To investigate Cohort Kaunas birth Gestational age, Birth certificate data, Residential surrounding Low birth weight models For subjects with low surrounding greenness 2015a, whether study cohort, preterm birth, birth Kaunas, Lithuania greenness, distance to adjusted for maternal and >1000m to the nearest park: Lithuania surrounding participants weight, low birth nearest park; Normalised marital status, education, Low birth weight↑ OR 2.23(95%CI 1.20,4.15) greenness levels recruited weight, term low Difference Vegetation Index, smoking, blood pressure, and/or distance between 2007-9 birth weight, and (NDVI) BMI, parity, chronic diseases, Term low birth weight OR 2.97 (95% CI et al. ↑ to city parks in the early stages small for gestational previous preterm birth, 1.04, 8.45) 2015a) affect birth of pregnancy. Age age paternal smoking and infant outcomes range 20 to 45 sex Preterm birth OR 1.77 (95% CI 1.10, 2.81) ↑ years old Term low birth weight Lower gestational age↑ (n = 3,292) adjusted for maternal marital status, education, Beneficial park effect on foetal growth in smoking, alcohol environment with least surrounding greenness consumption, BMI, blood ↗ pressure, parity, paternal smoking and infant sex Preterm adjusted for maternal marital status, education, smoking, renal diseases, stress, previous preterm birth, parity and paternal smoking Small for gestational age adjusted for maternal age, marital status, education, social status, smoking, BMI, parity and previous preterm birth Birth weight adjusted for maternal height, smoking, marital status, BMI, diabetes and chronic health diseases, parity Gestational age adjusted for maternal marital status, education, smoking, renal diseases, stress, parity,
2015a, Lithuania et al. 2015a) To investigate whether surrounding greenness levels and/or distance to city parks affect birth outcomes Cohort study Kaunas birth cohort, participants recruited between 2007-9 in the early stages of pregnancy. Age range 20 to 45 years old (n = 3,292) Gestational age, preterm birth, birth weight, low birth weight, term low birth weight, and small for gestational age Birth certificate data, Kaunas, Lithuania Residential surrounding greenness, distance to nearest park; Normalised Difference Vegetation Index, (NDVI) Low birth weight models adjusted for maternal marital status, education, smoking, blood pressure, BMI, parity, chronic diseases, previous preterm birth, paternal smoking and infant sex Term low birth weight adjusted for maternal marital status, education, smoking, alcohol consumption, BMI, blood pressure, parity, paternal smoking and infant sex Preterm adjusted for maternal marital status, education, smoking, renal diseases, stress, previous preterm birth, parity and paternal smoking Small for gestational age adjusted for maternal age, marital status, education, social status, smoking, BMI, parity and previous preterm birth Birth weight adjusted for maternal height, smoking, marital status, BMI, diabetes and chronic health diseases, parity Gestational age adjusted for maternal marital status, education, smoking, renal diseases, stress, parity, For subjects with low surrounding greenness and >1000m to the nearest park: Low birth weight↑ OR 2.23(95%CI 1.20,4.15) Term low birth weight ↑ OR 2.97 (95% CI 1.04, 8.45) Preterm birth ↑ OR 1.77 (95% CI 1.10, 2.81) Lower gestational age↑ Beneficial park effect on foetal growth in environment with least surrounding greenness ↗
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