Maternal mental health liveability shaped by composite residential environmental profiles

Women are a vulnerable population for mental illnesses, with the perinatal period representing a particularly high-risk susceptible window. Whereas maternal mental health research often narrowly focused on postpartum depression, psychological disturbances during pregnancy received insufficient attention. Here we analyzed a Chinese nationwide 13-year maternity cohort involving 216,442 pregnant women, revealing that the prevalence of prenatal mental distress symptoms peaked at 31.8%. We identified a broad spectrum of risk determinants, spanning socioeconomic disadvantages, behavioral vulnerabilities, medical histories and suboptimal residential environmental exposures. We estimated that 1.61 (95% uncertainty interval: 1.35–1.88) million prenatal mental distress symptoms were attributable to fine particulate matter (PM2.5) and heatwave exposure, while green spaces prevented 791.7 (95% uncertainty interval: 648.1–948.9) thousand cases. We further delineated multiple pathways through which urban greening confers mental well-being benefits, including attenuation of pollution-associated stress, reduction of heatwave occurrence, encouragement of outdoor physical activity and intrinsic mental restoration. Our study ultimately provides policy-oriented evidence to inform fertility-supportive and health-promoting urban planning, echoing China’s ‘three-child policy’ and ‘Healthy China 2030’ blueprint. In a cohort of 216,000+ pregnant women across China, air pollution and heat were linked to higher risks of prenatal mental distress, while nearby green space was protective. Urban greening could support maternal mental health and healthier cities.

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Publication Details

Journal
Nature Cities
Published
2026-11-02
DOI
https://doi.org/10.1038/s44284-026-00534-9
Primary Topic
Maternal Mental Health During Pregnancy and Postpartum
Type
article
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article

Maternal mental health liveability shaped by composite residential environmental profiles

Xukai Luo, He‐Feng Huang, Yanting Wu, Zhe Sun et al.
1 links
Nature Cities
Maternal Mental Health During Pregnancy and Postpartum
article

Maternal mental health liveability shaped by composite residential environmental profiles

Xukai Luo, He‐Feng Huang, Yanting Wu, Zhe Sun, Nick Watts, Jianbo Guo, Qingyi Xiang, Haihong Lao, Jingli Zhai, Yin Long, Jie Ban, Xiaoxia Bai, Gordon G. Liu, Yang Xie, 陈玉华, Yang Xiujuan, Haiyang Tang, Han Chen, Bernhard Schwartländer, Juan Gao, Yajuan Xu, L. Shek, 陳逸婷, Yi Guo, Chenchi Duan, Yanhui Yu, Han Liu, Chen Zhang, Jing Huang, Yijia Tian, Zekun Wang, Rexidamu Yimiti, Hongmei Li
article en

Abstract

Women are a vulnerable population for mental illnesses, with the perinatal period representing a particularly high-risk susceptible window. Whereas maternal mental health research often narrowly focused on postpartum depression, psychological disturbances during pregnancy received insufficient attention. Here we analyzed a Chinese nationwide 13-year maternity cohort involving 216,442 pregnant women, revealing that the prevalence of prenatal mental distress symptoms peaked at 31.8%. We identified a broad spectrum of risk determinants, spanning socioeconomic disadvantages, behavioral vulnerabilities, medical histories and suboptimal residential environmental exposures. We estimated that 1.61 (95% uncertainty interval: 1.35–1.88) million prenatal mental distress symptoms were attributable to fine particulate matter (PM2.5) and heatwave exposure, while green spaces prevented 791.7 (95% uncertainty interval: 648.1–948.9) thousand cases. We further delineated multiple pathways through which urban greening confers mental well-being benefits, including attenuation of pollution-associated stress, reduction of heatwave occurrence, encouragement of outdoor physical activity and intrinsic mental restoration. Our study ultimately provides policy-oriented evidence to inform fertility-supportive and health-promoting urban planning, echoing China’s ‘three-child policy’ and ‘Healthy China 2030’ blueprint. In a cohort of 216,000+ pregnant women across China, air pollution and heat were linked to higher risks of prenatal mental distress, while nearby green space was protective. Urban greening could support maternal mental health and healthier cities.

Nature Cities
Chongqing University (CN), National University of Singapore (SG), Shanxi Medical University (CN), Chinese Center For Disease Control and Prevention (CN), Peking University (CN), Fudan University (CN), Yanan University Affiliated Hospital (CN), Yan'an University (CN), Dalian Maternal and Child Health Hospital (CN), Women's Hospital, School of Medicine, Zhejiang University (CN), Karamay Central Hospital (CN), Third Affiliated Hospital of Zhengzhou University (CN), Obstetrics and Gynecology Hospital of Fudan University (CN), National Institute for Communicable Disease Control and Prevention (CN), University of Chinese Academy of Sciences (CN), First Affiliated Hospital Zhejiang University (CN), The University of Tokyo (JP), Zhejiang University (CN)
Good health and well-being, Sustainable cities and communities
Openalex Percentile: Top 12%
Maternal Mental Health During Pregnancy and Postpartum
DOIOpen Access PDFOpenAlex
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