Pregnancy Complications Like Preeclampsia and Gestational Diabetes May Be Linked to Slower Biological Development in Babies

Authors: Carrie Breton, Christine Ladd-Acosta, 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?

The researchers found that babies who were exposed to preeclampsia or gestational diabetes while they were developing in the womb were biologically younger than babies without those exposures, indicating that these exposures may have slowed down babies’ biological development. This difference was more noticeable in female babies compared to male babies.

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?

In this study, researchers found that certain pregnancy complications are related to slower biological development at birth, with girls being more affected than boys. These results provide an important clue about how pregnancy complications can affect underlying biological processes in newborn infants, as preeclampsia and gestational diabetes have been linked to child health outcomes.

Why was the study needed?

Preeclampsia (high blood pressure that can cause kidney or other organ damage during pregnancy) and gestational diabetes (high blood sugar during pregnancy) have been linked to a number of birth complications and children’s health outcomes, including birth weight. More research is needed to identify the biological processes in newborn babies that are affected by these pregnancy complications so doctors can use that information to provide treatments to improve children’s health. This study evaluated how pregnancy complications affect newborn infant’s epigenetic age, a measure of their “biological age” based on molecular markers in their cells.

Who was involved?

The study included 1,801 children from 12 ECHO cohorts across the United States. The participants were born between 1998 and 2008 to mothers who had preeclampsia or gestational diabetes during pregnancy.

What happened during the study?

ECHO researchers calculated each infant’s biological age by analyzing DNA samples collected at birth and compared their biological age (epigenetic age) to their chronological age at birth (measured in pregnancy weeks). Then, the researchers compared the biological ages of newborns exposed to pregnancy complications to the biological ages of babies who were not exposed.

What happens next?

The researchers will continue this research with a larger number of participants. They also plan to see whether the same biological changes detected at birth are related to health outcomes later in childhood.

Where can I learn more?

Access the full journal article, titled “Analysis of Pregnancy Complications and Epigenetic Gestational Age of Newborns,” in JAMA Network Open.

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

Published February 24, 2023

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Pregnancy Complications Like Preeclampsia and Gestational Diabetes May Be Linked to Slower Biological Development in Babies

ECHO Study Suggests Childhood Maltreatment of Mothers Linked to Asthma, ADHD, and Autism Spectrum Disorder in Their Children

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ECHO Study Suggests Childhood Maltreatment of Mothers Linked to Asthma, ADHD, and Autism Spectrum Disorder in Their Children

Authors: Claudia Buss, Nora K. Moog

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?

Results from this study suggest that mothers’ maltreatment experience as children may influence their own children’s future health. Children of mothers who were neglected or abused during childhood were more likely to have diagnoses of asthma, ADHD, and ASD. These children were also more likely to demonstrate symptoms and behaviors linked to depression (i.e., internalizing behaviors). Additionally, girls whose mothers experienced maltreatment during childhood were more likely to have obesity. Children with mothers who experienced childhood maltreatment were also more likely to develop several of these health outcomes at once. Furthermore, exposure to several different forms of maternal childhood maltreatment was associated with highest risk increases for most offspring health outcomes suggesting the more severe the maternal childhood experiences were, the higher the risk for adverse health outcomes in her child.

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 highlights the impact of maternal childhood maltreatment experiences as a major determinant of health across generations. While not all children of mothers who experienced abuse or neglect during childhood develop health problems, those who do are at higher risk for developing more than one condition. Results from this study suggest that screening and identifying these children early on, can allow the opportunity to direct targeted interventions to interrupt the intergenerational impact of adversity.

Why was the study needed?

Childhood maltreatment increases the risk for adverse health outcomes, and this risk can be transmitted from one generation to the next. Previous studies have investigated single health outcomes in children of mothers that were exposed to childhood abuse or neglect. However, health outcomes can often be connected to one another and affected by the same factors. This study investigated six health outcomes simultaneously and investigated whether a mother’s own exposure to maltreatment affects a child’s risk for experiencing more than one of these health outcomes.

