Studies evaluating the benefits and risks of green spaces on children’s health are scarce. The present study aimed to examine the associations between exposure to green spaces during pregnancy and early childhood with respiratory, cardiometabolic, and neurodevelopmental outcomes in school-age children. We performed an Individual-Participant Data (IPD) meta-analysis involving 35,000 children from ten European birth cohorts across eight countries. For each participant, we calculated residential Normalized Difference Vegetation Index (NDVI) within a 300 m buffer and the linear distance to green spaces (meters) during prenatal life and childhood. Multiple harmonized health outcomes were selected: asthma and wheezing, lung function, body mass index, diastolic and systolic blood pressure, non-verbal intelligence, internalizing and externalizing problems, and ADHD symptoms. We conducted a two-stage IPD meta-analysis and evaluated effect modification by socioeconomic status (SES) and sex. Between-study heterogeneity was assessed via random-effects meta-regression. Residential surrounding green spaces in childhood, not pregnancy, was associated with improved lung function, particularly higher FEV (β = 0.06; 95 %CI: 0.03, 0.09 I = 4.03 %, p < 0.001) and FVC (β = 0.07; 95 %CI: 0.04, 0.09 I = 0 %, p < 0.001) with a stronger association observed in females (p 0.001). This association remained robust after multiple testing correction and did not change notably after adjusting for ambient air pollution. Increased distance to green spaces showed an association with lower FVC (β = −0.04; 95 %CI: −0.07, −0.02, I = 4.8, p = 0.001), with a stronger effect in children from higher SES backgrounds (p 0.001). No consistent associations were found between green spaces and asthma, wheezing, cardiometabolic, or neurodevelopmental outcomes, with direction of effect varying across cohorts. Wheezing and neurodevelopmental outcomes showed high between-study heterogeneity, and the age at outcome assessment was only associated with heterogeneity in internalizing problems.. This large European meta-analysis suggests that childhood exposure to green spaces may lead to better lung function. Associations with other respiratory outcomes and selected cardiometabolic and neurodevelopmental outcomes remain inconclusive.

中文翻译：

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绿色空间与呼吸、心脏代谢和神经发育结果：对超过 35,000 名欧洲儿童的个体参与者数据荟萃分析


评估绿色空间对儿童健康的益处和风险的研究很少。本研究旨在探讨怀孕期间和幼儿期接触绿色空间与学龄儿童呼吸、心脏代谢和神经发育结果之间的关联。我们对来自 8 个国家 10 个欧洲出生队列的 35,000 名儿童进行了个体参与者数据 (IPD) 荟萃分析。对于每位参与者，我们计算了 300 m 缓冲区内的住宅归一化植被指数 (NDVI) 以及产前和儿童时期到绿色空间的线性距离（米）。选择了多种协调的健康结果：哮喘和喘息、肺功能、体重指数、舒张压和收缩压、非语言智力、内化和外化问题以及多动症症状。我们进行了两阶段 IPD 荟萃分析，并评估了社会经济地位 (SES) 和性别的影响修改。通过随机效应荟萃回归评估研究间异质性。童年时期住宅周围的绿色空间（而非怀孕）与肺功能改善相关，特别是较高的 FEV（β = 0.06；95 % CI：0.03、0.09 I = 4.03 %，p < 0.001）和 FVC（β = 0.07；95 %） CI: 0.04, 0.09 I = 0 %, p < 0.001)，在女性中观察到更强的关联性 (p < 0.001)。经过多次测试校正后，这种关联仍然保持强劲，并且在调整环境空气污染后没有显着变化。与绿色空间的距离增加与较低的 FVC 相关（β = -0.04；95 %CI：-0.07，-0.02，I = 4.8，p = 0.001），对来自较高 SES 背景的儿童影响更大（p < 0.001） 。 绿色空间与哮喘、喘息、心脏代谢或神经发育结果之间没有发现一致的关联，不同队列的影响方向也不同。喘息和神经发育结果显示出研究间的高度异质性，而结果评估的年龄仅与内化问题的异质性相关。这项大型欧洲荟萃分析表明，童年接触绿色空间可能会导致更好的肺功能。与其他呼吸系统结果以及选定的心脏代谢和神经发育结果的关联仍不确定。