Pregnant Women Living in Worse Neighborhood Conditions Were More Likely to Have Shorter Pregnancies and Smaller Babies

Author(s): Sheena Martenies, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) Program, Office of The Director, National Institutes of Health.

What were the study results?

In this study, ECHO researchers found that pregnant participants living in neighborhoods with higher exposure index scores, which reflect worse neighborhood conditions, had shorter pregnancies and smaller babies. For Black pregnant participants, there was a higher risk of preterm birth linked to increased combined exposures during pregnancy compared to White pregnant participants. The researchers also found that pregnant women living in rural areas had shorter pregnancies and smaller babies compared to pregnant women living in urban areas who had similar scores on the combined exposure index.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

This study provides additional support suggesting that neighborhood conditions can impact pregnancy and infant health. The effects of combined neighborhood-level exposures on childhood health can have notable effects on a national scale. Lower birthweight and shorter pregnancies are associated with health challenges later in life, including asthma and developmental delays.

Why was this study needed?

Previous studies have found that neighborhood conditions can influence pregnancy and infant health, but few have examined the effects of exposure to a combination of environmental and social stressors. It is important to look at multiple exposures simultaneously because this more closely mirrors real-world experiences on people’s health outcomes.

Existing tools for looking at combined exposures to environmental and social conditions in neighborhoods do not have national coverage or they do not extend across the time frames needed. To address this issue, researchers developed an exposure index to examine the relationship between combined environmental and social exposures at the neighborhood level and pregnancy and infant health in ECHO cohorts.

Who was involved?

This study included more than 13,000 infants born between 2010 and 2019. The participants were from 41 ECHO cohorts located throughout the United States.

What happened during the study?

ECHO researchers developed an exposure index that combined data on multiple environmental hazards and social circumstances into a single measure of neighborhood conditions. The index included factors such as air pollutants, vehicle traffic, poverty, and crowded housing. Pregnant participants were assigned an index score based on where they lived during their pregnancy. Then, the researchers looked at how this index score was associated with birthweight, length of pregnancy, and other pregnancy outcomes.

What happens next?

More research is needed to determine which of the exposures in the index are most important to child health outcomes. Some members of the research team are studying data from two ECHO cohorts to see how these neighborhood-level exposures might interact to influence obesity later in life.

Where can I learn more?

Access the full journal article, titled “Associations between combined exposure to environmental hazards and social stressors at the neighborhood level and individual perinatal outcomes in the ECHO-wide cohort,” in Health & Place.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published July 21, 2022

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Pregnant Women Living in Worse Neighborhood Conditions Were More Likely to Have Shorter Pregnancies and Smaller Babies

ECHO Study Finds Disparities across Racial, Ethnic Groups in Sleep Duration, Quality During Pregnancy

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ECHO Study Finds Disparities across Racial, Ethnic Groups in Sleep Duration, Quality During Pregnancy

Author(s): Maristella Lucchini, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health.

What were the study results?

Non-Hispanic Black/African American participants slept less and reported more sleep disturbances compared with non-Hispanic White participants. Hispanic participants slept longer, had better sleep quality, and fewer sleep disturbances compared with non-Hispanic White participants.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

This study is the first to investigate and report differences in pregnant individuals’ sleep quality across racial and ethnic groups. If these results are replicated in other studies, they may suggest the need for targeted interventions to improve sleep health in pregnancy.

Why was this study needed?

Pregnant women from racial/ethnic minority groups are more likely to experience complications during pregnancy, and poor sleep during pregnancy is known to increase the risk of poor maternal health. People from racial/ethnic minority groups often experience worse sleep compared to non-Hispanic White people, but little is known about differences in sleep during pregnancy.

The objective of this study was to examine whether sleep differences during pregnancy among racial/ethnic groups was a factor that contributed to racial/ethnic disparities in overall maternal health outcomes.

Who was involved?

Researchers analyzed information from 2500 pregnant individuals from 14 ECHO cohorts across the United States who reported on their sleep habits during pregnancy. Participants self-reported race and ethnicity were grouped into Hispanic, non-Hispanic White, non-Hispanic Black/African American, and non-Hispanic Asian individuals.

What happened during the study?

Participants completed questionnaires during pregnancy to report on their sleep duration, quality, and disturbances. Other information collected included maternal education level, pre-pregnancy weight, height, and age.

