Neighborhood-Level Poverty and Food Insecurity During Pregnancy Associated With Lower Birthweight and Small for Gestational Age Infants, NIH Study Finds

FOR IMMEDIATE RELEASE

 

Living in neighborhoods where residents have lower incomes and limited food access during pregnancy was associated with an increased risk of babies born small for gestational age or with lower birthweight, according to a new study from the NIH Environmental Influences on Child Health Outcomes (ECHO) Program.

Previous studies have shown that maternal diet during pregnancy can impact the physical and mental health of a mother. However, less is known about how food insecurity affects health outcomes for newborns. In a new research article, ECHO researchers analyzed data to understand what connections might exist between where a pregnant woman lives, their access to food, and birth outcomes.

This ECHO analysis, recently published in the American Journal of Clinical Nutrition, indicates a possible connection.

“Given the long-term effects of adverse birth outcomes on later cardiovascular disease risk and other conditions, more research is needed to evaluate whether interventions and policies that improve food access during pregnancy would be effective in improving birth outcomes and promoting child health,” said Izzuddin M. Aris, PhD, of the Harvard Pilgrim Health Care Institute.

Using nationwide data from more than 22,000 ECHO Cohort participants, a team of ECHO researchers found that, during pregnancy, 24% of those participants lived in a low-income neighborhood where a third or more residents lived over one mile from a grocery store (or more than 10 miles in rural areas). They also found that about 14% of the participants lived in neighborhoods with high poverty rates and where more than 100 households had no access to a vehicle and lived more than half a mile from the nearest grocery store.

Residence in low-income, low-food-access and low-income, low-vehicle-access neighborhoods was associated with lower birth weight, higher odds of babies born small for gestational age, and lower odds of babies born large for gestational age. However, researchers did not find any associations of individual food insecurity with birth outcomes.

To conduct this study, researchers matched pregnant individuals' home addresses with information about nearby food availability from the U.S. Food Access Research Atlas, which provided data on household income, the availability of a household vehicle, and where people can access food in different neighborhoods.

“In future studies, we want to look at health habits and chemical exposures to understand what else could be affecting birth outcomes,” said Dr. Aris.

Dr. Aris led a team of ECHO Cohort researchers from across the country who collaborated on the data analysis and writing for this research article.

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About ECHO: Launched in 2016, the Environmental influences on Child Health Outcomes (ECHO) Program is a research program in the Office of the Director at the NIH with the mission 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.

Read the research summary.

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.

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Follow @ECHOChildHealth for the latest ECHO Program updates on X (formerly known as Twitter).

ECHO Researchers Examine Fish Consumption and Supplement Use Among Pregnant Women

Collaborative ECHO research led by Emily Oken, MD, MPH of Harvard Medical School and the Harvard Pilgrim Health Care Institute, and Kristen Lyall, ScD of Drexel University, investigates fish consumption and the use of omega-3 supplements among pregnant women.

This research, titled “Demographic and health characteristics associated with fish and n-3 fatty acid supplement intake during pregnancy: results from pregnancy cohorts in the ECHO program,” is published in Public Health Nutrition.

Omega-3 fatty acids, also known as n-3 fatty acids, are essential nutrients during pregnancy for supporting child health and neurodevelopment and may also improve other pregnancy outcomes. Fish intake is the primary source of these nutrients in the diet. Prior research on who eats fish and uses supplements during pregnancy has been limited, involving fewer participants and older data that may not represent current consumption.

This study included 10,800 pregnant participants enrolled by 23 ECHO Cohort study sites that collected information on fish consumption, and 12,646 participants at 35 sites that collected information on omega-3 supplement use. While the ECHO Program began 2016, some study sites had been collecting participant data for many years before. In this study, information on fish consumption and omega-3 supplement use was collected from pregnant participants from 1999 to 2020.

After collecting this information, the researchers sorted participant data based on how often they ate fish: never or less than once per month, once per month to less than once per week, one to two times per week, or more than twice per week. They then compared participant fish consumption and supplement use across various demographic and lifestyle factors, including age, race, ethnicity, education, weight, and smoking status.

