“…More specifically, we aim to explore airshed and watershed exposure pathways as potential mediators of the association observed between proximity to active surface mining activities and adverse birth outcomes. 22 We undertake a mediation analysis within a logistic regression modeling framework to examine the odds of PTB, LBW, and term LBW outcomes as predicted by maternal proximity to surface mining activities during gestation from 1990 to 2015, overlaying surface mine airshed and watershed boundaries. To undertake these analyses, we use geolocated birth records spanning four states in the Central Appalachia region, representing nearly 200,000 births over 2.5 decades.…”