scholarly journals Mean and variance of greenness and pregnancy outcomes in Tel Aviv during 2000–14: longitudinal and cross-sectional approaches

2018 ◽  
Vol 48 (4) ◽  
pp. 1054-1072 ◽  
Author(s):  
Keren Agay-Shay ◽  
Yaron Michael ◽  
Xavier Basagaña ◽  
Èrica Martínez-Solanas ◽  
David Broday ◽  
...  

Abstract Background Natural environments may have beneficial impacts on pregnancy outcomes. However, longitudinal evidence is limited and the associations with variance in surrounding greenness is unknown. Our objective was to evaluate these associations among 73 221 live births in Tel Aviv, Israel. Methods Longitudinal exposure to mean of greenness during pregnancy and trimesters were calculated using satellite-based Moderate Resolution Imaging Spectroradiometer (MODIS) Normalised Difference Vegetation Index (NDVI) data. In addition, exposure to mean and variation of NDVI from high-resolution satellite and percentage of tree cover [Vegetation Continuous Fields (VCF)] at 300-m buffer were evaluated in a cross-sectional approach. Generalized linear models were used to estimate the crude and adjusted associations. We explore the possible mediating role of ambient exposures and distance to ‘outdoor gyms’ located in parks. Results Crude beneficial associations between exposure to higher mean NDVI during pregnancy and pregnancy outcomes were observed [for birthweight, 3rd/1st tertile exposure increased the mean by 25.5 g, 95% confidence intervals (CIs): 15.4, 35.5] and decreased the odds of low birthweight, small for gestational age, preterm deliveries (PTD) and very PTD. Adjustment for individual and neighbourhood-level markers of socio-economic status (SES) attenuated all the associations. Strongest associations were observed during the first and second trimesters. Cross-sectional associations for mean greenness were similar with narrower CIs, and associations with NDVI were stronger than with tree cover and stronger for mean compared with variance of greenness. Associations were consistent for term births, different buffer sizes and for further adjustment to maternal education. Stronger associations were observed for lowest SES. Distance to ‘outdoor gyms’ and variance of greenness had the largest estimates of mediation. Conclusion This study adds to the limited information on when exposure to greenness is most beneficial, on the association with variance of greenness and the possible pathways. These observations require confirmation in other populations.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Moussa Lingani ◽  
Serge H. Zango ◽  
Innocent Valéa ◽  
Daniel Valia ◽  
Maïmouna Sanou ◽  
...  

AbstractLow birthweight (LBW) is a worldwide problem that particularly affects developing countries. However, limited information is available on its magnitude in rural area of Burkina Faso. This study aimed to estimate the prevalence of low birthweight and to identify its associated factors in Nanoro health district. A secondary analysis of data collected during a cross-sectional survey was conducted to assess the prevalence of low birthweight in Nanoro health and demographic surveillance system area (HDSS). Maternal characteristics extracted from antenatal care books or by interview, completed by malaria diagnosis were examined through a multi-level logistic regression to estimate odd-ratios of association with low birthweight. Significance level was set at 5%. Of the 291 neonates examined, the prevalence of low birthweight was 12%. After adjustment for socio-demographic, obstetric and malaria prevention variables, being primigravid (OR = 8.84, [95% CI: 3.72–21.01]), or multigravid with history of stillbirth (OR = 5.03, [95% CI: 1.54–16.40]), as well as the lack of long-lasting insecticide treated bed net use by the mother the night preceding the admission for delivery (OR = 2.5, [95% CI: 1.1–5.9]) were significantly associated with neonate low birthweight. The number of antenatal visits however did not confer any direct benefit on birthweight status within this study area. The prevalence of low birthweight was high in the study area and represents an important public health problem in Burkina Faso. In light of these results, a redefinition of the content of the antenatal care package is needed.


Author(s):  
Swetha Munivenkatappa ◽  
Srinivas M. Govindaraj

Background: There has been a lot of interest in knowing the effects of oral health on adverse pregnancy outcomes like preterm births and low birth weight. Studies have yielded contradicting results and there are lot of confounding issues that blur the picture.  Aim of the study is to determine the prevalence of periodontitis is pregnant population and determine the effect of periodontitis on preterm births and low birth weight.Methods: This was a cross sectional study of singleton pregnant women attending ante-natal checkups with oral interview and clinical examination. Oral examination was done at the beginning of third trimester of pregnancy. They were followed up to delivery to note the duration of gestation, birth weight of babies.Results: The prevalence of periodontitis was 22% with 90.9% having mild and 9.1% having moderate periodontitis. Maternal education (high school and above) was associated with lower prevalence of periodontitis (p=0.042). There was no difference in the birth weights between the group with and without periodontitis (2.9±0.41kgs vs 2.74±0.36kgs, p=0.11). The incidence of low birth weights was also similar (p=0.22). The average gestational age was slightly less in the group with periodontitis (38 weeks 3 days vs 37 weeks 5 days) but the rates of preterm births were similar between the two groups (p=0.61).Conclusions: Mild/moderate periodontitis does not appear to have a significant effect on pre-term births and low birth weight. Maternal education and awareness seem to mitigate development of periodontitis and adverse pregnancy outcomes.


