiple Pathways of Residential Greenness to Pregnancy Outcomes Model in a Sample of Pregnant Women in the Metropolitan Area of Donostia-San Sebastián" International Journal of Environmental Research and Public Health 17, no. 12: 4520. https://doi.org/10.3390/ijerph17124520