BACKGROUND Residential greenness is linked to birth outcomes. However, the role of greenspace morphology remains poorly understood. Additionally, evidence is lacking regarding whether these relationships vary by subpopulation. OBJECTIVE We examined the association between preterm birth and residential greenspace morphology, including percentage, shape, connectedness, aggregation, closeness, and fragmentation. METHODS We analyzed 2,063,444 singleton live births between 2001 to 2016 in Georgia, USA. Thirty-meter resolution landcover data from National Land Cover Databased (2001-2016) were obtained to calculate greenspace morphology metrics for 1,953 census tracts in Georgia. A two-stage logistic regression examined associations between each greenspace morphology metric and preterm birth at individual level. Stratified analysis was conducted by maternal race, ethnicity, education, urbanicity, poverty rate, and greenspace percentage. RESULTS Higher greenspace percentage, aggregation, closeness, shape complexity, connectedness, and lower fragmentation were linked to a lower risk of preterm birth. After adjusting for poverty rate, associations with morphology attenuated, except for fragmentation [odds ratio (OR) = 1.014; 95% confidence interval (CI): 1.0001, 1.026] across the entire population. Strongest associations were found among black mothers and in high-poverty areas. Specifically, the odds of preterm birth in the highest quartile of greenspace percentage were 0.962 (95% CI: 0.933, 0.991) times the odds in the lowest quartile. Additionally, a lower risk of preterm birth was associated with higher greenspace aggregation (OR = 0.969; 95% CI: 0.947, 0.992), and a higher risk of preterm birth was associated with higher fragmentation (OR = 1.028; 95% CI: 1.009, 1.047), both in the black mothers group. In tracts with a high poverty rate, a lower risk of preterm birth associate with higher greenspace percentage (OR = 0.953; 95% CI: 0.910, 0.999), aggregation (OR = 0.976; 95% CI: 0.955, 0.997), and lower fragmentation (OR = 0.976; 95% CI: 0.958, 0.994). The association with greenspace morphology was most pronounced in census tracts with a medium level of greenspace percentage. DISCUSSION Our study complements other studies by showing the importance and protective effects of greenspace morphology. The observed effects are particularly prominent in census tracts characterized by a moderate level of greenspace percentage, high poverty rates, and among black women. Our findings suggest the need for tailored greenspace planning strategies based on varying levels of greenness in different areas. For locations with low greenness, increasing the greenspace percentage may be prioritized. In areas with a medium level of greenness, strategic enhancement of greenspace morphology is recommended. For areas with high greenness, the focus should be on improving spatial closeness of greenspace. https://doi.org/10.1289/EHP14571.

中文翻译：

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绿地形态学和早产：美国佐治亚州的一项全州研究（2001-2016 年）。


背景 住宅绿化与出生结果有关。然而，绿地形态的作用仍然知之甚少。此外，缺乏关于这些关系是否因亚群而异的证据。目的 我们检查了早产与住宅绿地形态之间的关联，包括百分比、形状、连通性、聚集性、接近性和碎片化。方法 我们分析了 2001 年至 2016 年美国佐治亚州的 2,063,444 例单胎活产婴儿。从国家土地覆盖数据库 （2001-2016） 获得 30 米分辨率的土地覆盖数据，以计算佐治亚州 1,953 个人口普查区的绿地形态指标。两阶段 logistic 回归检查了每个绿地形态指标与个体水平早产之间的关联。按母系种族、民族、教育程度、城市化、贫困率和绿地百分比进行分层分析。结果 较高的绿地百分比、聚集、接近度、形状复杂性、连通性和较低的碎片化与较低的早产风险有关。调整贫困率后，与形态学的关联减弱，除了整个人群的碎片化 [比值比 （OR） = 1.014;95% 置信区间 （CI）：1.0001,1.026]。在黑人母亲和高度贫困地区发现了最强的关联。具体而言，绿地百分比最高四分位数的早产几率是最低四分位数的 0.962 （95% CI： 0.933， 0.991） 乘以最低四分位数的几率。此外，较低的早产风险与较高的绿地聚集相关 （OR = 0.969;95% CI： 0.947， 0.992），较高的早产风险与较高的碎片化相关 （OR = 1.028;95% CI： 1.009， 1.047），均属于 Black Mothers 组。在贫困率高的地区，早产风险较低，绿地百分比较高（OR = 0.953;95% CI：0.910,0.999）、聚集率较高（OR = 0.976;95% CI：0.955,0.997）和较低的碎片化（OR = 0.976;95% CI：0.958,0.994）。与绿地形态的关联在绿地百分比中等的人口普查区中最为明显。讨论 我们的研究通过展示绿地形态的重要性和保护作用来补充其他研究。观察到的效果在绿地百分比适中、贫困率高的人口普查区和黑人女性中尤为突出。我们的研究结果表明，需要根据不同地区的不同绿化水平制定量身定制的绿地规划策略。对于绿化程度低的位置，可以优先考虑增加绿地百分比。在绿化程度中等的区域，建议战略性地增强绿地形态。对于绿化程度高的区域，应将重点放在提高绿地的空间接近度上。https://doi.org/10.1289/EHP14571。