Author: Jodi Snare

ECHO Researchers Evaluate an Adaptive, Short-form Questionnaire for Measuring Autism-related Traits in Children

Posted on by Jodi Snare

Collaborative ECHO research led by Aaron Kaat, PhD of Northwestern University, and Kristen Lyall, ScD of the AJ Drexel Autism Institute evaluates two different versions of the full 65-question Social Responsiveness Scale (SRS) for measuring autism-related traits in preschool and school-age children. This study compared the questions used on each version and developed a comparable scoring method for both forms. Then, the researchers used computer-adaptive testing, where a computer program tailors the questionnaire in real-time to each participant, and found that a median of 14 questions was sufficient to reach a reliable score. This research, titled “Modifying the Social Responsiveness Scale for Adaptive Administration,” is published in Quality of Life Research.

Prior research has developed and examined shortened versions of the SRS questionnaire, but researchers haven’t been able to evaluate the reliability of these questionnaires for capturing broader traits in the general population or for preschool-age participants. This study included over 7,000 children ages 2.5-18 years old, most of whom did not have an autism diagnosis. The researchers conducted several analyses to assess a variety of factors that may affect how the full SRS and shortened versions of the SRS are scored. They were then able to use these data to simulate how computer-adaptive testing would score each individual after completing the minimum number of questions required to reach a comparable result.

“The results of this study suggest opportunities to reduce the amount of time participants need to spend completing questionnaires like the SRS,” said Dr. Lyall. “These results also suggest computer-adaptive questionnaires can be used to collect information in a way that is comparable to standard paper-based questionnaires, offering additional flexibility.”

The researchers are continuing to evaluate the computerized version of the SRS questionnaire developed in this study, comparing it to other versions of the questionnaire. Future research is needed to examine how these different questionnaires perform in different groups of people, and if results differ when captured according to self vs. parent report.

Read the research summary.

New ECHO Research Investigates the Effects of the COVID-19 Pandemic on Infant and Toddler Development

Posted on by Jodi Snare

Collaborative ECHO research led by Sara Nozadi, PhD and Johnnye Lewis, PhD of the University of New Mexico, investigates whether the negative developmental effects observed in school-aged children over the course of the pandemic could also be seen in infants and toddlers. In this study, up to 15% of infants and toddlers who were developmentally on track prior to the COVID-19 pandemic showed signs of developmental delays during the pandemic. Male children showed more delays than female children, and language domain was the most affected developmental area. Additionally, families from minority communities and those with lower socioeconomic status were more likely to experience pandemic-related hardships. However, financial and social pandemic-related hardships were not associated with the individual changes observed in children’s developmental progress. This research, titled “Effects of COVID-19 financial and social hardships on infants’ and toddlers’ development in the ECHO program,” is published in International Journal of Environmental Research and Public Health.

This study included 684 children between the ages of 2 months and 4 years from eight ECHO cohort research sites across the United States. During this study, the researchers included children whose parents had filled out the Ages and Stages Questionnaire (ASQ), which uses parent-reported information to pinpoint a child’s developmental progress, within the 18-month periods before and after March 2020. Parents of participating children were also asked about financial hardship, defined as at least one parent experiencing job loss or change, or social hardships, defined as families’ quarantining from household members or extended family and friends, during the pandemic.

“This study highlights the importance of early developmental screening during times of adversity, such as pandemics, in order to identify delays and connect children to supportive services,” said Dr. Nozadi. “Previous studies have shown negative impacts of the pandemic on overall child development but have not looked at the effects of the pandemic on individual children’s development over time.”

In the future, we can follow the developmental progress of these children over time to determine whether COVID-19 hardships had an effect on children’s development over a longer period of time. Studies may also focus on pandemic-related stressors that could particularly effect infants and toddlers, such as family dynamics, parent-child interactions, and parental stress.

Read the research summary.

NIH Research Suggests Few Prenatal Supplements Meet All Nutrition Recommendations for Pregnancy

Posted on by Jodi Snare

FOR IMMEDIATE RELEASE

Katherine Sauder, PhD

Approximately 90 percent of pregnant women do not meet nutrition recommendations for pregnancy from diet alone and will need to supplement their diet with prenatal vitamins. At the same time, a majority of affordable prenatal supplements are missing the necessary amounts of at least one key nutrient, according to a new study funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

Researchers analyzed the diets of 2,450 pregnant participants from six ECHO cohorts across the United States to determine the amount of key nutrients participants got from their diets and what additional amount they would need from a supplement.

