927 Urban residential tree canopy cover: a potential buffer against prenatal stress


      To examine associations between urban residential tree canopy cover (TCC) & perceived stress in a cohort of pregnant women in Philadelphia, PA using Cohen Perceived Stress Scale (PSS-14).

      Study Design

      We performed a post-hoc analysis of the Motherhood & Microbiome Study, a cohort of patients who received prenatal care for singleton gestations at a single center in Philadelphia, PA from 2013 to 2016, recruited between the 16th and 21st week of pregnancy for a study on preterm birth risk factors (n=2000). Inclusion criteria for analysis were residence in Philadelphia & recorded PSS-14 score during the first study visit (n =1210). TCC was acquired from Philadelphia Parks & Recreation open access data and calculated as percent cover within 50, 100 & 500m radii buffers around participants’ homes. We used multilevel mixed effects linear regressions (PSS-14 score as dependent variable). Participant-level covariates were age, parity, race/ethnicity, insurance, education, and history of depression or anxiety. At the census-tract level, we adjusted for the neighborhood deprivation index, which captures socioeconomic status.


      Most participants were Non-Hispanic Black (70%), on Medicaid (59%), & 15% of participants had a prior history of depression or anxiety. Participants with a history of anxiety or depression had a greater mean (SD) PSS-14 score (26(7.8) vs 22.5(7.7)), P <0.001. There were no associations between TCC & PSS-14 overall, however, among those with a history of depression or anxiety, TCC was associated with lower PSS-14 scores across all 3 buffer sizes (-11.8; 95% CI -20.5, -3.2), 100m (-15.1; 95% CI -25.3, -5.0), 500m (-14.83; 95% CI -26.5, -3.18).


      Maternal stress is associated with adverse pregnancy outcomes. Novel to this study, we report that residential TCC is associated with reduced stress in pregnant patients with a history of depression or anxiety. Given their high risk for long term mental illness, innovative strategies such as increased exposure to greenness are needed. Understanding the causal pathways that underlie this association should be pursued. (R01NR014784)
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