The research team observed that about 25% of pregnant participants did not eat any fish or ate fish less than once per month, but older participants were more likely to eat fish. Participants who were non-Hispanic Black, non-Hispanic Asian, or Hispanic ate less fish on average than those who identified as non-Hispanic White. Participants categorized as overweight were also less likely to eat fish.

Omega-3 supplement use was also rare—with only 1 in 6 study participants reporting taking omega-3 supplements. Supplement use was more common in participants who were older and had more education, a lower body mass index (BMI), and a diet that included fish.

“This study observed that one-quarter of participants in this large nationwide dataset rarely or never consumed fish during pregnancy, and omega-3 supplement use was uncommon, even among those who did not consume fish,” Dr. Oken said.

Experts recommend that people need additional omega-3 fatty acids during pregnancy. Ongoing effective public health advice and resources to support clinicians are needed to encourage consumption of low-mercury fish during pregnancy and intake of omega-3 supplements among those who do not consume fish.

Read the research summary.

New ECHO Research Study Relationship Between Maternal Education and Children’s Neurocognitive Development Over Time

Collaborative ECHO research led by Santiago Morales, PhD of the University of Southern California investigates the relationship between maternal education and children’s neurocognitive development over time. This research, titled “Maternal Education Prospectively Predicts Child Neurocognitive Function: An ECHO Study,” is published in Developmental Psychology.

ECHO researchers wanted to examine the relationship between changes in a mother’s education over time and their children’s later neurocognitive functioning, such as executive function and language skills. Studies to date have focused on early childhood outcomes and have treated a mother’s education as unchanging over time.

This study included 2,688 children, adolescents, and young adults from 3 to 20 years of age at ECHO research sites in 42 states across the U.S.

Mothers reported their own education levels during pregnancy and their child’s infancy, and again, years later when their children’s neurocognitive functions were also assessed. For both periods, the study categorized the mother’s education level into one of five groups—less than high school; high school or GED equivalent degree; some college, associate degree or trade school; bachelor’s degree; and graduate degree. The same categories were used to measure maternal education during childhood. Maternal education and income are two commonly used indicators of socioeconomic status. However, missing income data in this study prevented investigators from fully assessing the impact of socioeconomic status and income on neurocognitive skills.

Researchers also measured child participants’ cognitive abilities during childhood, adolescence, or young adulthood using the NIH Toolbox Cognition Battery. These tests assess aspects of cognition including language, memory, and problem solving. Test results created scores that reflected language skills, executive function, and overall brain function. The analysis included child participants who contributed at least one score.

This study found that a mother’s education level during pregnancy and infancy was associated with children’s language and executive function. Increases in maternal education were related to improved language performance but were not associated with executive functioning performance.

“These results suggest that further examining these associations can provide important insights that can help inform policies and interventions designed to foster neurocognitive development,” said Dr. Morales.

Future research can explore the factors involved in the suggested association between maternal education and a child’s neurocognitive development.

Read the research summary.

 

New ECHO Study Finds No Statistically Significant Associations Between Small Molecules During Pregnancy and Childhood BMI

Collaborative ECHO research led by Rachel Kelly, PhD and Nicole Prince, PhD, of Brigham and Women’s Hospital and Harvard Medical School, and Donghai Liang, PhD, MPH of Emory University analyzes the relationship between small molecules in a mother’s blood during pregnancy and childhood BMI. This research, titled “Metabolomic Data Presents Challenges for Epidemiological Meta-Analysis: A Case Study of Childhood Body Mass Index from the ECHO Consortium,” is published in Metabolomics.

A child’s body mass index (BMI) can affect their future health. Some researchers are exploring the connection between factors during pregnancy and childhood BMI. Increasingly, researchers use molecular data to analyze the relationship between pregnancy and childhood health outcomes, sometimes combining molecular data from multiple study sites to increase the statistical power of these analyses.