After analyzing over 20,000 dietary supplements, researchers found only one that meets the nutritional recommendations for pregnancy for vitamin A, vitamin D, folic acid, calcium, iron, and omega-3 fatty acids when used to supplement the participants’ diets. The monthly cost was too high for some people and it required pregnant women to take seven pills a day. The researchers also identified other lower-cost supplements that provided the right amounts of at least five of the needed key nutrients.

“This research can inform pregnant women and their doctors about key nutrients they may be missing in their diet and help them choose prenatal vitamins that can provide the nutrients they need,” said Katherine Sauder, PhD, an ECHO Program investigator at the University of Colorado, Anschutz Medical Campus.

Dr. Sauder led this collaborative research published in The American Journal of Clinical Nutrition.

Sauder, C. et al. “Selecting a Dietary Supplement with Appropriate Dosing for Six Key Nutrients in Pregnancy.” American Journal of Clinical Nutrition. DOI: 10.1016/j.ajcnut.2022.12.018

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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 Compare Thousands of Prenatal Vitamins to Help Pregnant Patients Get the Nutrients They Need

Posted on by Jodi Snare

Collaborative ECHO research led by Katherine Sauder, PhD of the University of Colorado, Anschutz Medical Campus highlights six key nutrients essential for healthy pregnancies and identifies the best prenatal dietary supplements available in the United States to help pregnant women get the right amounts of these nutrients. Out of over 20,000 choices, the researchers found one prenatal dietary supplement that may potentially provide the right amounts of the most important nutrients needed during pregnancy: vitamin A, vitamin D, folic acid, calcium, iron, and omega-3 fatty acids. However, the supplement costs $200 per month and requires the patient to take seven pills a day, so the researchers identified other, more accessible vitamin supplement options that provide as close a match to the needed of amounts of nutrients as possible. This research, titled “Selecting a dietary supplement with appropriate dosing for six key nutrients in pregnancy," is published in The American Journal of Clinical Nutrition.

It is important for pregnant women to get optimal amounts of the right nutrients. There are thousands of options for prenatal vitamins in the United States, so ECHO researchers designed this study to help pregnant women and doctors select the ones that contain optimal doses of key micronutrients to support a healthy pregnancy.

This study included 2,450 pregnant participants from six ECHO cohorts located across the United States. ECHO researchers first analyzed data about what participants ate and drank during their pregnancies. Then, they calculated how much of the six key nutrients (vitamin A, vitamin D, folic acid, calcium, iron, and omega-3 fatty acids) mothers were getting in their regular diet. The researchers compared the participants’ diets to nutrition recommendations for pregnancy to determine the amount of nutrients the participants would need from prenatal vitamins to supplement their diet.

“This research will inform pregnant patients and their doctors about key nutrients they may be missing in their diet and help them choose prenatal vitamins that can provide the nutrients they need,” said Dr. Sauder. “Dietary supplement manufacturers can also use these results to inform better dosing in their products.”

The results of this study highlight the ongoing need for prenatal vitamin options that are low cost and convenient, while still containing the optimal amounts of key nutrients. More research on nutrients in foods will also be needed to help pregnant patients get more of these key nutrients in their daily diets.

Read the research summary.

New ECHO Research Suggests Differences in Placental Development for Male and Female Infants

Posted on by Jodi Snare

Collaborative ECHO research led by Catherine Bulka, PhD, of the University of South Florida, and Rebecca Fry, PhD, of the University of North Carolina at Chapel Hill, investigates whether gene activity in the placenta might differ base on the infant’s sex. The results of this study suggest that the placentas of males and females might develop differently. This research, titled “Sex-based differences in placental DNA methylation profiles related to gestational age: an NIH ECHO meta-analysis,” is published in Epigenetics.

This study included 774 infants (355 female and 419 male) from four ECHO research sites. One of the research sites enrolled infants born at less than 28 weeks, which provided samples from the earliest viable births. Research sites used placental tissue from male and female infants to investigate associations between gestational age (the amount of time the baby spent in-utero) and modifications of placental DNA. Researchers then located the modifications and identified the closest genes, allowing them to analyze the biological significance of the modifications.