2018 ◽  
Vol 69 (4) ◽  
pp. 340-349 ◽  
Author(s):  
Angel M. Dzhambov

AbstractPrevious research has suggested that natural urban environment (green space and blue space) benefit mental health, but only a few longitudinal studies have explored the underlying mechanisms. In this pilot study we aimed to examine mechanisms/variables mediating associations between residential green/blue space and symptoms of anxiety/depression in 109 Bulgarian students from Plovdiv university. The students were followed from the beginning to the end of the school year (October 2017 to May 2018). Residential green space was defined as the mean of the normalised difference vegetation index (NDVI) in circular buffers of 100, 300, and 500 m around their residences. Blue space was assessed based on its presence in the same buffers. Levels of anxiety/depression were assessed using the 12-item General Health Questionnaire. The investigated mediator variables included residential noise (LAeq) and air pollution (NO2), environmental annoyance, perceived restorative quality of the neighbourhood, neighbourhood social cohesion, physical activity, and sleep disturbance. Cross-sectional data (obtained at baseline) showed that higher NDVI correlated with better mental health only indirectly through higher physical activity and restorative quality. Longitudinal (follow-up) data showed improved mental health but no significant effect of mediator variables. Similarly, blue space correlated with better mental health in all models, but physical activity and restorative quality were significant mediator variables only in the cross-sectional analysis. Our findings support that green space and blue space are psychologically restorative features in urban environment. Future research should replicate these findings in the general population and employ longitudinal modelling tailored to the specific mechanisms under study.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
William Mueller ◽  
Paul Wilkinson ◽  
James Milner ◽  
Sotiris Vardoulakis ◽  
Susanne Steinle ◽  
...  

Abstract Background Greenspace has been associated with health benefits in many contexts. An important pathway may be through outdoor physical activity. We use a novel approach to examine the link between greenspace microenvironments and outdoor physical activity levels in the HEALS study conducted in Edinburgh (UK), the Netherlands, and Athens and Thessaloniki (Greece). Methods Using physical activity tracker recordings, 118 HEALS participants with young children were classified with regard to daily minutes of moderate to vigorous physical activity (MVPA); 60 were classified with regard to the metabolic equivalent task (MET)-minutes for each of the 1014 active trips they made. Greenspace indicators were generated for Normalised Difference Vegetation Index (NDVI), tree cover density (TCD), and green land use (GLU). We employed linear mixed-effects models to analyse (1) daily MVPA in relation to greenspace within 300 m and 1000 m of residential addresses and (2) trip MET-minutes in relation to average greenspace within a 50 m buffer of walking/cycling routes. Models were adjusted for activity, walkability, bluespace, age, sex, car ownership, dog ownership, season, weekday/weekend day, and local meteorology. Results There was no clear association between MVPA-minutes and any residential greenspace measure. For example, in fully adjusted models, a 10 percentage point increase in NDVI within 300 m of home was associated with a daily increase of 1.14 (95% CI − 0.41 to 2.70) minutes of MVPA. However, we did find evidence to indicate greenspace markers were positively linked to intensity and duration of activity: in fully adjusted models, 10 percentage point increases in trip NDVI, TCD, and GLU were associated with increases of 10.4 (95% CI: 4.43 to 16.4), 10.6 (95% CI: 4.96 to 16.3), and 3.36 (95% CI: 0.00 to 6.72) MET-minutes, respectively. The magnitude of associations with greenspace tended to be greater for cycling. Conclusions More strenuous or longer walking and cycling trips occurred in environments with more greenspace, but levels of residential greenspace did not have a clear link with outdoor MVPA. To build on our research, we suggest future work examine larger, more diverse populations and investigate the influence of greenspace for trip purpose and route preference.


