France has launched a national investigation into the number of babies being born with missing arms or hands - weeks after an initial inquiry closed.
The first investigation began after it emerged more than a dozen children had been born with the condition in clusters in three French regions.
It ended after health authorities failed to identify a common cause.
But now another 11 cases have come to light, prompting health officials to open a fresh investigation.
The condition is a type of agenesis, where the upper limbs of a foetus fail to form correctly during pregnancy.
It includes entire missing upper limbs, missing forearms and hands, or fingers - but not unrelated medical conditions, such as missing thumbs.
The cases are clustered in the regions of Ain in the east of France, and in neighbouring regions Brittany and Loire-Atlantique, on the north-west coast.
Health Minister Agnès Buzyn had already pledged a further investigation in the wake of the initial report's lack of explanations, amid continued public concern and widespread media coverage.
Speaking on French television on Wednesday morning, she said the first results from the national inquiry would be published in January, with more to follow by summer.
"I think all of France wants to know," said Ms Buzyn. "We don't want to rule anything out. Perhaps it's do with the environment, or something they ate, or something they drank. Perhaps it's what they breathed - right now I just don't know."
All the cases reported in Ain involve people within a 17km (11 miles) radius of the village of Druillat, leading to speculation about the possible influence of pesticides - which has yet to be proven.
The stories of some affected children were widely covered in the French media in the wake of the first report.
Ryan, now aged eight, is one of the children from the Ain region who is missing a hand.
His parents told French news channel Franceinfo that there had been no hint of a problem on ultrasound scans. Instead they found out when he was born, and doctors were unable to tell them why.