Who was involved?

This study included over 4,000 mothers and their children from 21 ECHO cohorts. About 44% of mothers who participated in the study reported experiencing some form of abuse or neglect during their own childhood.

What happened during the study?

Mothers self-reported on their childhood experiences, and researchers used this information to assign mothers to one of two groups: 1) exposed to childhood maltreatment and 2) not exposed to childhood maltreatment. The researchers compared the risk for physical and mental conditions, including asthma, internalizing behaviors (e.g., social withdrawal, trouble sleeping, symptoms of anxiety or depression), autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and obesity, between the children in the two groups. They also examined whether multiple health outcomes co-occur in the same child.

What happens next?

Follow-up studies will investigate the pathways between maternal childhood maltreatment experiences and child health outcomes. Other studies may also investigate if other forms of negative childhood experiences are linked to different consequences of childhood maltreatment in the next generation.

Where can I learn more?

Access the full journal article, titled “Intergenerational transmission of the consequences of maternal exposure to childhood maltreatment – a United States nationwide study of multiple cohorts in the ECHO program” in The Lancet Public Health.

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

Published February 23, 2023

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ECHO Study Suggests Childhood Maltreatment of Mothers Linked to Asthma, ADHD, and Autism Spectrum Disorder in Their Children

Screen Time for Children Rose During COVID-19 Pandemic, Remained High After Restrictions Lifted

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Screen Time for Children Rose During COVID-19 Pandemic, Remained High After Restrictions Lifted

Authors: Monique Hedderson, Assiamira Ferrara, et al.

Who sponsored this study?

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

What were the study results?

Total screen time among children ages 4 to 12 increased during the early stages of the COVID-19 pandemic as lockdowns and school closures were widespread. Screen time remained higher in the later pandemic, even after several restrictions had been lifted. The study found that children used screens an average of 1.75 hours/day more during the early pandemic (December 2020 – April 2021) compared to before the pandemic (July 2019 – March 2020). During the later pandemic (May 2021 – August 2021), screen time remained on average 1.11 hours/day higher than the pre-pandemic average. Both recreational and educational screen time increased during the COVID-19 pandemic.

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 shows that increases in screen time among children persisted more than one year into the pandemic, after many COVID restrictions had been lifted. These findings can help inform clinical guidelines that could aid parents and their children in re-establishing healthy media use habits. Pediatricians can help parents reset family media use priorities and limits that may have changed during the early stages of the COVID-19 pandemic using tools like the American Academy of Pediatrics Family Media Plan.

Why was this study needed?

Excessive screen time among children may be associated with obesity-promoting health behaviors and adverse mental health. The COVID-19 pandemic initially led to widespread school closures, shelter-in-place laws, closures of recreational facilities and cancellation of youth sports, increases in number of parents working from home, and social distancing recommendations, all of which may have impacted screen time among children. Prior studies have reported screen time levels during the pandemic but were unable to document changes in screen time because most lacked pre-pandemic assessments. This study is among a handful of ECHO studies to include pre-pandemic assessments of screen use in order to document changes during the pandemic.

Who was involved?

The study included 228 parent-child pairs from three ECHO cohorts across the United States (Colorado, California, and South Dakota). Parents reported their children’s screen time. The geographically, racially, and ethnically diverse participants ranged in age from 4 to 12 at the start of the study.

What happened during the study?

ECHO researchers surveyed parents about their children’s media use before, during the early, and later periods of the pandemic. The study assessed total, educational (not including remote school), and recreational screen time and examined trends in screen use before and at two points during the pandemic.

What happens next?

Additional studies are needed to determine whether the increases in screen time among children during the pandemic impacted longer term obesity and mental health outcomes in children. Future studies can also clarify whether specific types of screen time adversely impacted children’s health during the pandemic.

Where can I learn more?