In this study, ECHO researchers combined the results from multiple ECHO Cohort Study Sites to determine whether a relationship existed between small molecules in the mother’s blood during pregnancy and their child’s later BMI. It also aimed to use these data to test a framework for analyzing molecular data across multiple studies.

The study involved mothers in the second and third trimesters of pregnancy and their children from multiple study sites: the Atlanta ECHO Cohort, the New Hampshire Birth Cohort, and the Vitamin D Antenatal Asthma Reduction Trial. Pregnant participants from these sites provided blood samples, which were then used to measure a range of small molecules that provide information on each participant’s health and environment and the biological or genetic factors that could affect their pregnancy. These participants and their children were observed and assessed across pregnancy and the child’s early life. In this analysis, the authors used data from the aforementioned three study sites to evaluate the relationship between molecules measured during pregnancy and BMI at age 2, aiming to identify relationships that were consistent across all three.

The research team found that of all the small molecules tested, 20 showed up in all study sites, and 127 showed up in at least two. The study found that the levels of only six small molecules, primarily related to maternal diet, were associated with child BMI across all sites. However, statistical analysis across these study sites did not identify significant associations between these molecules and child BMI.

This study demonstrates some of the challenges of harmonizing molecular data across diverse study sites and highlights important considerations for researchers trying to conduct similar analyses.

“Differences in how molecular data were collected and measured between the sites in this study made it difficult to draw strong conclusions on the relationship between small molecules during pregnancy and childhood BMI,” Dr. Kelly said. “Future analyses could involve larger, more standardized studies that all use the same methods for sample collection and measurement of molecules present, which would improve the reliability and reproducibility of results.”

Many ECHO Cohort Study Sites are now measuring small molecules in mothers and children with a standardized approach under the ECHO Cohort Data Collection Protocol. ECHO researchers have an opportunity to use these data to power analyses that can explore the relationship between pregnancy health and child health outcomes.

Read the research summary.

Early-Life Airborne Lead Exposure Associated With Lower IQ and Self-Control in NIH Study

FOR IMMEDIATE RELEASE

Children who lived in areas with higher levels of airborne lead in their first five years of life appeared to have slightly lower IQs and less self-control, with boys showing more sensitivity to lead exposure, according to a new study from the NIH Environmental influences on Child Health Outcomes (ECHO) Program.

Lead exposure, even at low levels, can affect cognitive and physical development in children. While children’s blood lead levels have decreased in recent decades, inequities persist in areas with older, poorly maintained housing or inadequate water system management. There is limited research on how airborne lead from industrial emissions affects children.

ECHO Cohort researchers wanted to learn if airborne lead exposure is associated with children’s IQ and executive functioning. Their analysis, published in the American Journal of Public Health, suggests there may be an association between lead released into the air and children’s brain development.

“To ensure that children have a fair chance at healthy development, reducing the environmental pollution in general and focusing on factors such as nutrition could lessen the impact of lead exposure on children’s development,” said study author Lisa Gatzke-Kopp, PhD of Penn State.

In the study, lower average IQ scores were associated with high levels of airborne lead exposure in children between the ages of 4 and 8. A similar association was observed with executive function between the ages of 3 and 8, but only for impulse control and not the ability to follow changes in instructions. The association with impulse control was more pronounced in boys.

Click map to enlarge

To gain these insights, investigators used residential address data of more than 3,000 children from 14 ECHO Cohorts combined with an Environmental Protection Agency (EPA) database of historical and geographically specific estimates of airborne lead levels. After calculating the average lead exposures for each child over the course of their first five years, researchers analyzed their IQ and cognitive test scores from ages 3 to 8, while accounting for a number of additional factors, such as socioeconomic status.

These findings are consistent with a previous study, reinforcing the importance of examining air pollution and child development. However, researchers pointed out that other chemicals could also play a role, and factors like nutrition might help mitigate the effects of lead exposure.

Future studies can examine whether other factors in a child’s environment modify lead pollution and why boys appear to be more susceptible.

Dr. Gatzke-Kopp led this collaborative research in the American Journal of Public Health.

