{
  "abstract": "Importance: Gestational environmental chemical exposures are widespread. Some chemicals are known to adversely affect birth outcomes, but many remain understudied. Objective: To evaluate associations of gestational exposure to a priori identified chemicals in 10 classes with birth outcomes in a large, diverse US cohort. Design, Setting, and Participants: In the prospective Environmental influences on Child Health Outcomes Cohort study, 5318 mother-child pairs were enrolled from January 1, 2000, to December 31, 2021, with data on gestational urinary chemical concentrations, gestational age at birth, and birth weight. Statistical analysis was performed from January 2024 to February 2026. Exposures: In single, midgestation (median, 25 weeks [IQR, 21-30 weeks]) urine samples, concentrations of 113 analytes (chemicals or their metabolites) from 10 chemical classes were simultaneously measured: fungicides and herbicides (n = 11), insecticides (n = 20), halogenated phenols (n = 5), organophosphate esters (n = 10), benzophenones (n = 6), bisphenols (n = 14), parabens (n = 6), antimicrobials (n = 2), phthalates or alternative plasticizers (n = 32), and polycyclic aromatic hydrocarbons (PAHs) (n = 7). Main Outcomes and Measures: Linear mixed-effects regression models with a random effect for site were used to estimate covariate-adjusted differences in gestational age at birth (days) and birth weight-for-gestational age (BW-GA) z scores per IQR increase in urinary analyte concentrations. In secondary analyses, odds ratios (ORs) for preterm birth and small for gestational age (SGA) were estimated. Results: In the sample of 5318 mother-child pairs, most infants (2667 female [50%]; median gestational age at birth, 39.0 weeks [IQR, 38.0-40.0 weeks]) were born to college-educated (67% [3218 of 4785]), parous (56% [2815 of 5007]) mothers (median age at delivery, 30.7 years [IQR, 26.1-34.3 years]). A total of 43 of 113 analytes (38%) were detected in 50% or more of samples. Multiple phthalates or alternative plasticizers were associated with younger gestational age at birth or lower BW-GA z scores; for example, summed diisononyl phthalate metabolites were associated with a 0.6-day (95% CI, -1.0 to -0.1 days) younger gestational age (preterm birth OR, 1.16 [95% CI, 1.01-1.34]), and summed phthalate or alternative plasticizers were associated with a 0.06 (95% CI, -0.11 to -0.02) lower BW-GA z score (SGA OR, 1.09 [95% CI, 0.93-1.27]). Two halogenated phenols, benzophenone 8, bisphenol F, and several PAHs were associated with lower BW-GA z scores; for example, 1- and 9-hydroxphenanthrene were associated with a 0.04 (95% CI, -0.08 to -0.01) lower BW-GA z score (SGA OR, 1.13 [95% CI, 1.01-1.27]). Conclusions and Relevance: This large cohort study of diverse US pregnancies found widespread exposure to 10 classes of environmental chemicals, many of which were associated with differences in gestational age at birth or lower BW-GA z scores. These findings indicate that reducing gestational exposure to chemicals, particularly phthalates or alternative plasticizers and PAHs, could promote healthy deliveries and better child outcomes.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill",
    "Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland",
    "Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia",
    "Department of Biostatistics and Epidemiology, Environmental and Occupational Health Sciences Institute, Rutgers School of Public Health, Piscataway, New Jersey",
    "for the Environmental influences on Child Health Outcomes (ECHO) Cohort Consortium",
    "Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles",
    "School of Public Health, Washington University in St Louis, St Louis, Missouri",
    "Department of Public Health Sciences, University of California, Davis",
    "Department of Epidemiology, Brown University, Providence, Rhode Island",
    "Department of Food Science and Human Nutrition, Michigan State University, East Lansing",
    "Department of Pharmacology and Toxicology, Michigan State University, East Lansing",
    "Division of Research, Kaiser Permanente Northern California, Pleasanton",
    "Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia",
    "Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York",
    "Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire",
    "Department of Environmental & Occupational Health Sciences, University of Washington, Seattle",
    "Department of Pediatrics, University of Washington, Seattle",
    "Department of Environmental and Occupational Health, The George Washington University Milken Institute School of Public Health, Washington, DC",
    "Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor",
    "Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York, New York",
    "Department of Environmental Science, Policy and Management, University of California, Berkeley",
    "School of Public Health, University of California, Berkeley",
    "Department of Neuroscience, University of Rochester, Rochester, New York",
    "Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York",
    "Department of Psychiatry, University of Rochester, Rochester, New York",
    "Department of Family Medicine and Public Health, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City",
    "Department of Pediatrics and Seattle Children’s Research Institute, University of Washington, Seattle",
    "Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana",
    "MIND Institute, University of California Davis, Davis",
    "Department of Pediatrics, Grossman School of Medicine, New York University, New York",
    "Department of Population Health, Grossman School of Medicine, New York University, New York",
    "Wagner School of Public Service, New York University, New York",
    "Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland",
    "Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis",
    "Wadsworth Center, New York State Department of Health, Albany",
    "RTI Fellows Program, Research Triangle Institute, Research Triangle Park, North Carolina",
    "Department of Epidemiology and Population Health, School of Medicine, Stanford University, Stanford, California",
    "Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco",
    "Woods Institute, Doerr School of Sustainability, Stanford University, Stanford, California"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 100,
  "authors": [
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      ],
      "name": "Jessie Poulin Buckley",
      "orcid": "0000-0001-7976-0157"
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      "name": "Diana C. Pacyga",
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      "name": "Xiaoshuang Xun",
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      "name": "Dana Boyd Barr",
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      "name": "Emily S. Barrett"
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      "name": "Thomas G. O’Connor",
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      "name": "Jiwon Oh",
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      "name": "Perera Fp"
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      "name": "Christina A. Porucznik",
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      "name": "Megan E. Romano",
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      "name": "Sheela Sathyanarayana",
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      "name": "Susan L. Schantz"
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      "name": "Heather E. Volk",
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      "name": "Qi Zhao",
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      "name": "Zhongmin Li"
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      "name": "Edo D. Pellizzari"
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  "bibtex": "https://research.draconitic.com/paper/4g9y78w826d62.bib",
  "cited_by": 8,
  "doi": "10.1001/jamanetworkopen.2026.18883",
  "fulltext_url": null,
  "id": "4g9y78w826d62",
  "issns": [
    "2574-3805"
  ],
  "landing_url": "https://doi.org/10.1001/jamanetworkopen.2026.18883",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
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      "openalex",
      "2307|Effects and risks of endocrine disrupting chemicals"
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  "pdf_url": null,
  "pmcid": "PMC13276631",
  "pmid": "42307947",
  "published": "2026-06-17",
  "publisher": "American Medical Association",
  "ris": "https://research.draconitic.com/paper/4g9y78w826d62.ris",
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      "url": "https://doi.org/10.1001/jamanetworkopen.2026.18883"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2307|Effects and risks of endocrine disrupting chemicals",
      "subfield": "pharmacology-toxicology"
    }
  ],
  "title": "Gestational Exposure to 10 Classes of Priority Chemicals and Birth Outcomes in the ECHO Cohort",
  "title_text": "Gestational Exposure to 10 Classes of Priority Chemicals and Birth Outcomes in the ECHO Cohort",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T13:21:20Z",
  "url": "https://research.draconitic.com/paper/4g9y78w826d62",
  "venue": "JAMA Network Open",
  "versions": []
}