Greenest neighbourhoods produce bigger babies

Expecting mothers with access to trees and
grass delivered heavier babies: Study

Mothers who live in Metro Vancouver’s greenest neighbourhoods tend to deliver bigger babies and are more likely carry a baby to term than those who live in less green parts of the city, according to a new study published in the journal Environmental Health Perspectives.

Using data from more than 64,000 births and analysis of satellite imagery, researchers found that babies from the greenest residential spaces ­­— those with access to trees and grass within 100 metres — were up to 45 grams heavier, had a reduced likelihood of preterm birth and were less likely to be small for gestational age, according to the lead researcher Michael Brauer, a professor in the School of Population and Public Health at the University of British Columbia.

The positive effects of greenness persist even when the researchers control for other factors known to influence gestation and birth weight, including air pollution, noise, income, access to parks, opportunities for physical activity and the walkability of the immediate neighbourhood.

“We know from other studies that birth outcomes are influenced by pollution and noise in a negative way, so we went looking for something (in the urban environment) that is healthy,” said Brauer.

Cities in most of the developed world are designed to accommodate the automobile, which usually results in relatively barren, noisy and polluted environments. Brauer’s study seeks to quantify the benefits of a different approach to urban planning.

“If we didn’t design for automobiles and instead designed for people, the hope is that we would be healthier,” he said. “With the high cost of health care, modifying urban design features such as increasing green space may turn out to be an extremely cost-effective strategy to prevent disease.”

While 45 grams isn’t a lot of extra weight for one healthy infant, the effect of increased birth weight across the entire distribution of births moves thousands of babies from birth weights that are dangerously low into a healthier range.

“From a medical standpoint, those are small changes in birth weight, but across a large population, those are substantial differences that would have a significant impact on the health of infants in a community,” said co-author Perry Hystad, assistant professor in the College of Public Health and Human Sciences at Oregon State University.

Even in an urban area as rich in green space as Metro Vancouver the benefits conferred by the very greenest neighbourhoods compared with the least green neighbourhoods were substantial, including a 20-per-cent reduction in severely premature births and 13 per cent fewer moderately pre-term births.

The mechanism by which greenness translates into healthier babies is not exactly clear, but greener environments are known to facilitate social connectedness and reduce blood pressure, heart rate and stress-related hormones, according to the study, the third in a series of similar inquiries on the health impacts of urban spaces.

“Even when we eliminate the noise and the pollution and (a measure) of physical activity, we still see this benefit of green space,” he said. “What we don’t know is whether it is enough to see a tree out your window or do you have to have a park across the street where you chat with your neighbours.”

Source: Vancouver Sun

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Breathing air pollution may be as toxic as cigarette smoke for pregnant women

Photo: Adamr/freedigitalphotos.net

Breathing the air outside their homes may be just as toxic to pregnant women —if not more so — as breathing in cigarette smoke, increasing a mom-to-be’s risk of developing deadly complications such as preeclampsia, according to findings from a new University of Florida study.

UF researchers compared birth data with Environmental Protection Agency estimates of air pollution, finding that heavy exposure to four air pollutants led to a significantly increased risk for developing a high blood pressure disorder during pregnancy. The research was published in the January issue of the Journal of Epidemiology and Community Health.

The pollutants include two specific types of fine and coarse particulate matter, carbon monoxide and sulfur dioxide. According to the EPA, particulate matter includes acids, dust, metals and soil particles. These inhalable particles are released from industries and forest fires and can form when gases react with each other in the air. Sulfur dioxide is emitted from power plants and industries. Most carbon monoxide is produced by car exhaust.

“Fetal development is very sensitive to environmental factors,” said Xiaohui Xu, M.D., Ph.D., an assistant professor of epidemiology in the colleges of Public Health and Health Professions and Medicine. “That is why we wanted to do this research. Hypertension (high blood pressure), in particular, is associated with increased morbidity and mortality, causing a lot of problems for the mother and fetus, including preterm delivery.”

Hypertensive disorders such as gestational hypertension, preeclampsia and the deadly condition it leads to, eclampsia, affect about 10 percent of pregnancies. Despite the serious risks to mother and baby, little is known about what specifically causes these conditions to develop in pregnant women, the researchers say.

Although more studies are needed, the researchers hypothesize that exposure to air pollution during pregnancy may affect a woman’s normal pattern of blood pressure.

“We also want to look at preterm delivery and low birth-weight and find out what the effects of breathing contaminated air are on fetal development.” Xu said.