The most prominent differences were linked to genes that play significant roles in immunity, inflammation, and pregnancy complications. These differences seen between male and female infants may be important when looking at sex-specific health and developmental outcomes.

“These findings highlight the importance of considering infant sex in studies of the placenta,” said Dr. Bulka. “Doing so may help identify the origins of sex disparities in health and disease that persist throughout life.”

Researchers are now using this data to estimate an infant’s “biological” rather than “chronological” gestational age based on the modification of placental DNA, and the findings of this study suggest that it may be important to consider the infant’s sex when calculating “biological’” gestational age.

Read the research summary.

NIH Study Links Low Birthweight to Prenatal Per- and Polyfluoroalkyl Substances (PFAS) Exposure

Posted on by Jodi Snare

FOR IMMEDIATE RELEASE

 

High exposure to per- and polyfluoroalkyl substances (PFAS) during pregnancy may be associated with lower birthweights, according to a new study funded by Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

PFAS are widely used, long lasting chemicals, also known as “forever chemicals,” that break down slowly over time and can be found in drinking water, food, household products, personal care products, manufacturing facilities, and other sources.

“Outside of research studies, pregnant women are not tested for PFAS and are uncertain of the potential harms PFAS can cause,” said Amy Padula, PhD, MSc, an ECHO Program investigator at the University of California, San Francisco. “We need to better understand where people are most likely to be exposed to these substances given the number of sources, from drinking water to consumer products.”

This is the largest study to date to examine the role of PFAS in birth outcomes, involving more than 3,000 pregnant participants from 11 different ECHO research sites across the United States. Researchers measured PFAS levels in pregnant participants’ blood samples and found that the risk of giving birth to a baby of low birthweight increases with higher levels of these chemicals.

Dr. Padula and Tracey Woodruff, PhD, MPH, ECHO Program investigators at the University of California, San Francisco led this collaborative research published in Environmental Health Perspectives.

Padula, A. et al. Birth Outcomes in Relation to Prenatal Exposure to Per- and Polyfluoroalkyl Substances and Stress in the Environmental influences on Child Health Outcomes (ECHO) Program. Environmental Health Perspectives. DOI: 10.1289/EHP10723

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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 the Effect of Prenatal PFAS Exposure on Birthweight

Posted on by Jodi Snare

In a study investigating how per- and polyfluoroalkyl substances (PFAS) exposures affected pregnant mothers and their babies, ECHO researchers Amy Padula, PhD, MSc, and Tracey Woodruff, PhD, MPH, from the University of California, San Francisco found that higher levels of prenatal exposure to PFAS are associated with lower birthweights. The PFAS were detected in all participating mothers, suggesting some level of PFAS exposure from the environment. PFAS are widely used, long lasting chemicals that break down very slowly over time and are found in drinking water, food, household products, personal care products, manufacturing facilities, and other sources.

This research, titled “Birth Outcomes in Relation to Prenatal Exposure to Per- and Polyfluoroalkyl Substances and Stress in the Environmental influences on Child Health Outcomes (ECHO) Program,” is published in Environmental Health Perspectives.

For this study, the researchers collected blood samples and pregnancy data from more than 3,000 pregnant women in 11 different ECHO cohorts. They then measured PFAS levels in the mothers’ blood samples and asked them about their stress levels during pregnancy. The team found that mothers who had higher levels of PFAS chemicals in their bodies were more likely to give birth to a baby of low birth weight than mothers with lower levels of PFAS. Additionally, previous studies have found that psychosocial stress may affect PFAS exposures and birthweight. However, the team did not find that stress played a role in the relationships between low birthweight and PFAS exposure.

This research suggests that PFAS exposures during pregnancy can affect infant birth weight, demonstrating the importance of efforts to reduce sources of environmental PFAS exposure. “Outside of research studies, pregnant women are not tested for PFAS and are uncertain of the potential harms PFAS cause,” said Dr. Padula. “We need to better understand where people are most likely to be exposed to these substances given the number of sources, from drinking water to consumer products.”