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About ECHO:

Launched in 2016, the Environmental influences on Child Health Outcomes (ECHO) Program is a research program in the Office of the Director at the NIH with the mission 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 X (formerly known as Twitter).

ECHO Researchers Find Link Between Phthalate Exposure and Preterm Birth, Estimate Potential Costs

 

Collaborative ECHO research led by Leonardo Trasande, MD, MPP of NYU Langone Health investigates the potential connections between phthalates, their metabolites in the urine of pregnant individuals, and birth outcomes. This research, titled “Prenatal phthalate exposure and adverse birth outcomes in the USA: a prospective analysis of births and estimates of attributable burden and costs,” is published in The Lancet Planetary Health.

Phthalates are widely used chemicals found in some consumer products, and previous research has linked phthalate exposure to preterm birth. In response, the use of di-2-ethylhexyl phthalate (DEHP), a common type of phthalate, has decreased in recent years. However, there is limited research on the effects of the replacement phthalates, and the costs associated with phthalate exposure remain unquantified.

The study included 5,006 mother-child pairs from 13 ECHO Cohort Study Sites across the U.S.  Researchers analyzed levels of 20 phthalate metabolites in urine samples collected at three different points during each participant’s pregnancy. Then, the team looked for associations between these metabolite levels and preterm birth. The team also investigated the differences between specific types of phthalates, comparing di-2-ethylhexyl phthalate (DEHP), a common type of phthalate, with several newer alternatives developed to replace it.

When the researchers grouped mothers based on the amount of DEHP metabolites (substances produced when the body breaks down DEHP) found in their urine, they found that the 10% with the highest levels had a 50% higher chance of giving birth before the 37th week of pregnancy compared to the 10% with the lowest levels.

Some common alternatives to DEHP were associated with an even higher risk of preterm birth. Women exposed to the highest amounts of these alternative chemicals—phthalic acid, di-isodecyl phthalate (DIDP), di-n-octyl phthalate (DnOP), and diisononyl phthalate (DiNP)—had twice the risk of preterm birth compared to those with little to no exposure to these alternatives. The team also calculated the costs associated with phthalate exposure.

“The number of premature births in the U.S. that could be linked to phthalate exposure in 2018 was between 24,000 and 120,000, potentially costing between $1.6 billion and $8.1 billion in medical expenses over the lifetime of the children,” Dr. Trasande said.

Future research could look at how exposure to replacement phthalates affects child development after birth. The European Union has prohibited the use of certain phthalates in some consumer products—as have California and a few other U.S. states.

Read the research summary here.

New ECHO Research Highlights Gaps in Literature Studying Role of Fathers in Child Development

Collaborative ECHO research led by Elena Jansen, PhD of Johns Hopkins School of Medicine, and Kristine Marceau, PhD of the College of Health and Human Sciences at Purdue University reviewed existing literature on what is known about a father’s role in child development, highlighting how a father’s history and personal characteristics can influence their child’s health and well-being. This research, titled “The Role of Fathers in Child Development from Preconception to Postnatal Influences: Opportunities for the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) Program,” is published in Developmental Psychobiology.

While few studies on parental health and child development include fathers in any substantial way, a growing body of literature emphasizes their vital role—even before birth. This literature review studied existing research on the role of fathers in child development. It evaluated the quality of this research, focusing on three outcome areas of the ECHO Program: obesity, neurodevelopment, and positive health. The review also discussed how the ECHO Program can address gaps in the literature by designing studies that address unanswered questions.

The review first described data collected by the ECHO Cohort and identified critical gaps in the research related to the role of fathers in ECHO’s five key health outcome areas. After understanding the program’s data collection methods, the research team analyzed multiple research papers categorized into three broad stages of child development—preconception, prenatal, and postnatal.

This review focused on which previously studied characteristics or behaviors of fathers have been connected to children’s development. It demonstrated how studying the effect of fathers on child development has revealed additional insights into children’s health outcomes, including reasons for declines in physical or mental health. Compared to the pregnancy and pre-pregnancy stages, this study allowed researchers to better understand a father’s role once a baby is born.

