Prenatal exposure to green space and mental health in early adolescence: Findings from the TRAILS study

Abstract

Little is known about whether green space exposure prenatally contributes to mental health later in life. Using data from a Dutch cohort (Tracking Adolescents' Individual Lives Survey; n = 1476), we assessed associations between green space exposure prenatally (1989-1991) and 4 mental health outcomes: externalizing problems, internalizing problems, tobacco use, and alcohol use, self-reported at age 11 years (2001-2002), and we assessed mediation of gestational age and birth weight on these associations. In a structural equation model, adolescents with 1 SD unit more green space exposure prenatally had 0.119 SD (95% CI, 0.028-0.210) more externalizing problems in early adolescence. There are 2 potential explanations for this unexpected positive association. First, controlling for urbanicity attenuated this association to become non-significant, but the degree of attenuation was minor (0.096; 95% CI, -0.003 to 0.195). Second, this unexpected association might be a consequence of changes in green space exposure in the intervening years, namely childhood (from birth to early adolescence), indicating that individuals with increased green space exposure over childhood had fewer externalizing problems in early adolescence. For the prenatal green space-externalizing problems association, we did not observe mediation by gestational age or birth weight. Overall, these findings suggest no beneficial role of prenatal exposure to green space on adolescent mental health. Instead, increased green space exposure in childhood may lead to fewer externalizing problems in early adolescence.