Plant species richness, green spaces, and preterm birth risk in urban areas

Background: Growing evidence suggests that urban biodiversity may influence human health, though this relationship remains incompletely understood. While green spaces have shown beneficial effects on birth outcomes, the specific role of plant species richness has not been investigated in relation to...

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Main Authors: Mengyi Li, Qiping Fan, Yi Sun, Tarik Benmarhnia, Jiu-Chiuan Chen, Anqi Jiao, John Molitor, David A. Sacks, Jeff M. Slezak, Vicki Y. Chiu, Chantal C. Avila, Darios Getahun, Jun Wu
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Environment International
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Online Access:http://www.sciencedirect.com/science/article/pii/S0160412025003952
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author Mengyi Li
Qiping Fan
Yi Sun
Tarik Benmarhnia
Jiu-Chiuan Chen
Anqi Jiao
John Molitor
David A. Sacks
Jeff M. Slezak
Vicki Y. Chiu
Chantal C. Avila
Darios Getahun
Jun Wu
author_facet Mengyi Li
Qiping Fan
Yi Sun
Tarik Benmarhnia
Jiu-Chiuan Chen
Anqi Jiao
John Molitor
David A. Sacks
Jeff M. Slezak
Vicki Y. Chiu
Chantal C. Avila
Darios Getahun
Jun Wu
author_sort Mengyi Li
collection DOAJ
description Background: Growing evidence suggests that urban biodiversity may influence human health, though this relationship remains incompletely understood. While green spaces have shown beneficial effects on birth outcomes, the specific role of plant species richness has not been investigated in relation to preterm birth (PTB, <37 weeks’ gestation). Methods: Using Kaiser Permanente Southern California electronic health records (2015–2021), we analyzed 232,452 births to examine associations between plant species richness and PTB. Plant species richness was assessed at the maternal neighborhood level, defined using circular buffers of 1.5 km around maternal residences. Results: We found that increased plant species richness was associated with decreased PTB risk (adjusted odds ratio per interquartile range: 0.959, 95 % CI: 0.941, 0.977). The observed association persisted after further adjustment for multiple green space indicators. The proportions of mediation effects attributable to mean temperature during pregnancy ranged from 7.0 % to 7.8 % across plant species diversity indicators. In the subgroup analysis, plant species diversity demonstrated significantly stronger protective associations against PTB among mothers exposed to higher levels of Ozone, high ambient temperatures, and those gave birth during the pandemic period. Conversely, protective associations were more pronounced among mothers with lower NO2 exposure during pregnancy. Notably, the significant relationship between plant species richness and reduced PTB persisted in pandemic-period analyses after adjusting for COVID-19 infection during pregnancy. Conclusions: Our findings highlight a complex interplay of sociodemographic and environmental factors influencing PTB risks and underscore the critical need for public health interventions that consider the unique attributes of urban green space.
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spelling doaj-art-e17e74cb284e4243ae9ea32d2bf865a62025-08-20T02:35:19ZengElsevierEnvironment International0160-41202025-08-0120210964410.1016/j.envint.2025.109644Plant species richness, green spaces, and preterm birth risk in urban areasMengyi Li0Qiping Fan1Yi Sun2Tarik Benmarhnia3Jiu-Chiuan Chen4Anqi Jiao5John Molitor6David A. Sacks7Jeff M. Slezak8Vicki Y. Chiu9Chantal C. Avila10Darios Getahun11Jun Wu12Department of Environmental and Occupational Health, Joe C. Wen School of Population &amp; Public Health, University of California, Irvine, CA, USADepartment of Public Health Sciences, Clemson University, Clemson, SC, USADepartment of Environmental and Occupational Health, Joe C. Wen School of Population &amp; Public Health, University of California, Irvine, CA, USA; Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaScripps Institution of Oceanography, University of California, San Diego, CA, USA; Irset Institut de Recherche en Santé, Environnement et Travail, UMR-S 1085, Inserm, University of Rennes, EHESP, Rennes, FranceDepartments of Population &amp; Public Health Sciences and Neurology, University of Southern, California, Keck School of Medicine, Los Angeles, CA, USADepartment of Environmental and Occupational Health, Joe C. Wen School of Population &amp; Public Health, University of California, Irvine, CA, USACollege of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USADepartment of Research &amp; Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; Department of Obstetrics and Gynecology, University of Southern California, Keck School of Medicine, Los Angeles, CA, USADepartment of Research &amp; Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USADepartment of Research &amp; Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USADepartment of Research &amp; Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USADepartment of Research &amp; Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USADepartment of Environmental and Occupational Health, Joe C. Wen School of Population &amp; Public Health, University of California, Irvine, CA, USA; Corresponding author at: Department of Environmental and Occupational Health, Program in Public Health, Susan &amp; Henry Samueli College of Health Sciences, 856 Medical Sciences Rd (Quad), University of California, Irvine CA 92697-3957, USA.Background: Growing evidence suggests that urban biodiversity may influence human health, though this relationship remains incompletely understood. While green spaces have shown beneficial effects on birth outcomes, the specific role of plant species richness has not been investigated in relation to preterm birth (PTB, <37 weeks’ gestation). Methods: Using Kaiser Permanente Southern California electronic health records (2015–2021), we analyzed 232,452 births to examine associations between plant species richness and PTB. Plant species richness was assessed at the maternal neighborhood level, defined using circular buffers of 1.5 km around maternal residences. Results: We found that increased plant species richness was associated with decreased PTB risk (adjusted odds ratio per interquartile range: 0.959, 95 % CI: 0.941, 0.977). The observed association persisted after further adjustment for multiple green space indicators. The proportions of mediation effects attributable to mean temperature during pregnancy ranged from 7.0 % to 7.8 % across plant species diversity indicators. In the subgroup analysis, plant species diversity demonstrated significantly stronger protective associations against PTB among mothers exposed to higher levels of Ozone, high ambient temperatures, and those gave birth during the pandemic period. Conversely, protective associations were more pronounced among mothers with lower NO2 exposure during pregnancy. Notably, the significant relationship between plant species richness and reduced PTB persisted in pandemic-period analyses after adjusting for COVID-19 infection during pregnancy. Conclusions: Our findings highlight a complex interplay of sociodemographic and environmental factors influencing PTB risks and underscore the critical need for public health interventions that consider the unique attributes of urban green space.http://www.sciencedirect.com/science/article/pii/S0160412025003952Plant species richnessGreen spaceBiodiversityPreterm birthPregnancy outcomeMaternal exposure
spellingShingle Mengyi Li
Qiping Fan
Yi Sun
Tarik Benmarhnia
Jiu-Chiuan Chen
Anqi Jiao
John Molitor
David A. Sacks
Jeff M. Slezak
Vicki Y. Chiu
Chantal C. Avila
Darios Getahun
Jun Wu
Plant species richness, green spaces, and preterm birth risk in urban areas
Environment International
Plant species richness
Green space
Biodiversity
Preterm birth
Pregnancy outcome
Maternal exposure
title Plant species richness, green spaces, and preterm birth risk in urban areas
title_full Plant species richness, green spaces, and preterm birth risk in urban areas
title_fullStr Plant species richness, green spaces, and preterm birth risk in urban areas
title_full_unstemmed Plant species richness, green spaces, and preterm birth risk in urban areas
title_short Plant species richness, green spaces, and preterm birth risk in urban areas
title_sort plant species richness green spaces and preterm birth risk in urban areas
topic Plant species richness
Green space
Biodiversity
Preterm birth
Pregnancy outcome
Maternal exposure
url http://www.sciencedirect.com/science/article/pii/S0160412025003952
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