TY - JOUR

T1 - Urban environment in pregnancy and postpartum depression

T2 - An individual participant data meta-analysis of 12 European birth cohorts

AU - Cadman, Tim

AU - Strandberg-Larsen, Katrine

AU - Calas, Lucinda

AU - Christiansen, Malina

AU - Culpin, Iryna

AU - Dadvand, Payam

AU - de Castro, Montserrat

AU - Foraster, Maria

AU - Fossati, Serena

AU - Guxens, Mònica

AU - Harris, Jennifer R.

AU - Hillegers, Manon

AU - Jaddoe, Vincent

AU - Lee, Yunsung

AU - Lepeule, Johanna

AU - el Marroun, Hanan

AU - Maule, Milena

AU - McEachen, Rosie

AU - Moccia, Chiara

AU - Nader, Johanna

AU - Nieuwenhuijsen, Mark

AU - Nybo Andersen, Anne Marie

AU - Pearson, Rebecca

AU - Swertz, Morris

AU - Vafeiadi, Marina

AU - Vrijheid, Martine

AU - Wright, John

AU - Lawlor, Deborah A.

AU - Pedersen, Marie

N1 - Publisher Copyright: © 2024 The Author(s)

PY - 2024

Y1 - 2024

N2 - 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.

AB - 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.

KW - Ambient air pollution

KW - Built environment

KW - Natural spaces

KW - Postpartum depression

KW - Traffic noise

KW - Urban

U2 - 10.1016/j.envint.2024.108453

DO - 10.1016/j.envint.2024.108453

M3 - Journal article

C2 - 38368715

AN - SCOPUS:85185304316

VL - 185

JO - Environment international

JF - Environment international

SN - 0160-4120

M1 - 108453

ER -