Manchester Metropolitan University's Research Repository

    Urban environment in pregnancy and postpartum depression: An individual participant data meta-analysis of 12 European birth cohorts

    Cadman, T, Strandberg-Larsen, K, Calas, L, Christiansen, M, Culpin, I, Dadvand, P, de Castro, M, Foraster, M, Fossati, S, Guxens, M, Harris, JR, Hillegers, M, Jaddoe, V, Lee, Y, Lepeule, J, el Marroun, H, Maule, M, McEachen, R, Moccia, C, Nader, J, Nieuwenhuijsen, M, Nybo Andersen, AM, Pearson, R ORCID logoORCID: https://orcid.org/0000-0001-8527-3400, Swertz, M, Vafeiadi, M, Vrijheid, M, Wright, J, Lawlor, DA and Pedersen, M (2024) Urban environment in pregnancy and postpartum depression: An individual participant data meta-analysis of 12 European birth cohorts. Environment International, 185. 108453. ISSN 0160-4120

    Published Version
    Available under License Creative Commons Attribution.

    Download (2MB) | Preview


    Background: Urban environmental exposures associate with adult depression, but it is unclear whether they are associated to postpartum depression (PPD). Objectives: We investigated associations between urban environment exposures during pregnancy and PPD. Methods: We included women with singleton deliveries to liveborn children from 12 European birth cohorts (N with minimum one exposure = 30,772, analysis N range 17,686–30,716 depending on exposure; representing 26–46 % of the 66,825 eligible women). We estimated maternal exposure during pregnancy to ambient air pollution with nitrogen dioxide (NO2) and particulate matter (PM2.5 and PM10), road traffic noise (Lden), natural spaces (Normalised Difference Vegetation Index; NDVI, proximity to major green or blue spaces) and built environment (population density, facility richness and walkability). Maternal PPD was assessed 3–18 months after birth using self-completed questionnaires. We used adjusted logistic regression models to estimate cohort-specific associations between each exposure and PPD and combined results via meta-analysis using DataSHIELD. Results: Of the 30,772 women included, 3,078 (10 %) reported having PPD. Exposure to PM10 was associated with slightly increased odds of PPD (adjusted odd ratios (OR) of 1.08 [95 % Confidence Intervals (CI): 0.99, 1.17] per inter quartile range increment of PM10) whilst associations for exposure to NO2 and PM2.5 were close to null. Exposure to high levels of road traffic noise (≥65 dB vs. < 65 dB) was associated with an OR of 1.12 [CI: 0.95, 1.32]. Associations between green spaces and PPD were close to null; whilst proximity to major blue spaces was associated with increased risk of PPD (OR 1.12, 95 %CI: 1.00, 1.26). All associations between built environment and PPD were close to null. Multiple exposure models showed similar results. Discussion: The study findings suggest that exposure to PM10, road traffic noise and blue spaces in pregnancy may increase PPD risk, however future studies should explore this causally.

    Impact and Reach


    Activity Overview
    6 month trend
    6 month trend

    Additional statistics for this dataset are available via IRStats2.


    Repository staff only

    Edit record Edit record