Author: Jodi Snare

NIH Study Investigates Factors Affecting Asthma With Frequent Symptom Flare Ups in Young Children

Posted on by Jodi Snare

FOR IMMEDIATE RELEASE

 

Young children, ages 2 to 4 years, especially those with parental history of asthma, suffered the highest rates of asthma with recurrent exacerbations (ARE) over a nearly 30-year period studied in new research funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

“Describing the incidence rates of ARE across a large, diverse population of children is a critical first step for identifying potential risk factors and causes,” explained Christine Johnson, PhD, MPH, an ECHO Program investigator at Henry Ford Health.

During this study, ECHO researchers looked at data from over 17,000 children between 1990 and 2017 from across the U.S. including Puerto Rico in order to learn which factors influenced the rates of childhood ARE—a subtype of asthma where children experience frequent, severe episodes of asthma. They found that non-Hispanic Black and Hispanic Black children, children ages 2 to 4 years old, and children who lived in the Northeast and Midwest had the highest rates of ARE.

These findings suggest that different environmental and social factors may play a significant role in the onset of recurring asthma issues in children.

“Understanding these causes will help researchers determine how to best prevent ARE and associated asthma outcomes,” said Rachel L. Miller, MD, an ECHO Program investigator at the Icahn School of Medicine at Mount Sinai.

Drs. Miller and Johnson led this collaborative research published in the Journal of Allergy and Clinical Immunology.

Miller, R. et al. Incidence Rates of Childhood Asthma with Recurrent Exacerbations in the U.S. Environmental influences on Child Health Outcomes (ECHO) Program. DOI: 10.1016/j.jaci.2023.03.016

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About ECHO: ECHO is a nationwide research program supported by the NIH. Launched in 2016, ECHO aims to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

Media Contacts

For information or to request an interview, contact Rebekah Yeager,  rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact  NIHKidsandEnvironment@od.nih.gov.

Connect With Us

echo connectorCheck out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on Twitter.

ECHO Researchers Investigate Associations Between Gestational Diabetes, Perinatal Maternal Depression, and Early Childhood Behavioral Problems

Posted on by Jodi Snare

Collaborative ECHO research led by Lauren C. Shuffrey, PhD of Columbia University investigates the effects of gestational diabetes, a type of diabetes that mothers develop during pregnancy, prenatal depression, and postpartum depression on early childhood behavior. This study found gestational diabetes, prenatal maternal depressive symptoms, and postnatal maternal depressive symptoms were each independently linked to higher levels of externalizing and internalizing behavior problems during early childhood. The study also found that gestational diabetes was only associated with autism-related behaviors when children were exposed to higher levels of perinatal maternal depressive symptoms. Finally, maternal gestational diabetes was only associated with child behavioral problems for male children.

This research, titled “Association of Gestational Diabetes Mellitus and Perinatal Maternal Depression with Early Childhood Behavioral Problems: An Environmental Influences on Child Health Outcomes (ECHO) Study” is published in Child Development.

Although previous research has shown associations between gestational diabetes and pre- and postnatal depression in mothers, prior studies have not determined if the combination of these conditions affect child behavioral outcomes.

This study included 2,379 children from ECHO cohorts located in Colorado, Massachusetts, New York, Pennsylvania, and Tennessee. More than half of child participants (52%) were male, and 216 participants were born to mothers with gestational diabetes during pregnancy.

More than half of maternal participants were from an underrepresented minority group with 32% self-identifying as Black, 23% as Hispanic, 15% as Mixed Race, and 4% as Asian.

In this study, ECHO researchers used the Preschool Child Behavior Checklist (CBCL) to examine the behavior of children ages 2 to 5 years old. The researchers also collected information from the mothers, including gestational diabetes diagnosis and self-assessments of depression symptoms during and after pregnancy. The study evaluated how gestational diabetes, prenatal depression, and postpartum depression affected children’s behavioral outcomes using the CBCL.

“Our findings suggest that children born to mothers who had both gestational diabetes and symptoms of depression during pregnancy could benefit from receiving additional monitoring for behavioral problems during early childhood,” said Dr. Shuffrey. “Future research should investigate potential biological mechanisms underlying associations between gestational diabetes, maternal depression, and early childhood behavioral outcomes.”