The researchers evaluated the association between sleep duration, quality, and disturbances in each pregnancy trimester across racial/ethnic groups.

What happens next?

Future studies should research what factors contribute to these sleep disparities at a personal level, family level, and beyond. They should also explore to what extent differences in sleep duration, quality, and disturbances might contribute to disparities in maternal and child health outcomes across racial/ethnic groups.

Where can I learn more?

Access the full journal article, titled “Racial/ethnic disparities in subjective sleep duration, sleep quality and sleep disturbances during pregnancy: an ECHO study” in Sleep.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published June 21, 2022

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ECHO Study Finds Disparities across Racial, Ethnic Groups in Sleep Duration, Quality During Pregnancy

Depression in New Mothers Is Common, Especially When Babies Are Born Too Early

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Depression in New Mothers Is Common, Especially When Babies Are Born Too Early

Author(s): Nicole Bush, Danielle Roubinov, Rashelle Musci, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health.

Footnote: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

What were the study results?

During the first five years following childbirth, one out of every five mothers who gave birth to a preterm baby had symptoms of depression, while one out of every ten mothers who gave birth to a full-term baby had symptoms of depression. For mothers of preterm infants, it was also more common to have symptoms that got worse over time compared to women who gave birth to full-term babies. The most severe symptoms of depression were seen in women who gave birth early.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should always consult with a qualified healthcare provider for diagnosis and for answers to your personal questions.

What was the study's impact?

This study supports previous reports that many mothers struggle with their mental health after giving birth, and women who have preterm babies may be particularly at risk for symptoms of depression—such as sadness, stress, anxiety, and feelings of being overwhelmed. Maternal mental health can influence their child’s health and development. Right now, doctors only screen women for depression symptoms when they are pregnant and for six months after they have their babies. This study shows that some women continue to struggle with depression for years after they give birth or start experiencing depression when their children are older. This trend was especially true for women whose babies were born prematurely. This study shows the importance of asking women about their mental health for much longer than six months after they give birth and helping them find supportive interventions.

Why was this study needed?

The postpartum period can be especially hard for mothers when babies are born prematurely, but researchers don’t know much about the effect that preterm births can have on a mother’s mental health. This study assessed postpartum depressive symptom trajectories for mothers of preterm and full-term babies, and followed participating mothers for five years after birth to better understand the long-term risks for depression and potential opportunities for treatment.

Who was involved?

The study involved 11,320 pregnant women aged 18 to 52 years old from 35 ECHO cohorts across the United States. About 11% of these women had babies that were born before they were due (preterm infants) and 89% had babies that were born on or near their due date (full-term infants).

What happened during the study?

Researchers analyzed self-reported depression measurements for women when they were pregnant and after they had their babies. These women also completed at least one follow-up assessment before their children were 5 years old.

What happens next?

It is important for future research to study what factors put some women at higher risk of experiencing depression after giving birth, particularly mothers of premature babies. Future research should also investigate what types of programs can help support mothers and their mental health during pregnancy and after birth.

Where can I learn more?

Access the full journal article titled, “Trajectories of Depressive Symptoms Among Mothers of Preterm and Full-Term Infants in a National Sample” in Archives of Women's Mental Health.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published June 16, 2022

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Depression in New Mothers Is Common, Especially When Babies Are Born Too Early

Study Reveals Rising Levels of Plastics, Pesticides, and Replacement Chemicals in Pregnant Women

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Study Shows Rising Levels of Plastics, Pesticides, and Replacement Chemicals in Pregnant Women

Authors: Jessie P. Buckley, Tracey J. Woodruff, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health.

What were the study results?

Most of the chemicals were found in at least one of the women in the study and about a third of the chemicals were found in greater than half of the participants. One fifth of the chemicals were detected in over 90% of the pregnant women indicating widespread exposure to the chemicals measured.

The study found some chemicals were detected more often or were present in higher amounts in non-white women, those with lower education, those who were single, and those exposed to tobacco. Hispanic women had higher levels of some chemicals not included in previous biomonitoring studies including parabens (preservatives) as well as phthalates and bisphenols (from plastics).

