Residential vegetation during pregnancy and neonatal growth: evidence from a low- and middle-income country
- 1Department of Midwifery, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran
- 2Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, Kerman, Iran
- 3Non-Communicable Disease Research Center, Department of Environmental Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
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.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12884-026-09740-8.
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BibTeX
@article{alavizadeh2026residential,
title = {{Residential vegetation during pregnancy and neonatal growth: evidence from a low- and middle-income country}},
author = {Zeinab Alavizadeh and Mina Ghaenovi and Moslem Lari Najafi and Mohammad Miri},
journal = {BMC Pregnancy and Childbirth},
year = {2026},
month = aug,
doi = {10.1186/s12884-026-09740-8},
url = {https://doi.org/10.1186/s12884-026-09740-8},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Residential vegetation during pregnancy and neonatal growth: evidence from a low- and middle-income country
AU - Zeinab Alavizadeh
AU - Mina Ghaenovi
AU - Moslem Lari Najafi
AU - Mohammad Miri
PY - 2026
DA - 2026/08/01
JO - BMC Pregnancy and Childbirth
DO - 10.1186/s12884-026-09740-8
UR - https://doi.org/10.1186/s12884-026-09740-8
AB - 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. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12884-026-09740-8.
SN - 1471-2393
ER -