Read the research summary.

New ECHO Research Investigates Link Between Maternal Health, Newborn Metabolism, and Childhood BMI

Posted on by Jodi Snare

Collaborative ECHO research led by Britt Snyder, PhD, and Tina Hartert, MD, MPH, of Vanderbilt University Medical Center, and James Gern, MD, of the University of Wisconsin School of Medicine and Public Health, investigates the links between maternal health characteristics and the concentrations of various metabolites in newborns. In addition to identifying these links, the study also demonstrated that some metabolites were linked to childhood body mass index (BMI) at ages 1–3 years. The researchers collected data from 3,492 infants and their mothers and found that certain maternal health factors such as higher BMI before pregnancy or maternal age at delivery seemed to increase the levels of some key metabolites in newborns. This research, titled “The Associations of Maternal Health Characteristics, Newborn Metabolite Concentrations, and Child Body Mass Index among US Children in the ECHO Program,” is published in Metabolites.

This study expanded on previous research investigating links between a variety of maternal characteristics and metabolite levels in newborns and also explored the link between these metabolites and child growth patterns. The researchers also investigated how maternal factors and related chemical changes in utero could possibly contribute to the link between newborn metabolism and childhood BMI. To address these questions, the researchers collected data on maternal health characteristics from self-reported questionnaires, birth certificates, and medical records. They then collected child BMI from medical records and study visits and used statistical tools to evaluate possible links between maternal health characteristics and newborn metabolism.

“These findings provide additional insights on potential in utero pathways through which maternal health characteristics may affect newborn metabolism and later child growth patterns,” said Dr. Snyder.

Future studies are needed to further explore these pathways and understand the relationship between maternal health characteristics and child health.

Read the Research Summary.

NIH Study Examines Healthcare Use During the COVID-19 Pandemic for Children Born Preterm

Posted on by Jodi Snare

FOR IMMEDIATE RELEASE

 

Children and adolescents born preterm were more likely to use healthcare services for symptoms related to COVID-19, even after accounting for known risk factors of respiratory illness, according to new research funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

The study is among the first to look at healthcare use by a high-risk population during the pandemic.

“Understanding the different needs of children born preterm and their families during the first year of the pandemic is an important first step toward making healthcare more effective and efficient,” said Elisabeth McGowan, MD, of Brown University’s Alpert Medical School.

This study included data from 1,691 individuals ages 1–18 years, including 270 who were born preterm, 37 or fewer weeks of gestation. Among these participants, 159 were born at 28 or fewer weeks and were twice as likely to seek healthcare compared to those born at term.

Between April 2020 and August 2021, researchers collected caregiver- or self-reported questionnaires regarding COVID-19 pandemic and healthcare use. Respiratory symptoms were the most common reason for seeking care for those children.

“Understanding the factors associated with both overall healthcare use and symptom-specific use may help healthcare providers identify the best strategies to provide targeted care,” said Dr. McGowan.

Dr. McGowan and Barry Lester, PhD, of Brown University’s Alpert Medical School along with Monica McGrath, ScD, and Andrew Law, ScM, of Johns Hopkins Bloomberg School of Public Health led this collaborative research published in JAMA Network Open.

McGowan, E. C. et al, “Healthcare Utilization During the COVID-19 Pandemic Among Individuals Born Preterm.” JAMA Network Open. DOI:  10.1001/jamanetworkopen.2023.10696 

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About ECHO: ECHO is a nationwide research program supported by the NIH. Launched in 2016, ECHO aims to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

Media Contacts

For information or to request an interview, contact Rebekah Yeager,  rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact  NIHKidsandEnvironment@od.nih.gov.

Connect With Us

echo connectorCheck out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on Twitter.

