Abstract

There are significant racial disparities in obstetric outcomes with the incidence of preterm birth (PTB) being the highest in non-Hispanic black (NHB) women. The presence of green space, such as forests and parks, is now widely viewed as a health-promoting characteristic of residential environments; however, obstetric research involving green space is limited. The objective of this study was to examine the association between proximity of green space (measured as percent of tree canopy) to a prenatal residential address and the rates of PTB in NHB women. A retrospective case-control study utilizing hospital pregnancy records of self-identified NHB women. Addresses of women delivered between 2011 and 2019 were geocoded to characterize the percentage of tree canopy surrounding prenatal address using National Land Cover Database. The value of each pixel in the data represented 30-square meter resolution (Fig). The 100-, 150-, 250- and 500-meter buffers were used to assess exposure of tree canopy in proximity to a prenatal address. Univariable and multivariable analyses were conducted to determine whether tree canopy percent at 4 different proximity buffers (examined both in means and quartiles) was associated with PTB (<37wks). Of 2,771 NHB women included in the study, 333 (12.0%) had PTB. Less tree canopy coverage was significantly associated with PTB, whether that coverage was quantified as a mean or by quartile percent. In unadjusted and adjusted models, controlling for sociodemographic and clinical risk factors for PTB, each 10% increase in tree canopy was associated with lower odds of PTB at all 4 buffers (Table). When examining the green space by quartile of tree canopy percent, higher quartiles were associated with even lower odds of preterm birth at 100-,150-, and 250-meter buffers, but not at 500 meters (Table). Higher percent of tree canopy in proximity to prenatal residential address is associated with lower odds of PTB in NHB women. These findings suggest that increasing neighborhood access to green space could be a new strategy to reduce PTB in NHB women.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

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