Urban environment in pregnancy and postpartum depression: An individual participant data meta-analysis of 12 European birth cohorts

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  • Lucinda Calas
  • Malina Christiansen
  • Iryna Culpin
  • Payam Dadvand
  • Montserrat de Castro
  • Maria Foraster
  • Serena Fossati
  • Mònica Guxens
  • Jennifer R. Harris
  • Manon Hillegers
  • Vincent Jaddoe
  • Yunsung Lee
  • Johanna Lepeule
  • Hanan el Marroun
  • Milena Maule
  • Rosie McEachen
  • Chiara Moccia
  • Johanna Nader
  • Mark Nieuwenhuijsen
  • Rebecca Pearson
  • Morris Swertz
  • Marina Vafeiadi
  • Martine Vrijheid
  • John Wright
  • Deborah A. Lawlor

Background: Urban environmental exposures associate with adult depression, but it is unclear whether they are associated to postpartum depression (PPD). Objectives: We investigated associations between urban environment exposures during pregnancy and PPD. Methods: We included women with singleton deliveries to liveborn children from 12 European birth cohorts (N with minimum one exposure = 30,772, analysis N range 17,686–30,716 depending on exposure; representing 26–46 % of the 66,825 eligible women). We estimated maternal exposure during pregnancy to ambient air pollution with nitrogen dioxide (NO2) and particulate matter (PM2.5 and PM10), road traffic noise (Lden), natural spaces (Normalised Difference Vegetation Index; NDVI, proximity to major green or blue spaces) and built environment (population density, facility richness and walkability). Maternal PPD was assessed 3–18 months after birth using self-completed questionnaires. We used adjusted logistic regression models to estimate cohort-specific associations between each exposure and PPD and combined results via meta-analysis using DataSHIELD. Results: Of the 30,772 women included, 3,078 (10 %) reported having PPD. Exposure to PM10 was associated with slightly increased odds of PPD (adjusted odd ratios (OR) of 1.08 [95 % Confidence Intervals (CI): 0.99, 1.17] per inter quartile range increment of PM10) whilst associations for exposure to NO2 and PM2.5 were close to null. Exposure to high levels of road traffic noise (≥65 dB vs. < 65 dB) was associated with an OR of 1.12 [CI: 0.95, 1.32]. Associations between green spaces and PPD were close to null; whilst proximity to major blue spaces was associated with increased risk of PPD (OR 1.12, 95 %CI: 1.00, 1.26). All associations between built environment and PPD were close to null. Multiple exposure models showed similar results. Discussion: The study findings suggest that exposure to PM10, road traffic noise and blue spaces in pregnancy may increase PPD risk, however future studies should explore this causally.

OriginalsprogEngelsk
Artikelnummer108453
TidsskriftEnvironment International
Vol/bind185
Antal sider9
ISSN0160-4120
DOI
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
DAL works in a unit that is supported by the University of Bristol and UK Medical Research Council (MC_UU_00011/6).

Funding Information:
IS Global acknowledges support from the Spanish Ministry of Science and Innovation through the “Centro de Excelencia Severo Ochoa 2019-2023” Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program to ISGlobal.

Funding Information:
HEM was supported by the Stichting Volksbond Rotterdam, the Netherlands Organization for Scientific Research (NWO) Aspasia grant (No. 015.016.056), the European Union's Horizon 2020 Research and Innovation Program (LifeCycle, Grant Agreement 733 206 & HappyMums 101057390), and the Marie Skłodowska-Curie Actions Innovative Training Network (MSCA-ITN) programme (Serotonin and BEYOND, Grant agreement No: 953327). The funding agencies had no role in the design and conduct of the study, collection, management, analyses and interpretation of the data; and preparation, review or approval of the manuscript and the decision to submit it for publication.

Funding Information:
This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 874853 (ATHLETE project). Tim Cadman was supported by a Marie Curie-Sklodowska Individual Fellowship (URBINEX, 120616).

Publisher Copyright:
© 2024 The Author(s)

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