Access the full journal article, titled “Trends in screen time use among children during the COVID pandemic, July 2019 through August 2021” in JAMA Network Open.

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

Published February 15, 2023

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Screen Time for Children Rose During COVID-19 Pandemic, Remained High After Restrictions Lifted

Child Body Mass Index Dropped After Healthy, Hunger-Free Kids Act in Schools

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Child Body Mass Index Dropped After Healthy, Hunger-Free Kids Act in Schools

Author(s): Aruna Chandran, Emily Knapp, 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?

The study showed an overall decrease in BMI in the first few years following the implementation of the HHFKA compared to BMI in the decade prior to the program. Among children ages 12-18 years, who may have more autonomy in purchasing their own lunches or snacks during the school day, BMI decreased from year to year following the start of the HHFKA. This was a reversal of the trends seen during the decade before the program, during which adolescent BMI was increasing each year. This study also supported findings from previous studies that found the HHFKA had a positive effect on the health of children from lower-income families by contributing to an annual decrease in their BMI.

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 National School Lunch Program and School Breakfast Program (NSLP) provides free or low cost meals to over 30 million children annually, providing an estimated 50% of students’ caloric intake each school day. This study found that the HHFKA was associated with decreases in child and adolescent BMI. Increasing BMI trends before the HHFKA was implemented were stopped or even reversed in several populations after the law was implemented, which could critically influence their long-term health. The study also found that the implementation of the HHFKA decreased BMI of children from lower-income families, who are more likely to participate in the NSLP and are at higher risk of obesity. Accessibility to school meals and snacks represents a key opportunity for intervention to combat the childhood obesity epidemic.

Why was this study needed?

Childhood obesity is a serious health concern with long-term consequences for health and quality of life. Nearly 1 in 5 children in America is obese. The 2010 Healthy, Hunger-Free Kids Act (HHFKA) was the first legislation passed in nearly 3 decades aimed at improving the nutritional quality of breakfast, lunch, and snacks sold at schools. Studies have shown that the HHFKA has improved the quality of school meals without affecting cost or program participation, but only a few small studies have explored whether the HHFKA reduced body mass index (BMI) in children over time.

Who was involved?

This study included 14,121 children from the ECHO Program between the ages of 5 and 18 who had at least one height and weight measurement recorded between January 2005 to March 2020.

What happened during the study?

Researchers used height and weight measurements from children across 50 ECHO cohorts to calculate each child’s BMI and adjusted each measurement based on age and sex. They used these data to evaluate yearly BMI trends from before and after the implementation of the Healthy, Hunger Free Kids Act in September 2016.

What happens next?

Future studies are needed to further explore and verify the effect of improving the nutritional quality of school meals on childhood obesity. In addition, policymakers could use data from studies like this to evaluate policies related to improving the nutritional quality of meals provided in schools.

Where can I learn more?

Access the full journal article, titled “Changes in Body Mass Index Among School-Aged Children Following Implementation of the Healthy, Hunger-Free Kids Act,” in JAMA Pediatrics.

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

Published: February 13, 2023

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Child Body Mass Index Dropped After Healthy, Hunger-Free Kids Act in Schools

ECHO Researchers Investigate Whether Prenatal Chemical Exposures Affect the Development of Autism-related Traits in Children

Posted on January 26, 2023October 25, 2024 by Jodi Snare

Collaborative ECHO research led by Jennifer Ames, PhD of the Kaiser Permanente Northern California Division of Research and Ghassan Hamra, PhD of Johns Hopkins Bloomberg School of Public Health, investigates whether exposures to per- and polyfluoroalkyl substances (PFAS) during pregnancy were associated with the development of autism-related traits in children. The researchers looked at data from 1,224 mother-child pairs and found that prenatal exposure to one specific PFAS chemical, perfluorononanoic acid (PFNA), may be associated with an increase in autism-related traits in children. Prenatal exposure to the mixture of all PFAS chemicals combined was not associated with increased autism-related traits in children. This research, titled “Prenatal exposure to per- and polyfluoroalkyl substances and childhood autism-related outcomes,” is published in Epidemiology.