Large study finds exposure to even low levels of air pollution during pregnancy has risks

"Our findings suggest that a substantial proportion of cases of low birthweight at term could be prevented in Europe if urban air pollution, particularly fine particulate matter, was reduced", explains lead author Dr Marie Pedersen from the Centre for Research in Environmental Epidemiology in Barcelona, Spain.

The researchers estimate that for every increase of 5 micrograms per cubic metre (5µg/m³) in exposure to fine particulate matter during pregnancy, found in for example traffic fumes and industrial air pollutants, the risk of low birthweight at term rises by 18%. Importantly, this increased risk persists at levels below the existing EU annual air quality limit of 25µg/m³. 

Using data from the European Study of Cohorts for Air Pollution Effects (ESCAPE, coordinated by the University of Utrecht, the Netherlands), the investigators pooled data from 14 cohort studies in 12 European countries involving over 74 000 women who had singleton babies between Feb, 1994 and June, 2011.

Air pollution concentrations of nitrogen oxides and particulate matter were estimated at the home addresses using land-use regression models. Traffic density on the nearest road and total traffic load on all major roads within 100m of the residence were also recorded.

All air pollutants, particularly fine particulate matter (PM 2.5; with a diameter of 2.5 micrometers or less), and traffic density increased the risk of term low birthweight and reduced average head circumference at birth, after accounting for other factors like maternal smoking, age, weight, and education.

The researchers estimated that if levels of PM 2.5 were reduced,  22% of cases of low birthweight among term deliveries could be prevented.

According to Dr Pedersen, "The widespread exposure of pregnant women worldwide to urban ambient air pollution at similar or even higher concentrations than those assessed in our study provides a clear message to policy makers to improve the quality of the air we all share."

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Combination of stress and exposure to air pollution affects fetal development

Maternal psychological distress combined with exposure to air pollution during pregnancy have an adverse impact on the child's behavioral development, according to researchers at the Columbia Center for Children's Environmental Health at the Mailman School of Public Health.

The study, which appears in the journal Pediatrics, reports that "maternal demoralization", (a measure of psychological distress capable of affecting a mother's ability to cope with stressful situations), was linked with a number of behavioral problems, including anxiety, depression, attention problems, rule-breaking, externalizing problems, and aggressive behavior. The effects of demoralization were greatest among children with higher levels of prenatal exposure to polycyclic aromatic hydrocarbons (PAH) in air pollution.

"This study shows that the combination of physical and psychosocial stressors during fetal development magnifies the effect of each exposure," says lead author Frederica Perera, DrPH, PhD, director of the Center. "The findings are of concern because attention problems and anxiety and depression have been shown to affect peer relationships, academic performance, and future well- being of children."

The paper is the first to assess the interaction between PAH, combustion-related pollutants measured in air the mother breathed during pregnancy, and maternal demoralization on a variety of behavioral problems in childhood.

PAH are air pollutants generated by combustion sources such as motor vehicles, coal-fired power plants, residential heating and tobacco smoke. In Krakow, Poland, where the study took place, as in many areas worldwide, coal burning is an important air pollution source. Although Krakow has relatively high ambient concentrations of PAH from coal-burning and vehicle emissions, levels are within the range seen in many other urban areas worldwide. "Air pollution exposure is ubiquitous and often co-occurs with socioeconomic disadvantage and maternal psychological distress," notes Dr. Perera.

Researchers, led by Dr. Perera and Wieslaw Jedrychowski, MD, PhD, from the University of Krakow, followed 248 mother-child pairs from pregnancy through 9 years of age. Personal air sampling was completed during pregnancy to estimate prenatal PAH exposure. Behavioral problems were assessed using the Child Behavioral Checklist, a set of questions to which mothers responded about their child's behavior. Maternal demoralization has been correlated with socioeconomic factors such as material hardship. Levels of maternal demoralization were ascertained by a questionnaire during the second trimester.

Relationships between prenatal air pollution and behavioral or cognitive problems in childhood have previously been observed in the Center's Mothers & Newborns study in New York City and in the Polish cohort. This new study builds upon prior findings to examine the joint impact of maternal psychological distress and air pollution on behavioral problems.

Understanding the interactions between the social and physical environment will help to explain health disparities and create interventions to prevent health and developmental problems in children. Notes Dr. Perera, "The findings support policy interventions to reduce air pollution exposure in urban areas as well as programs to screen women early in pregnancy to identify those in need of psychological or material support."

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