The Modifying Role of Socioeconomic Position and Greenness on the Short-Term Effect of Heat and Air Pollution on Preterm Births in Rome, 2001–2013

Federica Asta, Paola Michelozzi, Giulia Cesaroni, Manuela De Sario, Chiara Badaloni, Marina Davoli and Patrizia Schifano
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Federica Asta: Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112-00147 Rome, Italy
Paola Michelozzi: Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112-00147 Rome, Italy
Giulia Cesaroni: Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112-00147 Rome, Italy
Manuela De Sario: Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112-00147 Rome, Italy
Chiara Badaloni: Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112-00147 Rome, Italy
Marina Davoli: Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112-00147 Rome, Italy
Patrizia Schifano: Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112-00147 Rome, Italy

IJERPH, 2019, vol. 16, issue 14, 1-12

Abstract: Urban green spaces have been associated with health benefits, but few studies have evaluated the role of greenness on pregnancy outcomes. We examined how the association between short-term exposure to heat and air pollution on the probability of preterm delivery is affected by the spatial variation of socioeconomic position (SEP) and greenness. We analyzed a cohort of newborns in Rome, from April to October of 2001–2013, defining preterm as births between the 22nd and the 36th week of gestation. We used a time series approach, with maximum apparent temperature (MAT), PM 10 , NO 2 , and O 3 as exposure variables. As greenness indicators, we considered maternal residential proximity to green spaces and the Normalized Difference Vegetation Index (NDVI) within a 100 m buffer around each woman’s residential address. We enrolled 56,576 newborns (5.1% preterm). The effect of a 1 °C increase in temperature on the daily number of preterm births was higher in women with low SEP (+2.49% (90% CI: 1.29–3.71)) and among those living within 100 m from green spaces (+3.33% (90% CI: 1.82–4.87)). No effect modification was observed for NDVI or PM 10 . SEP was an important effect modifier of the heat-preterm birth relationship. The role of greenness in modifying this association between heat and preterm delivery should be further investigated.

Keywords: Socioeconomic factors; Urban environment; Green spaces; Preterm birth; Maternal exposure; Temperature; Air pollution (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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