Prenatal and postpartum residential greenness and behavioral development in early Childhood: Findings from a birth...

Early life is a critical window for development, during which environmental exposures can have lasting impacts. While harmful exposures are widely studied, protective factors such as green space remain underexplored. This study examined associations between green space exposure during prenatal and postnatal periods and behavioral development in children aged 2-4 years.

Data were drawn from the Longitudinal Examination Across Prenatal and Postpartum Health in Taiwan cohort. Information on 408 families collected at early and mid-pregnancy, 1 month postpartum, and 2-4 years postpartum between 2017 and 2024 were analyzed. Green space exposure was accessed using the Normalized Difference Vegetation Index (NDVI) within 250-2000 m residential buffers. Children's behavioral development was evaluated using the Child Behavior Checklist for Ages 1½-5. Multiple regression models were applied.

Higher prenatal green exposure was associated with fewer attention problems at age 2 (β ranged -0.42 to -0.47 across NDVI buffer radii, p < 0.05) and at age 3 (β ranged -0.43 to -0.44 across NDVI buffer radii, p < 0.05). In multiple-time-point analyses, higher prenatal green exposure was linked to fewer sleep (β = -0.44, p = 0.04; significant only in the 250m buffer) and attention (β ranged -0.42 to -0.44 across NDVI buffer radii, p < 0.001) problems. Higher postnatal green exposure was associated only with fewer attention problems (β ranged -0.31 to -0.34 across NDVI buffer radii, p < 0.05).

Green space exposure was consistently linked to fewer behavioral problems, especially attention difficulties, in early childhood. Findings suggest enhancing access to green environments may benefit early behavioral development.