PFAS are widely used, long lasting chemicals, the components of which break down very slowly over time. Previous studies that have investigated the association between prenatal PFAS exposure and childhood autism spectrum disorder (ASD) have been inconsistent and mostly involved small sample sizes. This study leveraged the large, diverse ECHO-wide cohort to evaluate how prenatal PFAS exposure affects the development autism-related traits, even when a child does not receive a clinical ASD diagnosis.

This study included children born between 2011 and 2018 from 10 racially and ethnically diverse ECHO cohorts across the United States, including one cohort that enrolls children from families with an increased likelihood of ASD. The researchers measured the levels of eight different PFAS in blood samples collected from mothers during pregnancy. Later, when their children were aged 2.5 years or older, researchers asked caregivers to report on their child’s autism-related traits using a questionnaire called the Social Responsiveness Scale (SRS). The research team tracked the associations between these data to examine child SRS scores in relation to each individual PFAS as well as the combination of the PFAS.

“In the U.S. population, exposures to perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) have dropped substantially since the industry voluntarily phased out these chemicals in the early 2000s,” said Dr. Ames. “However, other PFAS exposures have increased over time, including thousands with unknown toxicity. These so-called ‘forever chemicals’ continue to pose risks to health even after they are phased out because they persist in the environment and inside people’s bodies and don’t break down easily.”

These results underscore the need for more research on whether PFAS chemicals might have more significant effects on child neurodevelopment, and whether factors such as genetics, underlying health conditions, or nutritional status may change the effect of PFAS exposure on brain development.

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ECHO Study Suggests Prenatal Exposure to Perfluorononanoic Acid (PFNA) May Be Linked to Autism-Related Traits in Children

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ECHO Study Suggests Prenatal Exposure to Perfluorononanoic Acid (PFNA) May Be Linked to Autism-Related Traits in Children

Authors: Jennifer Ames, Ghassan Hamra, 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?

The researchers found that prenatal exposure to one specific PFAS chemical, perfluorononanoic acid (PFNA) may be associated with an increase in autism-related traits in children. Prenatal exposure to the mixture of all PFAS chemicals combined was not associated with increased autism-related traits in 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 study draws attention to the potential risks of PFAS chemicals on child neurodevelopment. In the U.S., exposures to some specific PFAS, such as PFOA and PFOS, have dropped substantially since the industry voluntarily phased these chemicals out in the early 2000s. However, other PFAS exposures have increased over time, including thousands of these substances with unknown toxicity. These so-called “forever chemicals” continue to pose risks to health even after they are phased out because they persist in the environment and inside people’s bodies and don’t break down easily. While the estimated effects of PFAS chemicals on child autism-related traits are relatively small in this study, future studies may investigate whether early childhood exposure to PFAS chemicals are associated with effects on other neurodevelopmental outcomes.

Why was this study needed?

Per- and polyfluoroalkyl substances (PFAS) are widely used, long lasting chemicals, the components of which break down very slowly over time. Previous studies looking at associations between prenatal PFAS exposure and childhood autism spectrum disorder (ASD) are inconsistent and mostly conducted in small sample sizes. The objective of this research was to determine whether blood concentrations of PFAS during pregnancy were linked to the development of autism-related traits in children. The researchers in this study were able to examine this question by continuously measuring the development of autism-related traits in a large number of children across the U.S, independently of whether a child received a clinical ASD diagnosis.

Who was involved?

The participants of this study included 1,224 mother-child pairs from ten cohorts across the United States. The participants were geographically, racially, and ethnically diverse, and one of the cohorts included families with an increased genetic likelihood of ASD. Most of the participating children were born between 2011 and 2018.

What happened during the study?

