| 摘要: |
| 在健康城市的规划建设中，建成环境对母婴健康的支撑非常重要，但在中国学界和实践中暂未得到足够重视。以母婴健康中的孕妇(女性孕期)健康和妊
娠结局(婴儿出生)为表征，以知网、Web of Science和PubMed等数据库为基础，搜索城市建成环境与这2类健康结果的关联研究，开展综述以综合呈现该领
域研究进展。已有研究揭示了归一化植被指数(NDVI，或称绿量)和绿地率等绿色空间指标、道路密度和可步行性等道路交通指标，以及医疗设施可获得性等公共
服务设施指标对孕妇健康和妊娠结局的重要作用，其作用机制包括空气污染和噪声等健康风险、体力活动和社交活动等健康行为，以及医疗护理等健康资源三大
类。探讨了已有研究在建成环境和孕妇健康测度等方面的缺失点，提出了增补绿色空间类型等测度指标、构建孕妇健康时序数据集等未来研究方向，以期从城乡
规划和风景园林学科角度为保障母婴健康作出贡献。 |
| 关键词: 风景园林 健康城市 城市景观 建成环境 孕妇健康 妊娠结局 |
| DOI：10.19775/j.cla.2025.01.0023 |
| 投稿时间：2024-10-11修订日期：2024-11-19 |
| 基金项目:高密度人居环境生态与节能教育部重点实验室(同济大学)暨上海同济城市规划设计研究院有限公司联合自主课题(KY-2022-LH-A03) |
|
| The Impact of Urban Built Environment on Maternal Health and Birth Outcomes: Research Progressand Prospects |
| WANG Lan,LEI Anni,ZHANG Yutong,JIA Yinghui,MIAO Maohua |
| Abstract: |
| Against the backdrop of China's increasingly challenging population
problem, promoting maternal health and birth outcomes is one of the key
measures to address population issues. Studies in public health, clinical medicine,
and environmental science have confirmed that environmental factors such as
temperature, air pollution, and noise can have an impact on the health of pregnant
women and infants. From the perspective of healthy city planning, the built
environment plays an essential yet often overlooked role in supporting maternal
health and birth outcomes. In recent years, there are empirical studies have also
pointed out the impact of urban built environments such as green spaces, transport
facilities, and public facilities on maternal and child health, the impact of urban built
environment on maternal health and birth outcomes still lack of an overview that
demonstrates current research progress, which has hindered us from a panoramic
understanding of this specific research field. Using pregnancy complications and
birth outcomes as indicators of maternal and child health, this research attempts to
work through a comprehensive literature review using databases such as CNKI, Web
of Science, and PubMed, systematically explores the association between the urban
built environment and health outcomes of pregnant women and offspring, aiming to
provide a detailed synthesis of the research to date. The findings imply a significant
influence of green space metrics such as the Normalized Difference Vegetation
Index (NDVI) and green space rate, road traffic measures including road density
and walkability, and the availability of public service facilities, especially medical
facilities, on maternal and pregnancy health. These impacts manifest through three
primary mechanisms: risk factors of health (e.g., air pollution and noise), health
behaviors (e.g., physical activity and social participation), and health resources
(e.g., accessibility of medical services). From the perspective of measuring the
built environment, existing research mainly focuses on exploring single urban
built environment elements and has not yet formed comprehensive measurement
indicators systems to demonstrate the complexity of influential mechanism. This
lack has hindered in-depth conversations in this specific research field. From the
perspective of maternal and child health measurement, it could be speculated
that based on potential influencing mechanisms, certain pregnancy pathological
indicators (such as thyroid dysfunction and pregnancy kidney dysfunction, etc),
psychological health indicators (such as prenatal anxiety and childbirth fear), and
postpartum rehabilitation indicators (such as pelvic recovery, rectus abdominis
muscle rehabilitation, and pelvic floor rehabilitation) may be related to built
environment factors. However, their association has not been discussed and
deserves further research. Meanwhile, existing research has mostly focused on the
health of pregnant women during pregnancy, with insufficient tracking of their longterm
postpartum health status, presenting a limited understanding of the overall
impact of the built environment during pregnancy. In terms of research perspective,
existing studies mostly explore the relationship between built environment exposure
and maternal health and pregnancy outcomes at the population level. However,
pregnant women have different spatial abilities, preferences, and life experiences,
which may lead to diverse spatial cognitive and behavioral patterns, thus the
research results may not be categorized and analyzed properly. At present, most of
the research in this field focuses on the impact of existing built environments on
the health and pregnancy outcomes of pregnant women, with little tracking of the
changes in built environments such as the impact of regional changes in maternal
health and pregnancy outcomes. In terms of research methods, existing studies have
a fairly strong preference of using quantitative research methods to explore the
correlation between built environment and maternal health and pregnancy outcomes
under big data measurement. However, quantitative research has certain limitations
in exploring the mechanisms of influence, and qualitative research methods are
needed to provide richer hypotheses, more hierarchical research frameworks, and
analytical dimensions for quantitative research, in order to enhance the overall
explanatory level of research in this field. In terms of the universality of the impact
effect, current research has revealed the heterogeneity of the effects of urban
built environment on maternal health and pregnancy outcomes among different
populations. However, the impact mechanisms, thresholds, and practical standards
that are specific to diverse populations with different ethnicity, financial conditions
and social status have not been fully understood. As a result, these factors have not
effectively guided specific spatial practices and further research is needed. |
| Key words: landscape architecture healthy city urban landscape built environment maternal health pregnancy outcome |