The study found that levels of some of the chemicals used as replacements for more toxic ones that were banned or phased out, increased over time and were present in higher amounts than have been seen in previous studies. The levels of several phased out chemicals were found to remain stable or decrease over time.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

This is the largest study to date to measure exposure to a wide variety of environmental chemicals in a diverse group of pregnant women across the U.S. The results of this study highlight the widespread and unequal exposure of pregnant women to chemicals from air pollution, food, water, plastics, and other industrial and consumer products.

Why was this study needed?

There is little data on exposure of pregnant women to many pesticides and industrial chemicals, even those that could be harmful during pregnancy and throughout childhood development.

Who was involved?

The study included 171 women from five U.S. states and Puerto Rico who were part of an ECHO cohort. Of these women, 60% were Black or Hispanic.

What happened during the study?

Research team members measured 89 biomarkers for more than 100 chemicals in urine samples from pregnant women in nine ECHO cohorts. Most of the chemicals can be found in pesticides, plastics, sunscreens, personal care products, and flame retardants. Many of the chemicals measured are replacement chemicals: chemicals meant to replace other harmful chemicals (e.g., BPA, phthalates). The team used a new method that measured multiple chemicals in a single urine sample to determine if pregnant women were exposed to the chemicals. The researchers then studied how different factors—such as age, race, education level, and the year the sample was collected—related to the levels of chemicals found.

What happens next?

The research team will continue to study exposures in a larger, diverse population of pregnant women (more than 6,500) to see whether these prenatal chemical exposures are linked to negative birth outcomes. This data will be important for understanding the factors that may contribute to additional negative health effects during pregnancy and childhood.

Where can I learn more?

Access the full journal article titled, “Exposure to contemporary and emerging chemicals in commerce among pregnant women in the United States: The Environmental influences on Child Health Outcomes (ECHO) Program” in Environment Science & Technology.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published May 10, 2022

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Study Reveals Rising Levels of Plastics, Pesticides, and Replacement Chemicals in Pregnant Women

ECHO Study Identifies Biological, Behavioral, and Social Factors Affecting Pregnancy Health

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ECHO Study Identifies Biological, Behavioral, and Social Factors Affecting Pregnancy Health

Authors: Stephanie Eick, Rachel Morello-Frosch, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health.

What were the study results?

Pregnant participants who were over 30 years old and had a college degree had lower levels of oxidative stress. Levels of oxidative stress were higher among pregnant participants who were overweight or obese and unmarried. Also, current smokers or those with less than a high school education had higher levels of a oxidative stress biomarker. These results help identify how social, biologic, and behavioral factors may contribute to poor health in mothers and children.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

This is the largest study to date looking at the relationship between biological, social, and behavioral factors and oxidative stress during pregnancy. The results of this study provide important clues into how socioeconomic inequalities can contribute to poor health in pregnant women. This study may also inform future studies looking at risk factors for preterm birth.

Why was this study needed?

There is little data on what can cause oxidative stress during pregnancy. Oxidative stress is a process that can trigger cell damage and it is thought to play a role in the development of some diseases. By identifying biological, behavioral, and socioeconomic factors in a mother’s day-to-day life that may lead to increased risk for oxidative stress, research can help inform the development of targeted strategies for the prevention of poor prenatal health outcomes.

Who was involved?

This study involved approximately 2,000 pregnant participants in the mainland United States and Puerto Rico who were enrolled in one of four ECHO cohorts.

What happened during the study?

Researchers collected urine samples from participants and measured the levels of biomarkers for oxidative stress. Researchers calculated how levels of oxidative stress biomarkers changed in response to biological, behavioral, and social factors. Maternal age, pre-pregnancy body mass index, marital/partnered status, parity, and smoking status were included as biological and behavioral factors while race/ethnicity, maternal education, and stressful life events were considered social factors.

What happens next?

The research team is examining the impact of oxidative stress on adverse pregnancy outcomes, such as preterm birth.

Where can I learn more?

The full journal article, titled “Associations between social, biologic, and behavioral factors and biomarkers of oxidative stress during pregnancy: Findings from four ECHO cohorts” is published in Science of the Total Environment.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published April 29, 2022

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ECHO Study Identifies Biological, Behavioral, and Social Factors Affecting Pregnancy Health

Informed Mothers More Likely to Engage in Collective Action, Reduce Family- and Community-Level Chemical Exposures

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Informed Mothers More Likely to Engage in Collective Action, Reduce Family- and Community-Level Chemical Exposures

Authors: Amy Padula, Rachel Morello-Frosch, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, the Office of the Director, and the National Institutes of Health.

