Evidence map›Paper›PMID 41822184›Full record

ArticleEnvironmental epidemiology (Philadelphia, Pa.)2026

Exploring pathways between residential greenness and antepartum stillbirth: A mediation analysis.

Dario Ezequiel Elias, Marcia Furquim de Almeida, Rossana Pulcineli Vieira Francisco, Hillegonda Maria Dutilh Novaes, Lays Janaina Prazeres Marques, Regina Schultz, Mara Sandra Hoshida, Zilda Pereira da Silva, Osmara Alves Dos Santos, Gerusa Maria Figueiredo and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Environmental epidemiology (Philadelphia, Pa.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Dario Ezequiel EliasDepartamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0002-6576-8569
Marcia Furquim de AlmeidaDepartamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0003-0052-1888
Rossana Pulcineli Vieira FranciscoDepartamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0002-9981-8069
Hillegonda Maria Dutilh NovaesDepartamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0001-9849-0324
Lays Janaina Prazeres MarquesDepartamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0003-4511-4995
Regina SchultzDivisão de Anatomia Patológica, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0001-6777-6426
Mara Sandra HoshidaLaboratório de Investigação Médica em Obstetrícia (LIM 57), Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0003-2232-4631
Zilda Pereira da SilvaDepartamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0003-4648-113X
Osmara Alves Dos SantosDepartamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0001-6360-861X
Gerusa Maria FigueiredoDepartamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0001-9657-9675
Rafael Junqueira BuralliDepartamento de Política, Gestão e Saúde, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0001-7006-6177
Gabriella Ferreira DemarqueDepartamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0001-7104-8931
Clarisse Martins MachadoInstituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0003-1417-0249
Luciana Regina MeirelesInstituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0003-0913-1579
Rodrigo Melim ZerbinatiLaboratório de Virologia (LIM 52), Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0001-9936-9139
Andrés Jimenez Galisteo JuniorLaboratório de Investigação Médica em Protozoologia, Bacteriologia e Resistência Antimicrobiana (LIM 49), Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0003-1611-6721
Laura Cunha RodriguesLondon School of Hygiene & Tropical Medicine, London, United Kingdom.ORCID https://orcid.org/0000-0001-9008-660X
Nelson GouveiaDepartamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0003-0625-0265
Gizelton Pereira AlencarDepartamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.ORCID https://orcid.org/0000-0002-2354-9050

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Antepartum stillbirth is an important public health issue. This study aimed to identify mediation pathways from the vegetation greenness surrounding the maternal residence to antepartum stillbirth, through stillbirth risk factors. Methods: This study is part of the FetRisks project-a population-based case-control study of stillbirth and live births in 14 public hospitals in the Municipality of São Paulo, Brazil (December 2019-December 2023). We estimated vegetation greenness using the median value of the normalized difference vegetation index (NDVI) obtained from satellite images from the study period, considering buffer radii around the residences between 50 and 500 m. We used penalized logistic regressions to select maternal, placental, fetal, and neighborhood characteristics. Based on these data, we built a Bayesian network and performed counterfactual mediation analyses. Results: We analyzed 248 antepartum stillbirths (cases) and 301 live births (controls). The maternal residence of 19.4% (48/248) of cases and 30.9% (93/301) of controls had a median NDVI within a buffer radius of 150 m (NDVI-150m) greater than 0.104. Women living in residences with a median NDVI-150m greater than 0.104 had a lower risk of antepartum stillbirth (odds ratio: 0.50; 95% confidence interval [CI]: 0.33, 0.76). Fetal growth restriction and placental inflammatory signs mediated 38.5% (natural indirect effect: -0.0604; 95% CI: -0.0916, -0.0292) and 14.7% (natural indirect effect: -0.0230; 95% CI: -0.0412, -0.0047) of the effect of a median NDVI-150m greater than 0.104 on antepartum stillbirth, respectively. Conclusion: Higher residential vegetation greenness showed protective indirect effects on antepartum stillbirth partially through a lower risk of fetal growth restriction and placental inflammatory signs.

Indexed as

Fetal growth restrictionGreennessMediation analysisPlacentaSocioeconomic inequalitiesStillbirth

Identifiers

PMID41822184
PMCPMC12978829

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.