{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T06:35:49Z","timestamp":1776926149038,"version":"3.51.2"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Parabens (PBs) are common endocrine-disrupting preservatives linked to adverse pregnancy outcomes, while prenatal depressive symptoms are also prevalent and harmful. Their combined effects remain poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine individual and joint associations of prenatal PBs exposure with adverse pregnancy outcomes (APOs) and to assess modification by maternal depressive symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort of 934 mother-infant pairs from Ningxia, China, was analyzed. Maternal serum concentrations of five PBs were measured by HPLC-MS\/MS. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. APOs included small vulnerable newborns, macrosomia, fetal distress, and asphyxia. Logistic regression and quantile g-computation were used, with stratified and interaction analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the overall cohort, propylparaben (PrP) was significantly associated with fetal distress (OR\u202f=\u202f1.25, 95% CI: 1.05\u20131.49), while mixed PBs exposure increased the risk of macrosomia (OR\u202f=\u202f1.62, 95% CI: 1.06\u20132.48). Quantile g-computation revealed that ethylparaben (EtP), PrP, and heptylparaben (HeP) were the primary contributors to the mixture effect on macrosomia. Maternal depressive symptoms significantly modified these associations: among women with depressive symptoms (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f418), PrP was associated with overall APOs (OR\u202f=\u202f1.21, 95% CI: 1.03\u20131.41), and EtP was linked to small vulnerable newborns (OR\u202f=\u202f1.20, 95% CI: 1.04\u20131.38). In contrast, no significant associations were observed in women without significant depressive symptoms. Interaction analyses confirmed significant effect modification by depressive symptoms for PrP (\n                      <jats:italic>P<\/jats:italic>\n                      -int\u202f=\u202f0.049) and EtP (\n                      <jats:italic>P<\/jats:italic>\n                      -int\u202f=\u202f0.024).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Prenatal PBs exposure is associated with increased APOs risk, particularly among women with depressive symptoms, underscoring the importance of integrating environmental and mental health considerations into prenatal care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1802833","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T05:36:32Z","timestamp":1776922592000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of prenatal parabens exposure with adverse pregnancy outcomes: the role of prenatal depressive symptoms"],"prefix":"10.3389","volume":"14","author":[{"given":"Mengjun","family":"Chang","sequence":"first","affiliation":[{"name":"School of Public Health, Ningxia Medical University","place":["Yinchuan, China"]},{"name":"Key Laboratory of Environmental Factors and Chronic Disease Control","place":["Yinchuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianjia","family":"Li","sequence":"additional","affiliation":[{"name":"School of Public Health, Ningxia Medical University","place":["Yinchuan, China"]},{"name":"Key Laboratory of Environmental Factors and Chronic Disease Control","place":["Yinchuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ye","family":"Li","sequence":"additional","affiliation":[{"name":"School of Public Health, Ningxia Medical University","place":["Yinchuan, China"]},{"name":"Key Laboratory of Environmental Factors and Chronic Disease Control","place":["Yinchuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yueyi","family":"Lv","sequence":"additional","affiliation":[{"name":"School of Public Health, Ningxia Medical University","place":["Yinchuan, China"]},{"name":"Key Laboratory of Environmental Factors and Chronic Disease Control","place":["Yinchuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Ji","sequence":"additional","affiliation":[{"name":"School of Public Health, Ningxia Medical University","place":["Yinchuan, China"]},{"name":"Key Laboratory of Environmental Factors and Chronic Disease Control","place":["Yinchuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Can","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Public Health, Ningxia Medical University","place":["Yinchuan, China"]},{"name":"Key Laboratory of Environmental Factors and Chronic Disease Control","place":["Yinchuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunyun","family":"Du","sequence":"additional","affiliation":[{"name":"School of Public Health, Ningxia Medical University","place":["Yinchuan, China"]},{"name":"Key Laboratory of Environmental Factors and Chronic Disease Control","place":["Yinchuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuqin","family":"Ma","sequence":"additional","affiliation":[{"name":"General Hospital of Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzhen","family":"Guan","sequence":"additional","affiliation":[{"name":"School of Public Health, Ningxia Medical University","place":["Yinchuan, China"]},{"name":"Key Laboratory of Environmental Factors and Chronic Disease Control","place":["Yinchuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"112444","DOI":"10.1016\/j.mce.2024.112444","article-title":"Endocrine-disrupting chemical, methylparaben, in environmentally relevant exposure promotes hazardous effects on the hypothalamus-pituitary-thyroid axis","volume":"598","author":"Azeredo","year":"2025","journal-title":"Mol Cell Endocrinol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.chemosphere.2013.06.048","article-title":"The association between maternal nonylphenol exposure 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