Environmental Sciences Europe (Feb 2024)

Associations of residential greenness exposure during early pregnancy with the risk of spontaneous abortion: the China Birth Cohort Study

  • Yuchen Cui,
  • Shen Gao,
  • Boyi Yang,
  • Lizi Lin,
  • Wentao Yue,
  • Shaofei Su,
  • Enjie Zhang,
  • Jianhui Liu,
  • Shuanghua Xie,
  • Yue Zhang,
  • Zheng Zhang,
  • Ruixia Liu,
  • Guanghui Dong,
  • Chenghong Yin

DOI
https://doi.org/10.1186/s12302-024-00869-x
Journal volume & issue
Vol. 36, no. 1
pp. 1 – 9

Abstract

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Abstract Background Living in higher greenness level community has many benefits for pregnancy outcomes, however, few research have explored the relationship between greenness and spontaneous abortion (SAB). We aimed to analyze relationships between SAB and community greenness in Chinese pregnant women, and further assessed the modifying effects from air pollutants. Methods We studied 90 890 pregnant women from the China Birth Cohort Study from February 2018 to December 2021. We diagnosed SAB by certified obstetricians and gynecologists. The level of exposure to greenness during the first trimester was measured using the normalized difference vegetation index (NDVI) and the enhanced vegetation index (EVI). Particulate matter ≤ 2.5 μm (PM2.5), nitrogen dioxide (NO2) and ozone (O3) were used as proxies of ambient air pollution. Time-dependent multivariable adjusted Cox proportional hazards models, with gestational weeks as the time scale, were used to analyze the association between SAB and greenness. We additionally performed subgroup analyses stratified by age, urbanicity, research location, season of birth, temperature, humidity and air pollution levels. Results Lower SAB prevalence was related to living in greener places. A 0.1 unit increase in NDVI500m and EVI500m was significantly associated with a 12.3% (95% CI 9.9%, 15.5%) and 16.2% (95% CI 11.4%, 20.6%) lower risks of SAB, respectively. In sensitivity analysis, these relationships remained consistent. The associations were stronger among older, participants lived in the north of China and lived in places with higher PM2.5 and lower NO2 levels. Conclusions Our findings indicate significantly inverse associations between community greenness and SAB in Chinese pregnant women, especially for older and participants who live in the north of China, the PM2.5 and NO2 may modify the effects of greenness on SAB.

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