New Collaborative ECHO Research Demonstrates Effectiveness of “Eat, Sleep, Console” Approach in Caring for Newborns with Neonatal Opioid Withdrawal Syndrome

Posted on by Jodi Snare

A collaborative effort between the NIH’s Eunice Kennedy Shriver Institute of Child Health and Human Development (NICHD) Neonatal Research Network and the Environmental influences on Child Health Outcomes (ECHO) Program’s Institutional Development Award (IDeA) States Pediatric Clinical Trials Network (ISPCTN) found that the “Eat, Sleep, Console” (ESC) care approach is more effective for the treatment of newborns with neonatal opioid withdrawal syndrome (NOWS) than usual approaches to care. This research was led by ISPCTN investigators Leslie Young, MD of the University of Vermont; and Lori Devlin, DO, MHA, MS of the University of Louisville School of Medicine, Department of Pediatrics; along with Stephanie Merhar, MD, MS of Cincinnati Children’s Hospital and the NICHD Neonatal Research Network.

ESC prioritizes nonpharmacologic care, including holding, swaddling, and rocking in low-stimulus environments, as first-line treatment for neonatal opioid withdrawal symptoms. This research, funded through the NIH Helping to End Addiction Long-term® Initiative (HEAL), showed that infants cared for with ESC were medically ready for discharge after an average of 8.2 days, whereas infants cared for with usual approaches were medically ready for discharge after 14.9 days. That means that babies were, on average, able to go home 6.7 days sooner. Newborns cared for with ESC were also 63% less likely to receive medication as part of their treatment. Safety outcomes at three months of age were similar in both groups. This research, titled “Eat, sleep, console approach versus usual care for neonatal opioid withdrawal,” is published in the New England Journal of Medicine.

“The study included rural and medically underserved communities that have been hard hit by the opioid crisis,” said Matthew W. Gillman, MD, director of the ECHO program. “These findings promise to improve outcomes and address the long-term needs of opioid-exposed infants and their families.”

Newborns exposed to opioids before birth may develop symptoms of NOWS, including tremors, excessive crying and irritability, and problems with sleeping and feeding. In the United States, at least one newborn is diagnosed with NOWS every 24 minutes. There has not previously been strong evidence to support a standard approach to the care of babies with NOWS, and medical care for these babies has varied widely across hospitals.

Hospitals often use the Finnegan Neonatal Abstinence Scoring Tool (FNAST) to assess newborns with NOWS. The FNAST is an extensive scoring system that assesses signs of withdrawal in more than 20 areas. However, concerns have been raised about its subjectivity and overestimation of the need for opioid medication. The ESC care approach, developed about eight years ago, assesses an infant’s ability to eat, sleep, and be consoled without the introduction of medications. This approach keeps mother and baby together, empowering families to play a larger role in the care of their infants.

The study examined the hospital outcomes of a diverse group of 1,305 opioid-exposed infants from 26 hospitals across the U.S. that were randomized to transition from FNAST-based care to the ESC care approach at different times. These findings are based on three-month outcomes, and a two-year follow-up study of a subset of the infants is ongoing. This follow-up is critical to further inform the safety of the ESC care approach.

This study is part of the Advancing Clinical Trials in Neonatal Opioid Withdrawal (ACT NOW) Collaborative.

Learn more about this clinical trial and the NIH Helping to End Addiction Long-term® Initiative on the NIH HEAL Initiative® website.

Read the research summary.

ECHO Researchers Examine Healthcare Use During the COVID-19 Pandemic for Children Born Preterm

Posted on by Jodi Snare

Collaborative research led by Elisabeth McGowan, MD and Barry Lester, PhD, of Brown University and Monica McGrath, ScD, and Andrew Law, ScM, of Johns Hopkins Bloomberg School of Public Health examined healthcare use during the COVID-19 pandemic by children and adolescents born preterm.

The research, titled “Healthcare Utilization During the COVID-19 Pandemic Among Individuals Born Preterm,” is published in JAMA Network Open.

This is one of the first studies to look at healthcare use during the COVID-19 pandemic by a high-risk population—children and adolescents who were born preterm (37 or fewer weeks after gestation). By looking for possible patterns of healthcare utilization, this study can help healthcare providers to improve care for patients in future pandemics or other public healthcare crises.