The researchers measured the levels of eight different PFAS in blood samples collected from mothers during pregnancy. Later, when their children were aged 2.5 years or older, researchers asked caregivers to report on the child’s autism-related traits using a questionnaire called the Social Responsiveness Scale (SRS). The research team tracked the relationship between child SRS scores and prenatal exposure to each individual PFAS as well as the combination of the eight PFAS.

What happens next?

Additional research is needed to continue studying the effect of early life exposure to PFAS on child neurodevelopment, including cognition, attention, and other neurobehaviors. Future studies can also investigate whether biological sex and other factors—such as genetics, underlying health conditions, and nutritional status—may change the effect of PFAS exposure on brain development.

Where can I learn more?

Access the full journal article, titled “Prenatal exposure to per- and polyfluoroalkyl substances and childhood autism-related outcomes,” in Epidemiology.

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

Published January 12, 2023

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ECHO Study Suggests Prenatal Exposure to Perfluorononanoic Acid (PFNA) May Be Linked to Autism-Related Traits in Children

ECHO Study Suggests COVID-19 Pandemic Contributed to Developmental Delays in Infants, Toddlers

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ECHO Study Suggests COVID-19 Pandemic Contributed to Developmental Delays in Infants, Toddlers

Authors: Sara Nozadi, Johnnye Lewis, et al.

Who sponsored this study?

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

What were the study results?

In this study, up to 15% of infants and toddlers who were developmentally on track prior to the COVID-19 pandemic showed signs of developmental delays during the pandemic. Male children showed more delays than female children, and language was the most affected developmental area. Families from minority communities and those with lower socioeconomic status were more likely to experience pandemic-related hardships. However, financial and social pandemic-related hardships were not associated with the individual changes observed in children’s developmental progress.

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

Why was this study needed?

Many studies have focused on the COVID-19 pandemic’s effects on the development of school-aged children, evaluating the effects of the pandemic on academic performance and behavior problems. Fewer studies have examined the pandemic’s effects on the developmental progress of infants and toddlers, whose needs are different than those of school-aged children. During this study, researchers examined whether the negative developmental effects observed in school-aged children over the course of the pandemic could also be seen in infants and toddlers.

Who was involved?

The study included 684 children between the ages of 2 months and 4 years from 8 ECHO cohort research sites across the United States. Researchers included children whose parents had filled out the Ages and Stages Questionnaire (ASQ), which uses parent-reported information to pinpoint a child’s developmental progress, within the 18-month period before and after March 2020. Parents of participating children were also asked about financial hardship, defined as at least one parent experiencing job loss or change, or social hardships, defined as families’ quarantining from household members or extended family and friends, during the pandemic.

What happened during the study?

Parents answered 30 questions before and during the pandemic to determine whether their child had achieved developmental milestones in language, motor, cognitive or problem solving, and socioemotional development. Researchers also used the ECHO COVID-19 survey that was developed in April 2020 to gauge pandemic-related financial and social stress on families.

What happens next?

Future research can follow the developmental patterns in these children over time to determine if COVID-19 related delays are lasting or reversible. Studies may also focus on pandemic-related stressors that could particularly effect infants and toddlers, such as family dynamics, parent-child interactions and parental stress.

Where can I learn more?

Access the full journal article, titled “Effects of COVID-19 financial and social hardships on infants’ and toddlers’ development in the ECHO program,” in the International Journal of Environmental Research and Public Health.

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

Published January 5, 2023

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ECHO Study Suggests COVID-19 Pandemic Contributed to Developmental Delays in Infants, Toddlers

ECHO Study Finds Associations Between Neighborhood Social Vulnerability at Birth With Higher Childhood Body Mass Index

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ECHO Study Finds Associations Between Neighborhood Social Vulnerability at Birth With Higher Childhood Body Mass Index

Author(s): Izzuddin M. Aris, et al.

Who sponsored this study?

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

What were the study results?

