Residential vegetation during pregnancy and neonatal growth: evidence from a low- and middle-income country.

Authors

Zeinab Alavizadeh, Mina Ghaenovi, Moslem Lari Najafi, Mohammad Miri

Published in

BMC pregnancy and childbirth. Volume 26. Issue 1. Aug 01, 2026. Epub Aug 01, 2026.

Abstract

Evidence linking maternal exposure to residential greenspace with neonatal anthropometric outcomes is limited in low- and middle-income countries (LMICs). This study investigated associations between maternal greenspace exposure during pregnancy and birth outcomes in Sabzevar, Iran. In this cross-sectional study, 4,053 live births (May 2016-December 2018) were analyzed. Residential greenspace was assessed using NDVI and MSAVI2 within 100 m, 300 m, and 500 m buffers. Distances to any green space and to large green spaces (≥ 5000 m²) were also calculated. Outcomes included birth weight (BW), birth length (BL), and head circumference (HC). Linear regression models adjusted for maternal, pregnancy, and neighborhood factors were applied. Sex-stratified analyses were conducted. Each interquartile range (IQR) increase in NDVI within 100 m was associated with a 29.51 g higher BW (95% CI: 25.46-33.56; p < 0.01) and a 0.019 cm larger HC (95% CI: 0.002-0.037; p = 0.03). Distance from large green spaces (≥ 5,000 m²) was associated with lower BW (β = - 31.73 g; 95% CI: - 44.23 to - 19.23; p < 0.01) and smaller HC (β = - 0.091 cm; 95% CI: - 0.144 to - 0.038; p < 0.01). Associations with BL were weaker but inversely related to distance from green spaces. Sex-stratified analyses suggested stronger associations for BL and HC in girls, although interactions were not statistically significant. MSAVI2-based associations were generally weaker. Maternal exposure to residential greenspace, especially nearby vegetation, was associated with higher BW and HC in neonates. These findings suggest that greater accessibility to urban greenspaces may be associated with more favorable neonatal anthropometric outcomes and may inform future urban planning and maternal-child health strategies.

PMID:
42947033
Bibliographic data and abstract were imported from PubMed on 28 Oct 2026.

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