ArticleLancet regional health. Americas2023
Association between urban green space and postpartum depression, and the role of physical activity: a retrospective cohort study in Southern California.
Article in Lancet regional health. Americas, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 31 citations in OpenAlex.
- Assessing greenspace and cardiovascular disease risk through deep learning analysis of street-view imagery in the US-based nationwide Nurses' Health Study.Environmental epidemiology (Philadelphia, Pa.) · 2026Article
- Prenatal exposure to residential greenness, fetal growth, and birth outcomes: a cohort study in New York City.American journal of epidemiology · 2025Article
- Identifying the critical windows and joint effects of greenness and particulate matter exposures for preterm birth: a retrospective study across Guangdong Province in China from 2014 to 2018.BMC public health · 2025Article
- Mental health disparities among maternal populations following heatwave exposure in North Carolina (2011-2019): a matched analysis.Lancet regional health. Americas · 2025Article
- Daily walking habits can mitigate age-related decline in static balance: a longitudinal study among aircraft assemblers.Scientific reports · 2025Article
- Fine Particulate Matter, Its Constituents, and Spontaneous Preterm Birth.JAMA network open · 2024Article
- Association of Postpartum Temperature Exposure with Postpartum Depression: A Retrospective Cohort Study in Southern California.Environmental health perspectives · 2024Article
- Infant and early childhood physical health assessments in the HEALthy Brain and Child Development (HBCD) Study.Developmental cognitive neuroscience · 2024Article
- Article
- Pregnancy outcomes as related to in utero exposure to air pollution and greenness: The Life-GAP Project.Environmental epidemiology (Philadelphia, Pa.) · 2024Article
- Green spaces exposure and the risk of common psychiatric disorders: A meta-analysis.SSM - population health · 2024Article
- Neighborhood greenness and participation in specific types of recreational physical activities in the Sister Study.Environmental research · 2024Article
- "Urban-Satellite" estimates in the ABCD Study: Linking Neuroimaging and Mental Health to Satellite Imagery Measurements of Macro Environmental Factors.medRxiv : the preprint server for health sciences · 2024Article
- Mapping high-risk clusters and identifying place-based risk factors of mental health burden in pregnancy.SSM. Mental health · 2023Article
- Association of Antepartum and Postpartum Air Pollution Exposure With Postpartum Depression in Southern California.JAMA network open · 2023Article
- Analysis of Heat Exposure During Pregnancy and Severe Maternal Morbidity.JAMA network open · 2023Article
- Advancing application of satellite remote sensing technologies for linking atmospheric and built environment to health.Frontiers in public health · 2023Review
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 2 countries.
Funding
Abstract
Background: Little research exists regarding the relationships between green space and postpartum depression (PPD). We aimed to investigate the relationships between PPD and green space exposure, and the mediating role of physical activity (PA). Methods: Clinical data were obtained from Kaiser Permanente Southern California electronic health records in 2008-2018. PPD ascertainment was based on both diagnostic codes and prescription medications. Maternal residential green space exposures were assessed using street view-based measures and vegetation types (i.e., street tree, low-lying vegetation, and grass), satellite-based measures [i.e., Normalized Difference Vegetation Index (NDVI), land-cover green space, and tree canopy cover], and proximity to the nearest park. Multilevel logistic regression was applied to estimate the association between green space and PPD. A causal mediation analysis was performed to estimate the proportion mediated by PA during pregnancy in the total effects of green space on PPD. Findings: In total, we included 415,020 participants (30.2 ± 5.8 years) with 43,399 (10.5%) PPD cases. Hispanic mothers accounted for about half of the total population. A reduced risk for PPD was associated with total green space exposure based on street-view measure [500 m buffer, adjusted odds ratio (OR) per interquartile range: 0.98, 95% CI: 0.97-0.99], but not NDVI, land-cover greenness, or proximity to a park. Compared to other types of green space, tree coverage showed stronger protective effects (500 m buffer, OR = 0.98, 95% CI: 0.97-0.99). The proportions of mediation effects attributable to PA during pregnancy ranged from 2.7% to 7.2% across green space indicators. Interpretation: Street view-based green space and tree coverage were associated with a decreased risk of PPD. The observed association was primarily due to increased tree coverage, rather than low-lying vegetation or grass. Increased PA was a plausible pathway linking green space to lower risk for PPD. Funding: National Institute of Environmental Health Sciences (NIEHS; R01ES030353).
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