Effect of urban green space on parental sleep quality in the two years after childbirth

BACKGROUND: Green spaces are beneficial for sleep quality, particularly for maternal sleep quality, which in turn affects maternal health as well as the growth and development of offspring. However, few studies have examined the effect of green space on parental sleep quality, and even fewer have utilized the Normalized Difference Vegetation Index (NDVI). This study thus aims to explore the impact of urban green spaces on parental sleep quality during the two years after childbirth. METHODS: Participants were selected from the Longitudinal Examination across Prenatal and Postpartum Health in Taiwan cohort study. The study recruited and followed participants from early pregnancy to 6 years postpartum at five hospitals in Taipei since 2011. Participants who had used hypnotics were excluded. Sleep quality was assessed using self-reported questions at 24 months postpartum. Urban greenness was assessed using NDVI within a designated radius (250, 750, and 1500m) of participants’ residences during both the pregnancy and postpartum. Data were analyzed using multiple logistic regression. RESULTS: Out of the 804 pairs included in the analysis, we observed that an increase of 0.1 units in NDVI within a 1500m radius during pregnancy and postpartum periods (0-24 months) was associated with a 1.24 and 1.25-fold increase in maternal better sleep quality (95%CI:1.07,1.43 and 1.08, 1.43, respectively), after adjustment. These findings were consistent for both NDVI_250m and NDVI_750m. However, we did not find any association between NDVI and paternal sleep quality at any radius or time period. CONCLUSIONS: We highlight a positive association between exposure to urban green spaces during perinatal periods and better maternal sleep quality. These findings have implications for parents in choosing their living environment, as well as for policymakers in urban planning and environmental improvement initiatives to promote both maternal and child health. KEY MESSAGES: • Urban green spaces have a positive impact on maternal sleep quality from pregnancy to postpartum periods. • The residential environment is critical to facilitate sleep quality and promote maternal and child health.