NIH Study Suggests Maternal Inflammation Risk Factors Associated With Children’s Behavioral and Emotional Regulation

Maternal inflammation risk factors may be associated with dysregulation in children, according to a study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health. “Dysregulation” in this context refers to children’s attention, anxiety and depression, and aggression being measurably different from what is typically expected at their age.

While inflammation is a normal bodily response to injury or infection, ECHO investigators wanted to learn whether factors linked to inflammation during pregnancy might be associated with dysregulation in children.

More youth with dysregulation (35%) were born to mothers with prenatal infections compared with 28% of youth without dysregulation. Other maternal factors studied, including being overweight before pregnancy, attaining less education, and smoking during pregnancy, were associated with higher likelihoods of childhood dysregulation. Children and adolescents who had a parent or sibling with a mental health disorder were also more likely to experience dysregulation.

“Addressing factors and treating conditions associated with behavior challenges may help improve outcomes for these children,” said Jean Frazier, MD, of the University of Massachusetts Chan Medical School and a leader of the study.

Researchers used the Child Behavior Checklist (CBCL) to measure aggressive behavior, anxiety/depression, and attention problems in children. Approximately 13.4 % of children and adolescents in the study met the criteria for the CBCL Dysregulation Profile.

This study included 4,595 participants (ages 6-18 years) from 18 ECHO research sites across the United States.

Dr. Frazier and Mike O’Shea, MD, of the University of North Carolina at Chapel Hill led this collaborative research published in the Journal of the American Academy of Child and Adolescent Psychiatry.

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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

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

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NIH Study Links Prenatal Per- and Polyfluoroalkyl Substance Exposure to Higher BMI & Obesity Risk in Children

FOR IMMEDIATE RELEASE

 

Exposure to per- and polyfluoroalkyl substances (PFAS) during pregnancy was linked to slightly higher BMIs and an increased risk of obesity in children, according to new research funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

“There is a growing interest in understanding the effects of PFAS exposure on children’s health,” said Joseph Braun, PhD, of Brown University. “Studies like this one can help researchers and policymakers better understand the risks of PFAS to take effective actions to protect vulnerable populations.”

The researchers analyzed the levels of seven different PFAS in blood samples collected from mothers during pregnancy. These so-called “forever chemicals” are long-lasting substances that can be found in many household materials, as well as food and drinking water.

Researchers then calculated each child’s BMI, an approximate measure of body fat. Higher levels of PFAS in mother’s blood were related to slightly higher BMIs and increased risk of obesity were seen equally for male and female children.

The study used data collected over two decades from 1,391 children between the ages of 2 and 5 years and their mothers who were enrolled in eight ECHO research sites in California, Illinois, Massachusetts, Colorado, New Hampshire, Georgia, and New York.

Future studies will examine the associations between maternal PFAS exposure and obesity-related health outcomes in older children.

Dr. Braun and Yun Liu, PhD, ECHO Program investigators at Brown University, led this collaborative research published in Environmental Health Perspectives.

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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.

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NIH Study Finds Prenatal Substance Exposure Linked to Child Behavior Problems

Sarah Maylott, PhD

FOR IMMEDIATE RELEASE

 

Prenatal exposure to tobacco, alcohol, and illegal drugs may increase a child’s risk of displaying certain problem behaviors in later childhood, according to new research funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

Children ages 6 to 11 who were exposed to alcohol and tobacco before birth were more likely to display rule-breaking or aggressive behaviors, while children exposed to illegal drugs, such as cocaine, methamphetamine, or heroin, before birth were more likely to have higher rates of anxiety, depression, or withdrawn behaviors, according to findings published in the Journal of Pediatrics. However, ECHO researchers pointed out that not all children exposed to substances had behavioral problems.

“Our work shows that we may be able to identify children with certain behavioral challenges based on their mothers’ prenatal substance use profiles,” said Sarah Maylott, PhD of Duke University. “With further research, clinicians and researchers could use these results to identify and support children at higher risk for behavior problems.”

About 2,000 women from 10 ECHO cohorts across the country participated in the study from 2000-2020. The research team divided the women into two groups based on the types of substances used during pregnancy and then compared the behavior of both groups’ children.

Future large-scale studies can look at how the quantity and timing of substance use during pregnancy affect children’s risk for behavioral problems and how the home environment may contribute to that risk. Researchers can also explore what factors lead to resilient outcomes for children with prenatal substance exposure.

Dr. Maylott led this collaborative research published in the Journal of Pediatrics.

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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.

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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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NIH Study Finds Association Between Gestational Diabetes, Maternal Depression, and Early Childhood Behavior Problems

FOR IMMEDIATE RELEASE

 

Gestational diabetes, prenatal depression, and postpartum depression were each individually associated with higher levels of early childhood behavior problems such as attentional problems, anxiety, and depression in new research funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

Previous research has linked gestational diabetes to prenatal and postpartum depression. Researchers wanted to determine how that combination of maternal symptoms affected early childhood behaviors.

“Our findings suggest that children born to mothers who had both gestational diabetes and symptoms of depression during pregnancy could benefit from receiving additional monitoring for behavioral problems during early childhood,” said Lauren Shuffrey, PhD, an ECHO Program investigator at Columbia University.

The researchers also found that gestational diabetes was associated with autism-related behaviors only in children whose mothers reported higher levels of depressive symptoms during and immediately after pregnancy. Gestational diabetes was also associated with child behavioral problems only in male children.

This study included 2,379 children from ECHO research sites in Colorado, Massachusetts, New York, Pennsylvania, and Tennessee. More than half of participants were male, and 216 participants were born to mothers who were diagnosed with gestational diabetes.

During this study, ECHO researchers collected information from the participating mothers, including gestational diabetes diagnosis and self-reports of depression symptoms during and after pregnancy. To investigate the effect of these maternal conditions on child behavior, the researchers used the Preschool Child Behavior Checklist (CBCL) to examine the behavior of children ages 2 to 5 years old.

Dr. Shuffrey led this collaborative research published in Child Development.

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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.

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

FOR IMMEDIATE RELEASE

 

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

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

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

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

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

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

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

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

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

Media Contacts

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

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

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

FOR IMMEDIATE RELEASE

 

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

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

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

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

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

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

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

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

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

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

Media Contacts

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

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

Connect With Us

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

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

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

FOR IMMEDIATE RELEASE

 

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

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

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

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

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

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

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

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

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

Media Contacts

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

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

Connect With Us

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

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

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

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.

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

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

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.

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

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.