This study included data from 1,691 individuals ages 1–18 years, including 270 who were born preterm, 37 or fewer weeks of gestation. Among these participants, 159 were born at 28 or fewer weeks and were twice as likely to seek healthcare compared to those born at term.

Between April 2020 and August 2021, researchers collected caregiver- or self-reported questionnaires regarding the COVID-19 pandemic and healthcare use. The researchers studied healthcare use related to concerns about COVID-19 symptoms (like trouble breathing, fever, headache, muscle pain, fatigue, itchy eyes, nausea, diarrhea, vomiting, and loss of smell or taste) that resulted in overnight stays in hospitals, visits to urgent care centers or primary care offices, or virtual visits such as telehealth. Respiratory symptoms were the most common reason for seeking care for those children.

“Understanding the factors associated with both overall healthcare use and symptom-specific use may help healthcare providers identify the best strategies to provide targeted care,” said Dr. McGowan.

Further studies could evaluate the role socioeconomic factors may play in healthcare utilization.

Read the research summary.

ECHO Researchers Investigate the Effect of Family Hardships and Newborn Health Outcomes on the Behavior and Well-being of Young Children

Posted on by Jodi Snare

Collaborative ECHO research led by Julie Hofheimer, PhD of the University of North Carolina at Chapel Hill and Monica McGrath, ScD and Rashelle Musci, PhD, both of Johns Hopkins Bloomberg School of Public Health, investigates the link between family hardships, newborn health outcomes, and the behavior of young children. The researchers collected information on the behavior of 3,934 children between the ages of 18 and 72 months and used that data to identify early factors that increase a child’s risk for experiencing behavioral and emotional difficulties. The study found that children born preterm and those whose families had been exposed to more social, economic, or environmental hardships were more likely to experience continuous behavioral difficulties. This research, titled “Psychosocial and Neonatal Risk Factors Associated with Behavioral Dysregulation Trajectories Among Young Children from 18 through 72 Months of Age,” is published in JAMA Network Open.

Adverse conditions and family hardships have steadily increased over the past two decades, challenging the emotional and behavioral well-being of children and their families. To understand how health and environmental hardships affect a child’s risk for developing continuous behavioral problems, ECHO researchers collected early childhood behavior data from 20 ECHO cohorts from across the United States. About 20% of these children were born preterm (before 37 weeks of gestation).

The researchers collected caregiver self-reports, demographics, and medical and environmental data about the children and their mothers before and during pregnancy and from infancy through age six. Caregivers completed the Child Behavior Checklist at several study visits, and the researchers compared the children’s combined difficulty with anxiety, depression, attention, and aggression to their behavioral well-being across the first six years of life.

Some children who experienced less family adversity showed improved behavior over time. Importantly, some children were able to overcome hardships and improve their behavior. Through this study, the researchers were able identify early factors that increase a child’s risk for experiencing behavioral and emotional difficulties.

“Conditions during pregnancy and early infancy can identify toddlers who may benefit from early enriched services,” said Dr. Hofheimer. “Family support services tailored to the individual needs of children may prevent later behavioral problems and improve future outcomes for vulnerable children and their families.”

Future ECHO research may examine how childhood behavior continues to develop from six years onward, examining the link between early risk factors and behavioral patterns in middle school and adolescence.

Read the research summary.

NIH Study Examines Early Life Factors Affecting Behavior and Well-being of Young Children

Posted on by Jodi Snare

FOR IMMEDIATE RELEASE

 

Children born preterm and those whose families experienced social, environmental, or economic hardships were more likely to have persistent behavior difficulties, according to new research funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

ECHO researchers found that factors such as preterm birth, family hardship, and prenatal substance exposure may increase a child’s risk for persistent behavior and emotional difficulties. These difficulties in early childhood can potentially lead to later problems such as anxiety, depression, attention deficits, and aggression.

“Conditions during pregnancy and early infancy can identify toddlers who may benefit from early enriched services,” said Julie Hofheimer, PhD, of the University of North Carolina at Chapel Hill.

ECHO researchers collected early childhood behavior data on nearly 4,000 children born between 1990 and 2019 from 20 ECHO research sites from across the United States. Researchers then compared the children’s scores for emotional difficulties (anxiety, depression, attention, and aggression) to their behavioral well-being in the first six years of life.

