Do maternal self-reported socio-demographic and green space characteristics influence neonatal birth weight? Evidence from Ghana

BACKGROUND: Neonatal birth weight is a critical indicator of infant survival and long-term health, particularly in low- and middle-income countries where the burden of low birth weight remains high. While maternal socio-demographic factors are well-established determinants of birth weight, growing evidence suggests that environmental exposures such as access to and interaction with green spaces may also influence pregnancy outcomes through pathways related to stress reduction, physical activity, and improved environmental quality. However, empirical evidence on the role of maternal green space exposure in shaping neonatal birth weight is limited in sub-Saharan Africa, including Ghana. This study, therefore, aimed to examine the relationship between maternal self-reported socio-demographic and green space characteristics and neonatal birth weight in Sunyani, Ghana. METHODS: This study was cross-sectional and exploratory. An interviewer-administered questionnaire was administered to 383 mothers in a hospital-based setting in Sunyani, Ghana. Eleven (11) Socio-demographic and seven (7) green space characteristics were investigated. Chi-square, Univariate and multivariate logistic regression were used to identify relationships among factors. RESULTS: Among the defined maternal age categories, mothers aged 25-29 years had significantly higher odds of having neonates with normal birth weight compared to those aged < 20 years (AOR = 12.18, 95% CI: 1.06-139.15). Mothers who often visited green spaces during pregnancy were two times more likely to have a normal birth weight compared to others who 'rarely' did (AOR = 2.73, 95%CI [1.14-6.48]). Mothers who indicated green spaces and natural vegetation were 'somewhat visible' were less likely to have neonates with normal birth weight (AOR = 0.11, 95%CI [0.01-0.95]) compared to those who were 'highly visible'. CONCLUSIONS: Our study findings suggest that neonatal birth weight is influenced by both maternal socio-demographic and green space characteristics. Child health policy must not only look at maternal socio-demographic or clinical factors, but green space exposure during pregnancy as well. Further studies are recommended to explore relationships using objective measures of green space.