“One unique aspect of this work is describing how fathers can impact the child by first influencing the mother, for example, by helping her follow healthy behaviors, such as cooking or helping to cook healthy meals and eating healthy food himself,” Dr. Jansen said.

This literature review also revealed gaps in the research community’s understanding of the father’s role in child development, highlighting the need to incorporate maternal and paternal reported data on fathers’ characteristics. While many studies offer insights into the role of fathers, often fathers do not provide this information themselves, or existing data do not allow researchers to compare the roles of fathers and mothers.

Additionally, the study team proposed a new conceptual model to guide future inquiry considering paternal influences, and suggest methods researchers can use to help fill in some knowledge gaps.

“Our model can help guide other researchers to focus on the pieces of the puzzle that we currently know very little about,” Dr. Jansen said. “It may help explain how each parent interacts with their child and which influence has a stronger impact or is more prevalent for which parent.”

With more data becoming available from the ECHO Program, information on fathers’ characteristics can be connected to the rich data on family characteristics, mothers’ influences, and child development. Additional data will be gathered to provide further insights and answer remaining questions.

Read the research summary.

NIH Study Finds Flame-Retardant Chemicals May Increase Risk Of Preterm Birth, Higher Birth Weight

FOR IMMEDIATE RELEASE

An NIH Environmental influences on Child Health Outcomes (ECHO) Cohort study finds that certain organophosphate esters (OPEs) were linked to increased odds of preterm birth, especially in girls. 

Pregnant individuals exposed to specific classes of flame-retardant chemicals known as organophosphate esters (OPEs) may face an increased risk of preterm birth, especially for baby girls, or higher birth weights for girls and boys, according to a recently published study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health.

Manufacturers commonly use OPEs in products such as furniture, baby items, electronics, clothes, and building materials to prevent fires and make plastics more flexible. People can come into contact with OPEs in various ways, including swallowing or breathing indoor dust or absorbing it through the skin.

In the past decade, OPEs have been increasingly used as flame retardants after polybrominated diphenyl ether (PBDE) flame retardants were phased out due to health risks. ECHO researchers wanted to learn how these now more widespread OPE chemicals might affect pregnancy outcomes such as preterm birth and birth weight.

"The widespread use of products with new flame retardants among pregnant women in the U.S. means that a significant number of births could be affected by these compounds," said Deborah Bennett, PhD, of the University of California, Davis. “In fact, ECHO researchers learned that more than 85% of the study participants had three specific markers of OPE exposure in their bodies.”

Those three substances—diphenyl phosphate (DPHP), a combination of dibutyl phosphate and di-isobutyl phosphate (DBUP/DIBP), and bis(1,3-dichloro-2-propyl) phosphate—were associated with shorter pregnancies and higher risks of preterm birth only among female infants. Among male infants, higher concentrations of DPHP were associated with longer pregnancies.

Babies born to mothers with detectable levels of three other OPE markers—bis(1-chloro-2-propyl) phosphate, bis(2-methylphenyl) phosphate, and dipropyl phosphate—tended to have higher birth weights compared to those whose mothers had no detectable levels of these substances. Babies with a higher birth weight might be more likely to have jaundice, breathing problems, or congenital disorders.

Researchers measured a total of nine OPE markers in urine samples collected from 6,646 pregnant participants across 16 ECHO Cohort Study Sites—often during their third or second trimesters. The researchers assessed birth outcomes, including the length of pregnancy and birth weight, using medical records or parent reports.

“These substances tend to stay in the body for short periods, usually just hours to days,” said Dr. Bennett. “Conducting more thorough studies with various urine tests can help us figure out how they might be linked to birth outcomes.”

Dr. Bennett led this collaborative research published in Environmental Health Perspectives.

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About ECHO: Launched in 2016, the Environmental influences on Child Health Outcomes (ECHO) Program is a research program in the Office of the Director at the NIH with the mission 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 X (formerly known as Twitter).