Author(s):  
Tom Clemens ◽  
Chris Dibben

IntroductionWe know that rates of adverse pregnancy outcome such as low birthweight and preterm births vary both by socio-economic status and across geographical areas. Furthermore, more deprived neighbourhoods show higher rates of adverse outcomes. However, much of the evidence comes from cross-sectional observational studies where causality is difficult to assess. Objectives and ApproachNeighbourhood crime and a resultant increase in maternal stress is a plausible explanation for the deprivation-birth outcome relationship. Without an experiment, isolating this pathway from other confounding effects is challenging. Because many mothers (within the Scottish maternity dataset) experience multiple pregnancies and varying exposure for the same person, we can assume a quasi-experimental allocation to exposure. We model associations as both within mother (comparing exposures between pregnancies to the same mother) and between mother (comparing different people between more and less deprived areas) partitioning the variation and effects accordingly. ResultsWe find that both composite neighbourhood deprivation and neighbourhood crime specifically is associated with reduced birthweight. However, the composite neighbourhood deprivation measure is only significant when modelled as a between mother effect. Neighbourhood crime on the other hand is significantly associated with both between mother and within mother effects (though the latter is reduced compared to the former). These results suggest that much of the observed relationship with deprivation in general is therefore confounded by factors associated with the composition of individuals in these areas rather than an area deprivation effect per se. In contrast, the association with neighbourhood crime can be considered in isolation from the composition of individuals and is therefore likely to be an independent “area” effect. Conclusion/ImplicationsThese results are important because outcomes of pregnancy including birthweight and premature births influence health and social outcomes not just in infancy but across the life course. This study suggests policies targeting neighbourhood crime may help to reduce neighbourhood disparities in pregnancy outcomes and therefore health inequalities in general.


Author(s):  
Marta Nunes ◽  
Stephanie Jones ◽  
Renate Strehlau ◽  
Vuyelwa Baba ◽  
Zanele Ditse ◽  
...  

Objective: Evaluate the impact of the timing of SARS-CoV-2 infection on pregnancy outcomes in a low-middle income setting. Design: two parallel, observational studies. Setting and population: pregnant women or women presenting for labour, enrolled between April-September 2020, in South Africa. Methods: i) longitudinal follow-up study of symptomatic or asymptomatic pregnant women investigated for SARS-CoV-2 infection antenatally, ii) cross-sectional study of SARS-CoV-2 infection at time of labour. SARS-CoV-2 infection was investigated by nucleic acid amplification test (NAAT). Main Outcome Measures: association of SARS-CoV-2 infection on nasal swab and birth outcomes. Results: Antenatally, 793 women were tested for SARS-CoV-2. Overall SARS-CoV-2 infection was confirmed in 138 women, including 119/275 with symptomatic illness (COVID-19) and 19/518 asymptomatic women; 493 women were asymptomatic and SARS-CoV-2 non-reactive. Women with COVID-19 were 1.66-times (95%CI: 1.02, 1.71) more likely to have a low-birthweight newborn (30%) compared to asymptomatic women without SARS-CoV-2 (21%). Overall, 3117 women were tested for SARS-CoV-2 infection at delivery, including 1560 healthy women with an uncomplicated term delivery. Adverse birth outcomes or pregnancy-related complications were not associated with infection at delivery. Among women with SARS-CoV-2 infection at delivery, NAAT was reactive on 6/98 of maternal blood samples, 8/93 of cord-blood, 14/54 of placentas and 3/22 of nasopharyngeal swabs from newborns collected within 72-hours of birth. Conclusions: Antenatal, but not intrapartum, SARS-CoV-2 infection was associated with low-birthweight delivery. Maternal infection at the time of labour was associated with in utero foetal and placental infection, and possible vertical and/or horizontal viral transfer to the newborn.


Author(s):  
Jennifer Gia-linh Nguyen ◽  
Shanika Nanayakkara ◽  
Alexander C. L. Holden

Maternal gum disease is associated with adverse pregnancy outcomes such as preterm birth and low birthweight. This study aims to evaluate the knowledge, attitudes and practice behaviour of Australian midwives regarding the periodontal health of pregnant women to inform interprofessional antenatal care. This was an observational, cross-sectional study. We circulated an online questionnaire to Australian midwives from August 2018 to February 2019. Key outcome variables were knowledge, attitudes, and practice behaviours related to oral health. Key predictor variables were years of practice, practice location, and dental history. We summarized responses with frequency tables and assigned tallied scores for analysis using non-parametric statistical tests. 100 responses were analysed, including from rural (n = 23) and urban (n = 77) midwives. Eighty percent of midwives agreed that maternal dental care can positively affect pregnancy outcomes. Fluoridated toothpaste use (19.1%) was incorrectly answered to prevent gum disease more often than psychological stress control (7.9%), a correct answer. Rural midwives demonstrated a significantly higher knowledge score (p = 0.001) and significantly more positive practice behaviours towards oral health (p = 0.014) than urban midwives. Australian midwives have positive attitudes towards antenatal oral health but misunderstand gum disease aetiology and prevention. This study highlights areas to improve interprofessional education for optimal oral health and pregnancy outcomes.