What were the study results?

This study found that participants knew about the dangers of chemical exposures and were motivated to act to protect the health of their families and communities, although they have busy family lives, and the pandemic has further prevented them from participating in collective action. Participants requested strategies that were time-efficient and included straightforward, accessible information on how to reduce exposures at the personal and community level.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

Researchers have an opportunity to directly learn from participants about how to improve the way in which chemical exposure results are reported in future studies. Report-back systems, or ways that study results are returned to participants, can present valuable information for participants about environmental health and how to lower chemical exposures in their homes and communities, and hold policy makers responsible for protecting parents and children from harmful chemical exposures. Researchers can use tools like the Digital Exposure Report Back Interface (DERBI) to give their participants access to individualized chemical results with information about how to take individual and collective action to reduce exposures.

Why was this study needed?

Participants in chemical exposure studies who receive reports on their personal exposures often look for information to reduce those exposures. Many chemical exposures are the result of policies, regulations, and practices, not individual behaviors and lifestyles. Individuals can address those policies and regulations through collective action, which is working with others to reach a common goal. Researchers wanted to understand the role of personal exposure reports in a participant’s interest in engagement in collective action.

Who was involved?

In summer 2020, the researchers held three online focus groups in English and Spanish with a diverse group of 18 participants from pregnancy cohorts in Illinois and California.

What happened during the study?

This study aimed to understand how much participants know about sources of potentially harmful chemical exposures and their experience and interest in participating in collective action. Focus group participants talked about some of the barriers and strategies to participating in collective action, and their preferences for receiving and using their personalized reports about environmental chemical exposures. Input from these focus groups can be used to help design tools and content to report results of exposure research to ECHO participants.

What happens next?

The researchers are currently studying participant surveys from before and after participants received their chemical exposure reports to learn more about how participants use DERBI. These surveys may also reveal how DERBI reports may influence participant efforts to reduce exposure in their homes and communities through collective action.

Where can I learn more?

More information about the Digital Exposure Report Back Interface (DERBI) can be found on the Silent Spring Institute website.

Access the full journal article, titled “Perspectives of peripartum people on opportunities for personal and collective action to reduce exposure to everyday chemicals: Focus groups to inform exposure report-back” in Environmental Research.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published March 26, 2022

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Informed Mothers More Likely to Engage in Collective Action, Reduce Family- and Community-Level Chemical Exposures

ECHO Study Suggests Antimony Exposure During Pregnancy Contributes to Lower Birth Weight

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ECHO Study Suggests Antimony Exposure During Pregnancy Contributes to Lower Birth Weight

Authors: Caitlin Howe, Margaret R. Karagas, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health.

What were the study results?

Researchers found that combined exposure to all metals in the mixture did not affect birth weight. Mothers with high levels of the metal antimony in their urine had smaller babies across all three of the ECHO cohorts. Two other metals – cadmium and molybdenum – had no impact on fetal growth. Findings for other metals (cobalt, mercury, nickel, tin) varied depending on the study population and whether the baby was male or female.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

This study used an approach that looked at multiple chemicals at once, in contrast to previous studies that have typically evaluated one chemical at a time. The findings suggest that antimony, an understudied metalloid, may harm fetal growth in different populations across the United States.

Why was this study needed?

Exposure to toxic metals can harm fetal growth (how much a baby grows during pregnancy), while nutritionally essential metals can support fetal growth. Previous research studying the effects of metals during pregnancy on fetal growth has usually focused on one metal at a time. However, most people are exposed to multiple metals, which may have complex effects on fetal growth. Therefore, combining data from three ECHO cohorts representing different geographic regions in the U.S., the research team looked at how maternal exposure to multiple metals affects fetal growth, an important indicator of future health.

Who was involved?

This study included approximately 1,000 pairs of mothers and newborns who are participating in three ECHO cohorts:

The MADRES study, a predominantly lower income Hispanic cohort in Los Angeles, California
The NHBCS, a primarily non-Hispanic white cohort in northern New England
The PROTECT study, a Hispanic cohort in northern Puerto Rico.

What happened during the study?