Early Breastfeeding Linked to Lower Risk of Childhood Obesity, Regardless of Mother’s Weight, NIH Study Finds

FOR IMMEDIATE RELEASE

Consistently breastfeeding infants in any amount during their first three months was associated with a lower risk of childhood obesity, regardless of the mother's body mass index (BMI) before pregnancy, according to a new study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health.

While previous studies have shown that breastfeeding may protect children against obesity and other chronic conditions, this relationship has not been studied much in women with obesity. ECHO Cohort researchers wanted to explore the possible link between breastfeeding practices in women with obesity and overweight before pregnancy and a child’s BMIz score. Researchers use BMIz scores to compare children’s height and weight to those of their peers, while the more familiar BMI assesses body weight in relation to height.

In this ECHO Cohort study, researchers found that any amount of consistent breastfeeding during an infant’s first three months was associated with lower BMIz scores, calculated later at ages between 2 and 6 years, regardless of the mother’s pre-pregnancy BMI. This protective association appeared stronger for children with mothers who had obesity before pregnancy compared to those categorized as overweight during the same time. (A BMI of 25 to 29.9 is considered overweight, and a BMI of 30 or higher is considered obese.)

“Our findings highlight that each additional month of breastfeeding, whether a consistent amount or exclusively, may contribute to a lower weight later in childhood, especially for mothers who had obesity before pregnancy,” said Gayle Shipp, PhD, RDN of Michigan State University.

The study looked at BMI measurements from 8,134 pairs of mothers and kids at 21 study sites in 16 states and Puerto Rico. The researchers calculated BMI and BMIz scores from measurements taken at study visits, medical records, or self-reported data for the mother and child. Additionally, the study examined two breastfeeding situations: whether the mother ever breastfed or whether the mother was exclusively breastfeeding the infant at 3 months old. This continuous breastfeeding measure included the duration of any breastfeeding allowing for formula or other food and the duration of exclusive breastfeeding with no formula feeding or other food.

Exclusive breastfeeding at three months was associated with a lower child BMIz score only among women with a pre-pregnancy BMI in the normal range. Each additional month of any or exclusive breastfeeding correlated with a significantly lower child BMIz, particularly for mothers categorized as overweight (in the case of any breastfeeding) or as having obesity (for any or exclusive breastfeeding) prior to pregnancy.

“Health professionals can use this study’s findings as an opportunity to encourage and promote breastfeeding among all women, especially those who have obesity,” said Shipp.

Dr. Shipp led this collaborative research published in Pediatrics.

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About ECHO: Launched in 2016, the Environmental influences on Child Health Outcomes (ECHO) Program is a research program in the Office of the Director at the NIH with the mission 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 X (formerly known as Twitter).

New ECHO Research Finds No Association Between Arsenic Exposure and Birth Outcomes

Collaborative ECHO research led by Jonathan Lewis, MHS, Emily Knapp, PhD, MHS, and Amii Kress, PhD, MPH of Johns Hopkins Bloomberg School of Public Health investigates the relationship between arsenic exposure and certain birth outcomes. This research, titled “Associations Between Area-Level Arsenic Exposure and Adverse Birth Outcomes: An ECHO-Wide Cohort Analysis,” is published in Environmental Research.

Researchers captured proxy exposure to arsenic using a residential history of arsenic violations from the preconception period throughout pregnancy, a time when environmental influences could disrupt fetal growth.  Violations were used as a proxy for arsenic exposure. The study used data from 15,000 mother-child pairs at 51 research sites across the U.S., focusing on children born in 2006 or later. In 2006, the Environmental Protection Agency (EPA) revised the enforceable standard for arsenic concentrations in drinking water to 10 parts per billion.

Low birth weight, gestational age at birth, preterm birth, and birth size were not found to be associated with potential arsenic exposure in areas with violations. However, infants whose mothers experienced continuous exposure to arsenic from three months before conception through birth exhibited a statistically significant increase in birth weight compared to those born in areas without violations.

In future studies, researchers aim to improve the identification of the community water systems that serve ECHO participants. Future research could also consider ECHO participants’ exposure to arsenic in foods and from other sources of drinking water.

Read the research summary.