123
activity as another potential mechanism underlying the aforementioned associations
(Banay et al. 2017). The potential mediatory role of other factors such as stress
(Markevych et al. 2014a), noise and heat exposure and social contact are yet to be
investigated.
6.2 Pregnancy and Childhood as Important Windows
of Vulnerability
An accumulating body of evidence has documented the especial vulnerability of
foetuses and infants to the effects of socio-environmental factors (Nieuwenhuijsen
et al. 2013). Accordingly, pregnancy and childhood are increasingly recognised as
particularly influential for shaping health over the course of life (Hines et al. 2009).
The influence of exposures during these periods is not limited to reproductive and
childhood outcomes and can extend over a lifetime, as stated by the Developmental
Origins of Health and Diseases (DOHaD) concept (Barker 1995; Gluckman and
Hanson 2006). DOHaD suggests that environmental exposures during the prenatal
and early postnatal periods may permanently alter the body’s physiology, metabolism and structure, and that such changes can promote disease long after the environmental exposure has ceased (Hanson et al. 2016). In this context, the ability of
green spaces to promote health and development of foetuses and children and to
mitigate adverse health effects of urban-related environmental hazards such as air
pollution, noise and heat could have lifelong implications.
6.3 Pregnancy Outcomes and Complications
Among different pregnancy outcomes and complications that have been evaluated
in relation to maternal exposure to green spaces, the association with foetal growth
was the most consistent (Banay et al. 2017; Dzhambov et al. 2014). Higher greenness surrounding maternal residences has been associated with higher birth weight,
higher head circumference, lower risk of low birth weight and lower risk of smallfor- gestational age (Banay et al. 2017; Dadvand et al. 2012a, b, 2014b; Dzhambov
et al. 2014). Although less consistently shown in the literature, green spaces have
been associated with longer gestational age at delivery and lower risk of preterm
birth (Banay et al. 2017). A limited body of evidence has associated green spaces
with a lower risk of pregnancy complications such as pre-eclampsia, gestational
diabetes and peripartum depression (Banay et al. 2017). These associations have
been suggested to be stronger among women of lower socio-economic status (Banay
et al. 2017). A study from England reported that while for Caucasian British mothers there was a beneficial association between residential green spaces and birth
weight, there was no such association for British mothers of Pakistani origin
6 Green Spaces and Child Health and Development
activity as another potential mechanism underlying the aforementioned associations
(Banay et al. 2017). The potential mediatory role of other factors such as stress
(Markevych et al. 2014a), noise and heat exposure and social contact are yet to be
investigated.
6.2 Pregnancy and Childhood as Important Windows
of Vulnerability
An accumulating body of evidence has documented the especial vulnerability of
foetuses and infants to the effects of socio-environmental factors (Nieuwenhuijsen
et al. 2013). Accordingly, pregnancy and childhood are increasingly recognised as
particularly influential for shaping health over the course of life (Hines et al. 2009).
The influence of exposures during these periods is not limited to reproductive and
childhood outcomes and can extend over a lifetime, as stated by the Developmental
Origins of Health and Diseases (DOHaD) concept (Barker 1995; Gluckman and
Hanson 2006). DOHaD suggests that environmental exposures during the prenatal
and early postnatal periods may permanently alter the body’s physiology, metabolism and structure, and that such changes can promote disease long after the environmental exposure has ceased (Hanson et al. 2016). In this context, the ability of
green spaces to promote health and development of foetuses and children and to
mitigate adverse health effects of urban-related environmental hazards such as air
pollution, noise and heat could have lifelong implications.
6.3 Pregnancy Outcomes and Complications
Among different pregnancy outcomes and complications that have been evaluated
in relation to maternal exposure to green spaces, the association with foetal growth
was the most consistent (Banay et al. 2017; Dzhambov et al. 2014). Higher greenness surrounding maternal residences has been associated with higher birth weight,
higher head circumference, lower risk of low birth weight and lower risk of smallfor- gestational age (Banay et al. 2017; Dadvand et al. 2012a, b, 2014b; Dzhambov
et al. 2014). Although less consistently shown in the literature, green spaces have
been associated with longer gestational age at delivery and lower risk of preterm
birth (Banay et al. 2017). A limited body of evidence has associated green spaces
with a lower risk of pregnancy complications such as pre-eclampsia, gestational
diabetes and peripartum depression (Banay et al. 2017). These associations have
been suggested to be stronger among women of lower socio-economic status (Banay
et al. 2017). A study from England reported that while for Caucasian British mothers there was a beneficial association between residential green spaces and birth
weight, there was no such association for British mothers of Pakistani origin
6 Green Spaces and Child Health and Development