Greenness, civil environment, and pregnancy outcomes: perspectives with a systematic review and meta-analysis
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REVIEW
Open Access
Greenness, civil environment, and pregnancy outcomes: perspectives with a systematic review and meta-analysis Kyung Ju Lee1,2,3*† , Hyemi Moon4†, Hyo Ri Yun4, Eun Lyeong Park4, Ae Ran Park4, Hijeong Choi5, Kwan Hong2,3 and Juneyoung Lee4*
Abstract Background: Various maternal conditions, especially in utero conditions and prenatal exposure to environments with air pollution and greenness, have been reviewed to address the enhancement and prevention of susceptibility to health risks, including low birthweight, preterm delivery, and preeclampsia. This study aimed to qualitatively and quantitatively investigate the associations between pregnancy outcomes and the characteristics of surrounding living environment, including greenness, air pollution, and civilization. Methods: A secondary search of the MEDLINE, EMBASE, Cochrane Library, K-eArticles, and CINAHL databases was conducted without language restrictions to identify the relevant publications from the time of inception of the databases to April 2019. Results: A total of 89 studies were identified, and 10 were included in the quantitative synthesis. The greenness of the environment within 100-, 250- and 500-m buffers, after adjusting for the air quality and civilization factors, was weakly but positively associated with birthweight. The pooled regression slope was 0.00134 (95% confidence interval [CI], 0.000, 0.0020). The greenness of the environment was also associated with a significant decrease in the incidence of poor pregnancy outcomes, namely, low birthweight, small for gestational age (odds ratio [OR] 0.94; 95% CI, 0.92, 0.97), and preterm delivery (OR 0.98; 95% CI, 0.97, 0.99). Conclusions: The greenness of the environment had a positive effect on the pregnancy outcomes, despite poor air quality and civilization. Following urbanization, planning for greenness management, environmental medicine, and public health is important and thus should be proposed as preventive methods as way of increasing birthweight and life expectancy. Keywords: Greenness, Green space, Air pollution, Civilization, Pregnancy outcomes
* Correspondence: [email protected]; [email protected] † Kyung Ju Lee and Hyemi Moon contributed equally to this paper as first authors. 1 Department of Obstetrics and Gynecology, Korea University Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul 02841, South Korea 4 Department of Biostatistics, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, South Korea Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Common
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