The study found that children who lived in higher opportunity or less vulnerable neighborhoods early in life had lower average BMI and lower risk of obesity from childhood to adolescence. The neighborhoods children lived in at birth affected these health outcomes more than the neighborhoods they lived in later in childhood. These associations were not affected by individual and family sociodemographics or by prenatal risk factors for childhood obesity.

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 research focuses on how community resources can enhance children’s health outcomes. The Child Opportunity Index, Social Vulnerability Index, and other measures of neighborhood characteristics could help inform efforts to reduce neighborhood barriers and improve access to community resources so families can better support their children’s health and well-being.

Why was this study needed?

The physical and social characteristics of neighborhoods may influence how children grow and develop. Children’s body mass index (BMI)—an estimation of their overall body fat—and childhood obesity are significant risk factors for heart disease later in life. The associations between neighborhood characteristics and children’s BMI and risk of obesity remains understudied. This study compared neighborhood-level measures of opportunity and social vulnerability with BMI and obesity patterns in children from birth to adolescence.

Who was involved?

This study included 20,677 children from 54 ECHO cohorts located across the United States.

What happened during the study?

ECHO researchers collected each child’s home address and weight at birth, infancy (6 months‒1.5 years), early childhood (2‒5 years), and mid-childhood (5‒10 years). The researchers linked participants’ addresses throughout childhood to data from the Child Opportunity Index and Social Vulnerability Index. The Child Opportunity Index measures neighborhood conditions and resources that may affect child health outcomes including education, health and environment, and social and economic factors. The Social Vulnerability Index identifies communities with high numbers of public health emergencies and other stressors by looking at demographics, socioeconomic status, type of housing, access to transportation, and other factors.

The researchers used these data to examine links between children’s neighborhood-level opportunity and social vulnerability and their BMI and obesity over time.

What happens next?

More research is needed to determine how changes to specific aspects of neighborhood environments might influence weight gain and obesity in children.

Where can I learn more?

Access the full journal article, titled “Associations of Neighborhood Opportunity and Vulnerability with Trajectories of Child Body Mass Index and Obesity Among U.S. Children,” in JAMA Network Open.

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

Published: December 22, 2022

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ECHO Study Finds Associations Between Neighborhood Social Vulnerability at Birth With Higher Childhood Body Mass Index

ECHO Study Suggests Link Between Severe Bronchiolitis During Infancy and Asthma During Childhood

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ECHO Study Suggests Link Between Severe Bronchiolitis During Infancy and Asthma During Childhood

Author(s): Kohei Hasegawa, et al.

Who sponsored this study?

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

What were the study results?

Bronchiolitis is a wheezing illness usually caused by a lung infection such as Respiratory Syncytial Virus (RSV). During this study, researchers found that the hospitalized infants with bronchiolitis were more likely to develop asthma by the age of 12 years when compared to hospitalized infant without bronchiolitis. The researchers also saw that this effect was stronger for non-Hispanic White and non-Hispanic Black infants, compared with Hispanic infants.

What was the study's impact?

This is the first nationwide investigation that demonstrates the role of severe bronchiolitis during infancy on influencing long-term childhood asthma risk and identifies subgroups of children who are most at risk for developing asthma following bronchiolitis during infancy. These results could help future investigations to identify what factors may influence the association between severe bronchiolitis and childhood asthma risk across different demographic groups, which could advance the development of targeted prevention strategies for childhood asthma.

Why was this study needed?

Severe bronchiolitis is the most common reason for hospitalization in U.S. infants younger than 2 years old. Many studies have shown that severe bronchiolitis, requiring hospitalization during infancy, is a risk factor for developing childhood asthma. However, these studies have been too narrow to evaluate how severe bronchiolitis during infancy affects childhood asthma risk in various demographic subgroups.

Who was involved?

