Environmental Phthalate Exposure and the Odds of Preterm Birth: An Important Contribution to Environmental Reproductive Epidemiology

In this issue of JAMA Pediatrics, Ferguson et al¹ make an important public health contribution by demonstrating a sizable impact of phthalates, a class of commonly used chemicals, on a health outcome of major public health concern: the growing burden of preterm birth. Worldwide, 15 million babies are born preterm (<37 weeks’ gestation), with rates increasing over 2 decades in almost all countries that have reliable data.² While the regions with the highest preterm birth rates in 2010 were Southeastern Asia, South Asia, and sub-Saharan Africa, the United States is sixth among the 10 countries with the greatest number of preterm births. In fact, cases in the United States account for 42% of all preterm births in developed countries.³