Original Investigation

Community Water Fluoridation and Birth Outcomes

JAMA Network Open 10.1001/jamanetworkopen.2025.54686

January 20, 2026 at 11:00 AM EST

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Is community water fluoridation (CWF) associated with changes in birth weight among infants born before and after its introduction in US counties?In this cohort study of 11 479 922 singleton births across 677 counties between 1968 and 1988, aggregated to the county-month level, CWF was not associated with statistically significant changes in birth weight.These findings suggest that concerns about changes in birth weight associated with CWF may be unfounded, underscoring the value of rigorous research designs in evaluating potential adverse effects from CWF.

Corresponding Author: Matthew Neidell, PhD, Department of Health Policy and Management, Columbia University, 722 W 168th St, New York, NY 10032 (mn2191@columbia.edu).

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