The next steps for this research include examining potential sources of PFAS exposure. Additional studies may examine how factors like body mass index and other health conditions in pregnancy might additionally affect the relationship between PFAS exposure and infant birthweight.

The US Environmental Protection Agency (EPA) has created a Roadmap to address PFAS as part of the Biden Administration plan to accelerate efforts to better protect Americans from PFAS exposure.

Read the research summary.

ECHO Researchers Compare Methods of Placental Sample Preservation for Metabolite Analysis

Posted on by Jodi Snare

Jennifer Straughen, PhD

Collaborative ECHO research led by Jennifer Straughen, PhD, of Henry Ford Health System compared two different methods of placental sample preservation for metabolite analysis: flash freezing versus room-temperature fixation in methanol. The results of this study demonstrated that the room-temperature collection method can produce similar metabolism data to the flash-freezing, the standard method. This research, titled “Comparison of methanol fixation versus cryopreservation of the placenta for metablomics analysis,” is published in Scientific Reports.

For this study, researchers collected placental samples from mothers following delivery at Henry Ford Health. The researchers then removed pea-sized pieces of placental tissue and preserved them using either flash-freezing or methanol fixation. Metabolite analysis of these samples revealed similar quality results for both methods—although a greater number of metabolites were typically detected in the methanol-fixed samples and methanol extract.

“The results presented in this paper allow for the collection of placental tissue samples for metabolite analysis at room temperature instead of by flash freezing,” said Dr. Straughen. “Room-temperature fixation in methanol requires less equipment than flash freezing and may be more feasible to perform in community-based hospitals.”

More work is needed in the future to describe the metabolic data collected during this study and compare it to data from previous studies. Researchers will also need to repeat this study with a larger sample size to confirm these findings.

Read the research summary.

ECHO Investigators Conduct Research on How Nutrition Influences Child Health

Posted on by Jodi Snare

March is National Nutrition Month. ECHO investigators are conducting important research on how nutrition influences child health across all five ECHO Program health outcome areas. This month’s edition of the Connector highlights recent ECHO research in this area.

The Research Spotlight features ECHO research that suggests that children’s body mass index (BMI) has decreased following implementation of the Healthy, Hunger-Free Kids Act, possibly due to increased diet quality. ECHO’s large sample size, diversity, and ability to follow kids over long periods of time means that our researchers can leverage “natural experiments”—like policy changes or the COVID-19 pandemic—to examine how they affect children.

As a reminder, ECHO, assisted by NIH partners, will host a Virtual Return of Individual Research Results Workshop March 16-17, 2023. I invite you to join us for this two-day event aimed at identifying best practices for large-sample studies of pregnancy and childhood to ethically and feasibly return individual research results to participants. More information on workshop topics and registration information is available here.

NIH Study Investigates Link Between Mental Health and Pregnancy During the COVID-19 Pandemic

Posted on by Jodi Snare

FOR IMMEDIATE RELEASE

 

Being pregnant during the COVID-19 pandemic was associated with higher levels of stress and depression symptoms, according to a new study funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

Pregnant women who reported receiving more emotional support and engaging in more physical activity before and during the pandemic had lower stress and fewer symptoms of depression. The results also showed that the duration of pregnancies during the pandemic were slightly shorter on average, but there was no impact on infant birth weight.

“Providing access to emotional support and mental health care during pregnancy and encouraging more physical activity may help to improve maternal health,” said Alison Hipwell, PhD, ClinPsyD, an ECHO Program investigator at the University of Pittsburgh. “More research is needed to understand how social support and physical activity may protect pregnant women during stressful times.”

This study included 501 pregnant women who gave birth during the COVID-19 pandemic between March 12, 2020 and May 30, 2021 and 501 pregnant women who gave birth prior to March 11, 2020. Participants were 31 years old on average and enrolled in one of 16 ECHO research sites across the United States.

Irene Tung, PhD, of California State University Dominguez Hills, and Dr. Hipwell led this collaborative ECHO research published in Psychological Medicine.

Hipwell, A. E., et al. Impact of Sedentary Behavior and Emotional Support on Prenatal Psychological Distress and Birth Outcomes During the COVID-19 Pandemic. Psychological Medicine. DOI: 10.1017/S0033291723000314

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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.