The researchers analyzed data from 11,762 infants enrolled in 53 ECHO research sites across the United States. All of these infants were hospitalized at age 12 months or younger between 2001-2021. Of these infants, 10% were hospitalized with bronchiolitis. One of the participating ECHO cohorts selectively enrolled children with a parental history of asthma.

What happened during the study?

The researchers collected data from participating infants under 12 months old on caregiver-reported hospitalization for bronchiolitis. The researchers then used data on caregiver-reported asthma diagnosis prior to age 12 to evaluate the relationship between severe bronchiolitis and childhood asthma to determine how this relationship may be affected by major demographic and clinical factors.

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 happens next?

Future studies are needed to investigate the reasons underlying the links among infant bronchiolitis, demographic and clinical factors, and the development of asthma. These findings not only provide an evidence base for early identification of children who are at high risk for asthma but also offer opportunities for early preventive interventions in this large, high-risk population.

Where can I learn more?

Access the full journal article, titled “Association of Severe Bronchiolitis during Infancy with Childhood Asthma Development: An Analysis of the ECHO Consortium,” in Biomedicines.

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

Published: December 22, 2022

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ECHO Study Suggests Link Between Severe Bronchiolitis During Infancy and Asthma During Childhood

Mothers Who Experience More Life Changes Due to the COVID-19 Pandemic Reported More Symptoms of Traumatic Stress

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Mothers Who Experience More Life Changes Due to the COVID-19 Pandemic Reported More Symptoms of Traumatic Stress

Authors: Tracy Bastain, Amy Margolis, et al.

Who sponsored this study?

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

What were the study results?

The study identified two groups of mothers based on their pandemic experiences. One of these groups experienced more changes to their daily life routines, more isolation from friends and family, and more changes to their health behaviors, when compared to the other group who experienced fewer pandemic-related changes in their lives.

Mothers who reported more life changes also reported more symptoms of traumatic stress due to the pandemic. The mothers who fell into the group that experienced more changes and reported more symptoms of traumatic stress tended to be women with higher incomes and higher education. Sixty-six percent of the women in the high change group were white. The women in the high change group were more likely to report financial concerns as a cause of stress. They were also more likely to report that the pandemic affected their healthcare.

In contrast, the group that reported fewer changes tended to have lower education and lower income. The women in this group were primarily Black and Native American. Hispanic women were split evenly between the two groups.

Both groups reported similar rates of COVID-19 infection in the household and similar work changes.

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.

Impact

As compared to fathers, during the COVID-19 pandemic more mothers have been affected by job and income losses, taken on more childcare burdens related to remote schooling, and have made major adjustments to their daily routines. This study found that mothers who had the most changes to their work, health, and social support systems also reported the highest amounts of traumatic stress due to the pandemic. These findings suggest that the association between sociodemographic, stressful life events, and mental health should be considered in future studies examining the long-term outcomes of the COVID-19 pandemic.

Why was this study needed?

The goal of this study was to better understand the mental health impacts of the COVID-19 pandemic on mothers in the United States and Puerto Rico.

Who was involved?

This study included 11,473 mothers from 62 ECHO cohorts across the U.S. and Puerto Rico.

What happened during the study?

ECHO researchers investigated the potential impacts of the COVID-19 pandemic on maternal mental health, from April 2020 through August 2021. The researchers looked for patterns of pandemic-related changes in maternal health and health behaviors, healthcare visits, work and finances, and coping strategies. They then used these data to group the mothers by those who had more or fewer pandemic-related changes to examine whether these groups reported higher or lower symptoms of traumatic stress related to the pandemic.

What happens next?

Future studies could examine how changes over the course of the pandemic affect mothers’ stress and well-being.

Where can I learn more?

Access the full journal article, titled “COVID-19 Pandemic Experiences and Symptoms of Pandemic-Associated Traumatic Stress Among Mothers in the US,” in JAMA Network Open.

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

Published December 16, 2022

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Mothers Who Experience More Life Changes Due to the COVID-19 Pandemic Reported More Symptoms of Traumatic Stress