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Purpose To clarify the associations of placental inflammatory response and oxidative stress with myopia in the offspring and explore the modifying role of outdoor time trajectories at early childhood.Methods Data were from the Ma’anshan Birth Cohort Study established in 2013. A total of 1256 mother–child pairs were analysed. Placental inflammation and oxidative stress biomarkers mRNA expression were tested using real-time quantitative PCR. Outdoor time was measured annually from 4 to 7 years. Children underwent cycloplegic refraction and ocular biometry to obtain spherical equivalent (SE) and axial length at 7–8 years. Binary logistic regression, generalised linear and Quantile g-Computation models were used to examine the associations.Results Among the children, 306 (24.4%) children were myopic. Each unit increase in monocyte chemoattractant protein-1 was correlated to a 1.6% higher risk of myopia (OR=1.016, p=0.025), 0.008 D lower SE (β=−0.008, p=0.024) and a 0.006 mm elongation in AL (β=0.006, p=0.014). Each unit elevate in interleukin-4 increased SE by 0.003 D (β=0.003, p=0.043) and decreased AL by 0.003 mm (β=−0.003, p=0.017), with similar trends in outdoor time declining trajectory. However, all associations were not significant after false discovery rate adjustment. Furthermore, each unit increase in the mixed exposure of oxidative stress was associated with a 0.070–0.074 D reduction in SE.Conclusions Parsing insights into the potential relationships between placental inflammation and oxidative stress and myopia in the offspring and exploring the nurture effect of outdoor time based on life-cycle conceptual models will facilitate the early prevention of childhood myopia for clinical and public health practice.