The research team combined data from the three cohorts to measure multiple metals in the mothers’ urine samples collected during pregnancy. They then looked at associations between seven metals and birth weight for gestational age using a multi-chemical mixture approach. Birth weight for gestational age is commonly used as a measure for fetal growth.

What happens next?

Since antimony may harm fetal growth, it is important to identify major sources of exposure to this metal so that exposure can be reduced for pregnant women. In future studies, the team would like to include more ECHO cohorts in their research, explore other indicators of metal exposures (such as placental measures of metals), and identify time periods when toxic and essential metal exposures are most harmful or beneficial for pregnant women and their children.

Where can I learn more?

The full journal article, titled “Prenatal metal(loid) mixtures and birth weight for gestational age: a pooled analysis of three cohorts participating in the ECHO Program” is published in Environment International.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published March 01, 2022

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ECHO Study Suggests Antimony Exposure During Pregnancy Contributes to Lower Birth Weight

ECHO Study Links PFAS Exposure During Pregnancy to Lower Birth Weight for Black Mothers

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ECHO Study Links PFAS Exposure During Pregnancy to Lower Birth Weight for Black Mothers

Authors: Che-Jung Chang, Donghai Liang, et al.

Who sponsored this study?

This work was supported by the Environmental Influences on Child Health Outcomes (ECHO) program Opportunities and Infrastructure Fund, Office of the Director, National Institutes of Health, and the Environmental Protection Agency (USEPA).

Footnote: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

What were the study results?

Some PFAS exposures were linked to a greater risk of low birth weight for babies that African American women delivered. PFAS exposures were also associated with the changes in the levels of small molecules needed for the baby’s development. These molecules included amino acids, lipid/fatty acids, bile acids, and sex hormones.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

This is one of the first studies researching the connections and relationships between exposures to PFAS, metabolomic changes during the baby’s development, and the baby’s growth. The chemical analysis showed that changes in the levels of the molecules may be responsible for the effects on birth weight. Future studies may target the important chemical mechanisms of the molecules, which may help develop early detection and intervention strategies for babies with low birth weight due to PFAS.

Why was this study needed?

Per- and polyfluoroalkyl substances (PFAS) are called “forever chemicals” because they stay in the environment a long time. PFAS exposures have been linked to adverse pregnancy and birth outcomes, such as lower birth weights, but there is little information on why this relationship exists and how PFAS exposures affect the body. Also, African American women and children are exposed to higher levels of environmental pollutants and have a higher risk of negative birth outcomes, so studies focusing on this population are very important for reducing heath disparities.

Who was involved?

This study included 313 participants enrolled in the Atlanta African American Maternal-Child ECHO cohort between March 2014 and May 2018.

What happened during the study?

Researchers collected blood samples from participants and measured the levels of PFAS and small molecules essential to a baby’s development. Using this information, the researchers calculated how the levels of the molecules changed in response to PFAS exposures and how these exposures affected the birth weight of babies.

What happens next?

The research team is working on additional analyses on the impact of exposures to PFAS before birth and the levels of essential small molecules in newborns. They are also planning to conduct larger analyses in order to get a more holistic view of the connection between PFAS exposures and adverse birth outcomes.

Where can I learn more?

For research updates, follow them on Twitter @donghai_liang, @chejung_chang, @EmoryRollins, and @EmoryHERCULES, and check out the Environmental Metabolomics Research Group’s website.

Access the full journal article, titled “Per- and polyfluoroalkyl substance (PFAS) exposure, maternal metabolomic perturbation, and fetal growth in African American women: A meet-in-the-middle approach” in Environment International.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published November 1, 2021

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ECHO Study Links PFAS Exposure During Pregnancy to Lower Birth Weight for Black Mothers

ECHO Study Maps Environmental Exposures During Pregnancy to Molecular Changes Associated with Key Health Processes

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ECHO Study Maps Environmental Exposures During Pregnancy to Molecular Changes Associated with Key Health Processes

Authors: Brett T. Doherty, Megan E. Romano, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health, under Award Numbers U2COD023375 (Coordinating Center), U24OD023382 (Data Analysis Center), and UH3 OD023275, and NIH NIEHS P42ES007373. Additional supporting entities include the Dartmouth Center for Molecular Epidemiology NIGMS, P20 GM104416) and the RTI Children’s Health Exposure Analysis Resource (CHEAR) Exposure Assessment Hub (NIEHS, U2CES026544, Fennell PI), among others

What were the study results?

