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Meta-Analysis
. 2024 Mar:185:108453.
doi: 10.1016/j.envint.2024.108453. Epub 2024 Feb 13.

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

Tim Cadman  1 , Katrine Strandberg-Larsen  2 , Lucinda Calas  3 , Malina Christiansen  2 , Iryna Culpin  4 , Payam Dadvand  5 , Montserrat de Castro  5 , Maria Foraster  5 , Serena Fossati  5 , Mònica Guxens  6 , Jennifer R Harris  7 , Manon Hillegers  8 , Vincent Jaddoe  9 , Yunsung Lee  7 , Johanna Lepeule  10 , Hanan El Marroun  11 , Milena Maule  12 , Rosie McEachen  13 , Chiara Moccia  12 , Johanna Nader  14 , Mark Nieuwenhuijsen  5 , Anne-Marie Nybo Andersen  2 , Rebecca Pearson  15 , Morris Swertz  16 , Marina Vafeiadi  17 , Martine Vrijheid  5 , John Wright  13 , Deborah A Lawlor  4 , Marie Pedersen  2
Affiliations
Free article
Meta-Analysis

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

Tim Cadman et al. Environ Int. 2024 Mar.
Free article

Abstract

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.

Keywords: Ambient air pollution; Built environment; Natural spaces; Postpartum depression; Traffic noise; Urban.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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