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<jats:p>Results from studies evaluating potential effects of prenatal exposure to radio-frequency electromagnetic fields from cell phones on birth outcomes have been inconsistent. Using data on 55,507 pregnant women and their children from Denmark (1996\u20132002), the Netherlands (2003\u20132004), Spain (2003\u20132008), and South Korea (2006\u20132011), we explored whether maternal cell-phone use was associated with pregnancy duration and fetal growth. On the basis of self-reported number of cell-phone calls per day, exposure was grouped as none, low (referent), intermediate, or high. We examined pregnancy duration (gestational age at birth, preterm\/postterm birth), fetal growth (birth weight ratio, small\/large size for gestational age), and birth weight variables (birth weight, low\/high birth weight) and meta-analyzed cohort-specific estimates. The intermediate exposure group had a higher risk of giving birth at a lower gestational age (hazard ratio = 1.04, 95% confidence interval: 1.01, 1.07), and exposure-response relationships were found for shorter pregnancy duration (P &lt; 0.001) and preterm birth (P = 0.003). We observed no association with fetal growth or birth weight. Maternal cell-phone use during pregnancy may be associated with shorter pregnancy duration and increased risk of preterm birth, but these results should be interpreted with caution, since they may reflect stress during pregnancy or other residual confounding rather than a direct effect of cell-phone exposure.<\/jats:p>","DOI":"10.1093\/aje\/kwz092","type":"journal-article","created":{"date-parts":[[2019,3,29]],"date-time":"2019-03-29T16:12:17Z","timestamp":1553875937000},"page":"1270-1280","source":"Crossref","is-referenced-by-count":31,"title":["Associations of Maternal Cell-Phone Use During Pregnancy With Pregnancy Duration and Fetal Growth in 4 Birth Cohorts"],"prefix":"10.1093","volume":"188","author":[{"given":"Ermioni","family":"Tsarna","sequence":"first","affiliation":[{"name":"Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marije","family":"Reedijk","sequence":"additional","affiliation":[{"name":"Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands"},{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Ellen","family":"Birks","sequence":"additional","affiliation":[{"name":"ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain"},{"name":"Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain"},{"name":"Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f2nica","family":"Guxens","sequence":"additional","affiliation":[{"name":"ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain"},{"name":"Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain"},{"name":"Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain"},{"name":"Department of Child and Adolescent Psychiatry\/Psychology, Erasmus University Medical Centre\u2013Sophia Children\u2019s Hospital, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferran","family":"Ballester","sequence":"additional","affiliation":[{"name":"Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain"},{"name":"Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Universitat Jaume I\u2013Universitat de Vale\u0300ncia, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mina","family":"Ha","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Jim\u00e9nez-Zabala","sequence":"additional","affiliation":[{"name":"Environment Epidemiology and Child Development Area, BIODONOSTIA Health Research Institute, San Sebastian, Spain"},{"name":"Public Health Division of Gipuzkoa, Basque Government, San Sebastian, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leeka","family":"Kheifets","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aitana","family":"Lertxundi","sequence":"additional","affiliation":[{"name":"Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain"},{"name":"Environment Epidemiology and Child Development Area, BIODONOSTIA Health Research Institute, San Sebastian, Spain"},{"name":"Department of Preventive Medicine and Public Health, Universidad del Pais Vasco\/Euskal Herriko Unibertsitatea, Leioa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung-Ryul","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorn","family":"Olsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ll\u00facia","family":"Gonz\u00e1lez Safont","sequence":"additional","affiliation":[{"name":"Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Universitat Jaume I\u2013Universitat de Vale\u0300ncia, Valencia, Spain"},{"name":"Unitat Predepartamental de Medicina, Universitat Jaume I, Castell\u00f3 de la Plana, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhuri","family":"Sudan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, California"},{"name":"Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark"},{"name":"College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Cardis","sequence":"additional","affiliation":[{"name":"ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain"},{"name":"Department of Experimental and Health 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