“Family support services tailored to the individual needs of children may prevent later behavioral problems and improve future outcomes for vulnerable children and their families,” said Dr. Hofheimer.

Monica McGrath, ScD, and Rashelle Musci, PhD, both of Johns Hopkins Bloomberg School of Public Health, and Dr. Hofheimer led this collaborative research published in JAMA Network Open.

Hofheimer, J. et al. Psychosocial and Neonatal Risk Factors Associated with Behavioral Dysregulation Trajectories Among Young Children from 18 through 72 Months of Age. DOI: 10.1001/jamanetworkopen.2023.10059.

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About ECHO: ECHO is a nationwide research program supported by the NIH. Launched in 2016, ECHO aims to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

Media Contacts

For information or to request an interview, contact Rebekah Yeager,  rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact  NIHKidsandEnvironment@od.nih.gov.

Connect With Us

echo connectorCheck out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on Twitter.

ECHO Researchers Showcase Child Health Research at 2023 Pediatric Academic Societies Meeting

Posted on by Jodi Snare

Several ECHO researchers are showcasing ECHO research at the Pediatric Academic Societies (PAS) Annual Meeting in Washington D.C. this weekend. The PAS Meeting will take place from April 27-May 1, and will feature presentations, posters, and exhibitions from physicians and researchers sharing the latest advancements in pediatric health. In addition to the in-person events at the Walter E. Washington Convention Center, PAS registrants have access to on-demand, pre-recorded presentations and a bank of e-posters.

ECHO-related Sessions:

Determining Subpopulations of Children with Multiple Chronic Health Outcomes using Unsupervised Clustering
Friday, April 28, 2023, 5:15-7:15 p.m. ET (Poster number 514)
Drew Day, PhD, Seattle Children’s Research Institute

 

 

 

Psychosocial and Neonatal Risk Factors Associated with Behavioral Dysregulation Trajectories from 18 to 72 Months of Age Among ECHO Children
Saturday, April 29, 2023, 3:00-3:15 p.m. ET (Convention Center, 202 B)
Julie Hofheimer, PhD, University of North Carolina at Chapel Hill School of Medicine

 

 

 

The Epigenetic Response of Bronchopulmonary Dysplasia and Antenatal Steroids on the HPA-axis System
Sunday, April 30, 2023, 11:00-11:15 a.m. ET (Convention Center, 208 AB)
Kenyaita Hodge , MPH, Emory University

 

 

 

Eat, Sleep, Console versus Usual Care for Neonatal Opioid Withdrawal Syndrome – ESC-NOW a Cluster Randomized Controlled Trial
Sunday, April 30, 2023, 3:15-3:30 p.m. ET (Convention Center, Ballroom A)
Leslie Young, MD, University of Vermont

 

 

 

Perceived Discrimination and Neurocognitive Development Among Black and White Children: An Analysis from ECHO Cohorts
Sunday, April 30, 2023, 3:30-6:00 p.m. ET (Poster number 662)
Jennifer Porter, MD, University of Louisville

 

 

 

Associations of Non-nutritive Suck (NNS) and Gestational Phenol Exposure in Full-term Infants from Two U.S. Birth Cohorts in the ECHO Program
Sunday, April 30, 2023, 3:30-6:00 p.m. ET (Poster number 616)
Megan Woodbury, PhD, Northeastern University
Emily Zimmerman, PhD, CCC-SLP, Northeastern University

NIH Obesity Research Task Force to Host Virtual Symposium: June 6, 2023

Posted on by Jodi Snare

REGISTRATION FOR THIS EVENT HAS CLOSED

The NIH Obesity Research Task Force will host a virtual symposium on June 6, 2023, featuring advances in childhood obesity research by the NIH Environmental influence on Child Health Outcomes (ECHO) Program.

This seminar will cover several determinants of childhood obesity that take advantage of ECHO’s size and diversity, including natural experiments, community level factors, social and chemical stressors, and health behaviors.

Please visit the seminar webpage for more details, including registration information and an agenda.