Some of the chemical exposures were related to changes in the amounts of certain small molecules in the blood. Specifically, chemical exposures had the most impact on the amounts of a certain amino acids, which are the building blocks of many proteins that are important to both mother and child. When considered together, these molecule changes suggest that some of the chemical exposures may impact key health processes.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

This study used new tools to study how chemical exposures can affect important small molecules during pregnancy. The study results provide clues to the potential impact of these chemical exposures on the health of both mother and baby. In the future, further investigation of these chemical exposures may reveal more about their link to specific health endpoints.

Why was this study needed?

Pregnant women are exposed to chemicals in their environment. It is important to know how these chemicals might impact their health and the health of their babies. New tools can help us study how these chemicals affect health.

Who was involved?

This study included pregnant women in the New Hampshire Birth Cohort Study (NHBCS), who lived in north-central New England. A total of 177 women participated in this specific study within NHBCS.

What happened during the study?

During early pregnancy, women wore silicone wristbands for one week that captured chemicals in their environment. About three months later, the same women provided a blood sample, which was used to measure important molecules in their blood. Researchers looked at the link between environmental chemicals and the amounts of different molecules in the blood in order to better understand the health effects of these chemical exposures.

What happens next?

Going forward, it may be helpful to look for a link between the changes in molecules and related health processes and outcomes. Researchers may also want to reproduce these findings in other cohorts to better understand these environmental effects.

Where can I learn more?

Access the full journal article, titled “Chemical co-exposures assessed via silicone wristbands and endogenous plasma metabolomics during pregnancy,” is published in the Journal of Exposure Analysis and Environmental Epidemiology.

Learn about silicone wristbands at the MyExposome website.

Learn about small molecules and the methods to measure them through The UNC Nutrition Obesity Research Center (NORC) Metabolism and Metabolomics Core.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published October 26, 2021

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ECHO Study Maps Environmental Exposures During Pregnancy to Molecular Changes Associated with Key Health Processes

ECHO Study Identifies Demographics of Pregnant Women Least Likely to Get the Nutrients They Need

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ECHO Study Identifies Demographics of Pregnant Women Least Likely to Get the Nutrients They Need

Author(s): Katherine Sauder, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health.

What were the study results?

More than one in every five pregnant women did not eat enough of the vitamins D, E, K, and choline and the minerals magnesium and potassium, even when taking dietary supplements. The women most likely to not get enough vitamins and minerals were those aged 14-18 years, those who were Hispanic or Black, those who had less than a high school education, and those with obesity. Non-Hispanic women were the most likely to eat too much folic acid.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

The study showed that many pregnant women are at a high risk of not getting enough nutrients from food alone, so it is important for pregnant women to improve their diet quality and take dietary supplements when needed. The risk of not getting enough vitamins or minerals for women of various ages, races/ethnicities, education levels, or weights is often a problem, even when using dietary supplements.

This study shows that the dietary supplements women use today do not help them get all the nutrients they need in the right amounts. Pregnant women need guidance specific to their bodies to manage the vitamins and supplements they need. Different combinations and formulas of dietary supplements taken before getting pregnant may also help this problem and make sure women do not receive too much folic acid, iron, and zinc.

Why was this study needed?

One in three pregnant women in the United States eats too little or too many key vitamins and minerals. Prior studies do not tell us what groups are at the most risk for poor nutrition during pregnancy. Knowing who is at risk for poor nutrition can make it easier for doctors and public health workers to help pregnant women manage their nutrition.

Who was involved?

The researchers studied 9,801 women aged 14-50 years living across the United States who were pregnant between 1999 and 2019.

What happened during the study?

Pregnant women reported their daily food and dietary supplement intake during pregnancy. Researchers compared their daily intake of 19 vitamins and minerals to the Institute of Medicine recommendations for pregnant women.

What happens next?

The researchers will study how much vitamins and minerals women are getting from foods and compare this amount to the amount pregnant women should get. They will identify dietary supplements that can give women the right amounts of the vitamins and minerals they need.

Where can I learn more?

Access the full journal article, titled “Disparities in risks of inadequate and excessive intake of micronutrients during pregnancy” in Journal of Nutrition.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published September 7, 2021

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ECHO Study Identifies Demographics of Pregnant Women Least Likely to Get the Nutrients They Need