Author(s):  
Giulia Squillacioti ◽  
Valeria Bellisario ◽  
Stefano Levra ◽  
Pavilio Piccioni ◽  
Roberto Bono

Paediatric Asthma contributes in paediatric global burden of diseases, as the most common chronic disease in children. Children are exposed to many environmental risk-factors, able to determine or worsen respiratory diseases, and contributing to asthma and asthma-like symptoms increases, especially in metropolitan areas. In urban settings, surrounding vegetation (greenness) may provide important benefits to health, including the promotion of physical activity and the mitigation of air and noise pollution. The aim of this study was to investigate the association between greenness and respiratory health. A total of 187 children (10–13 yrs old) were recruited in Turin, the north-western part of Italy. The prevalence of asthma and asthma-like symptoms was calculated from self-reported data collected by SIDRIA questionnaire. Spirometry test was performed to obtain respiratory flow measurements. Greenness was measured at individual level through the Normalised Difference Vegetation Index (NDVI) estimations from remote-sensing images. Higher exposure (3rd tertile vs. 1st tertile) to NDVI was associated to significantly lower ORs for asthma [0.13 CI 95% 0.02–0.7, p = 0.019], bronchitis [0.14 CI 95% 0.05–0.45, p = 0.001], and current wheezing [0.25 CI 95% 0.09–0.70, p = 0.008]. A significative positive association was found between greenness and FEF25–75, since children exposed to the 2nd tertile of NDVI reported a significantly decreased FEF25–75 compared to those in the 3rd tertile [B: −2.40; C.I.95%: −0.48–0.01; p = 0.049]. This cross-sectional study provided additional data on still inconsistent literature referring to respiratory health in children and green spaces, attesting a positive effect of greenness in a specific area of Italy. Further research is still needed.


Author(s):  
Leny Leny

ABSTRACT Prenatal care is health care by health personnel to care the pregnant according to standards. Worlrd Health Organization (WHO) estimates more than 500.000 women die during pregnancy or childbirth. Maternal mortality in Indonesia is 307 per 100,000 live births. The quantity of pregnant women’s visit in Kabupaten Banyuasin in 2009 of 89.1%. The purpose of this study to determine the relationship between education and occupation with prenatal care at Puskesmas Mariana  Kecamatan Banyuasin I Kabupaten Banyuasin in 2011. This study uses analytic approach survey by Cross Sectional methods, the population are 1.946 pregnant women and the samples as many as 332 people. The results of univariate analysis study of pregnant women who are higher education as much as 45.2%, and  low maternal education as much as 54.8%. In pregnant women who work of 43.4%, and pregnant women who do not work for 56.6%. From the results of bivariate analysis and Chi-Square statistical tests found a significant association between education of pregnant women with prenatal care with P Value = 0.000, and there was a significant association between occupation of pregnant women with prenatal care with P Value = 0.000. Can be concluded that there is a relationship between education and occupation of pregnant women with prenatal care. Expected to health workers to provide counseling on the importance of prenatal care in pregnant women and expected future studies may explore again the factors associated with prenatal care with the different variables.   ABSTRAK Pemeriksaan kehamilan adalah pelayanan kesehatan oleh tenaga kesehatan untuk memeriksakan ibu hamil sesuai standar. World Health Organization (WHO) memperkirakan lebih dari 500.000 ibu pertahunnya meninggal saat hamil atau bersalin. AKI di Indonesia 307 per 100.000 kelahiran hidup. Jumlah kunjungan ibu hamil di Kabupaten Banyuasin tahun 2009 sebesar 89,1%. Tujuan penelitian ini untuk mengetahui hubungan antara pendidikan dan pekerjaan dengan pemeriksaan kehamilan di Puskesmas Mariana Kecamatan Banyuasin I Kabupaten Banyuasin tahun  2011. Penelitian ini menggunakan metode survey analitik dengan pendekatan Cross Sectional, populasi ibu hamil dengan jumlah 1.946 orang dan jumlah sampel sebanyak 332 orang. Hasil penelitian Analisa Univariat adalah ibu hamil yang pendidikan tinggi sebanyak 45,2%, dan pendidikan rendah ibu hamil sebanyak 54,8%. Pada variabel pekerjaan ibu hamil yang bekerja sebesar 43,4%, dan ibu hamil yang tidak bekerja sebesar 56,6%. Dari hasil analisa bivariat dan uji statistik Chi-Square  didapatkan hubungan yang bermakna antara pendidikan ibu hamil dengan pemeriksaan kehamilan dengan  P Value = 0,000, dan ada hubungan yang bermakna antara pekerjaan ibu hamil dengan pemeriksaan kehamilan dengan P Value = 0,000. Dapat disimpulkan bahwa ada hubungan antara pendidikan dan pekerjaan ibu hamil dengan pemeriksaan kehamilan. Diharapkan kepada petugas kesehatan agar dapat memberikan penyuluhan tentang pentingnya pemeriksaan pada ibu hamil dan diharapkan penelitian yang akan datang dapat menggali lagi faktor-faktor yang berhubungan dengan pemeriksaan kehamilan dengan variabel yang berbeda.


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