{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:15:06Z","timestamp":1787004906013,"version":"build-2736575974"},"reference-count":57,"publisher":"Georg Thieme Verlag KG","issue":"11","funder":[{"name":"March of Dimes Prematurity Research Center, March of Dimes Foundation, U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Nursing Research","award":["R01NR014784"],"award-info":[{"award-number":["R01NR014784"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:p>Objective\u2003Urban neighborhood greenness is associated with greater cardiovascular health in the general population, and with better pregnancy and neonatal outcomes. Hypertension in pregnancy is a leading cause of maternal mortality and long-term cardiovascular morbidity and mortality in women. We sought to examine the association between greenness and hypertensive disorders of pregnancy.<\/jats:p>\n                  <jats:p>Study Design\u2003This study is a secondary analysis of a prospective cohort study of 1,943 women who received prenatal care from December 2013 to December 2016 at a single, urban, and tertiary academic medical center in Philadelphia, PA. Greenness measure was quantified via residential tree canopy cover within circumferential buffers of 100- and 500-meter radii around participants' homes. Associations between greenness and hypertensive disorders of pregnancy (defined as gestational hypertension or preeclampsia) were estimated by using multilevel logistic regression accounting for maternal sociodemographic information (race-ethnicity, insurance status, and age) medical history (diabetes, body mass index, smoking history, and parity), neighborhood deprivation index, and including 1,225 Philadelphia residents for whom key exposure and outcome data were available.<\/jats:p>\n                  <jats:p>Results\u2003At baseline, the participants' mean (SD) age was 27.5 (5.9) years, (range: 14\u201344 years). The majority of participants were non-Hispanic Black (857, 70.2%). Participants with less residential tree canopy cover were significantly more likely to have hypertensive disorders of pregnancy. The multivariable-adjusted odds ratio of hypertensive disorders of pregnancy among participants with less than 10% compared with those with greater than 30% tree canopy cover was 2.14 (95% confidence interval [CI]: 1.11\u20134.15) within 100-meter buffer.<\/jats:p>\n                  <jats:p>Conclusion\u2003In our cohort, greenness was associated with lower hypertensive disorders of pregnancy odds. Our findings add to evidence that greenness may confer health benefits and warrant further investigations in identifying whether there is a causal pathway through which greenness may be protective against hypertensive disorders of pregnancy.<\/jats:p>\n                  <jats:p>Key Points<\/jats:p>","DOI":"10.1055\/s-0041-1733786","type":"journal-article","created":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T18:57:01Z","timestamp":1630090621000},"page":"1185-1192","source":"Crossref","is-referenced-by-count":9,"title":["Association between Low Urban Neighborhood Greenness and Hypertensive Disorders of Pregnancy"],"prefix":"10.1055","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5468-8926","authenticated-orcid":false,"given":"Max Jordan Nguemeni","family":"Tiako","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Center for Emergency Care and Policy Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"},{"name":"Urban Health Lab, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"},{"name":"Yale School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Maternal and Child Health Research Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary F.","family":"Meisel","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Center for Emergency Care and Policy Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"},{"name":"Leonard Davis Institute of Health Economics, Wharton School of the University of Pennsylvania, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal A.","family":"Elovitz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Maternal and Child Health Research Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather H.","family":"Burris","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Maternal and Child Health Research Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"},{"name":"Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenia","family":"South","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Center for Emergency Care and Policy Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"},{"name":"Urban Health Lab, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania"},{"name":"Leonard Davis Institute of Health Economics, Wharton School of the University of Pennsylvania, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,8,27]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1053\/j.semperi.2011.09.011","article-title":"Maternal mortality from preeclampsia\/eclampsia","volume":"36","author":"L Ghulmiyyah","year":"2012","journal-title":"Semin Perinatol"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"e36171","DOI":"10.1371\/journal.pone.0036171","article-title":"Hypertension in women of reproductive age in the United States: NHANES 1999-2008","volume":"7","author":"B T Bateman","year":"2012","journal-title":"PLoS One"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1161\/HYPERTENSIONAHA.117.09246","article-title":"All hypertensive disorders of pregnancy increase the risk of future cardiovascular disease","volume":"70","author":"J Tooher","year":"2017","journal-title":"Hypertension"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.ijcard.2019.02.005","article-title":"Women-specific predictors of cardiovascular disease risk - 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