No Association Between Antidepressant Use During Pregnancy, Child’s Risk for Autism-Related Traits

No Association Between Antidepressant Use During Pregnancy, Child's Risk for Autism-Related Traits

Authors: Patricia Brennan, 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?

This study found that prenatal use of antidepressants, including selective serotonin reuptake inhibitors (SSRIs), did not increase a child’s risk for ASD or related traits.

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?

Pregnant women who are diagnosed with depression must weigh a number of risks when making decisions about treatments. Sometimes medical providers may recommend treatment with antidepressants. This study suggests that maternal use of antidepressants, including SSRIs, during pregnancy does not increase a child’s risk for autism-related traits. This information can be valuable in helping pregnant women and their physicians decide whether antidepressant treatment is right for them.

Why was this study needed?

Previous studies have reported mixed findings on the relationship between prenatal antidepressant use and child autism. Pregnant women and the physicians that treat them need more data to inform their decisions about whether to take certain medications during pregnancy.

Who was involved?

This study included 3,129 mothers and their children enrolled in ECHO cohorts across the United States. Participants provided data on prenatal exposure to antidepressants as well as measures of autism-related traits collected when the child was between 1 and 12 years of age. About 5% of the participating mothers took antidepressants during pregnancy.

What happened during the study?

The researchers used medical records and maternal self-reports to determine what medicines mothers used during pregnancy. Mothers reported on whether their child received an autism spectrum disorder (ASD) diagnosis and also completed rating scales about their child’s behavior, including social, language, and other traits related to autism.

What happens next?

Future studies might consider whether the dose or timing of antidepressant use during pregnancy changes its effect on child health outcomes.

Where can I learn more?

Access the full journal article, titled “Prenatal Antidepressant Exposures and Autism Spectrum Disorder or Traits: A Retrospective, Multi-Cohort Study,” in Research on Child and Adolescent Psychopathology.

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

Published November 22, 2022

Access the associated article.

Download this summary

No Association Between Antidepressant Use During Pregnancy, Child's Risk for Autism-Related Traits

ECHO Study Suggests Eating Processed Foods May Affect How Long Mothers Breastfeed Their Babies

<< Back to Research Summaries

ECHO Study Suggests Eating Processed Foods May Affect How Long Mothers Breastfeed Their Babies

Authors: Emily Zimmerman, 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 results from this study suggested that pregnant women who reported eating the most processed food and take-out tended to breastfeed for an average of 16 weeks (4 months), while pregnant women who reported eating the least amount of processed food and take-out breastfed for an average of 41 weeks (10 months).

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 first large and diverse cohort study examining the potential link between maternal food quality during pregnancy and breastfeeding duration. The results from this study suggest that pregnant women who eat a lot of processed food or take-out during pregnancy, tend to breastfeed for a shorter period of time.

Why was this study needed?

Breastfeeding promotes positive health outcomes for infants, but few studies have looked at the connection between the quality of mothers’ food during pregnancy and the length of time they breastfed. This study examined the relationship between self-reported food quality and preparation (e.g., organic foods, processed foods, take out) during pregnancy and breastfeeding duration.

Who was involved?

This study included 751 mothers who were at least 18 years old and their infants from 12 ECHO cohorts located across the United States.

What happened during the study?

Mothers reported on their food source and preparation during pregnancy and were placed in one of three groups: high, moderate, or low food source quality. Mothers also reported on their breastfeeding duration. Researchers investigated whether there was a relationship between the mothers’ food quality during pregnancy and the length of time they breastfed.

What happens next?

Future studies are needed to understand the relation between breastfeeding duration and maternal food quality over time. These studies can also provide more specific information on maternal diet, food source, and preparation during pregnancy while considering other important factors, like socioeconomic status, that may affect the types of foods mothers have access too.

Where can I learn more?

Access the full journal article, titled “Association Between Quality of Maternal Prenatal Food Source and Preparation and Breastfeeding Duration in The Environmental influences on Child Health Outcome (ECHO) Program,” in Nutrients.

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

Published November 21, 2022

Access the associated article.

Download this summary

ECHO Study Suggests Eating Processed Foods May Affect How Long Mothers Breastfeed Their Babies

ECHO Study Suggests Oxidative Stress Contributes to Mother’s Risk for Preterm Birth

<< Back to Research Summaries

ECHO Study Suggests Oxidative Stress Contributes to Mother's Risk for Preterm Birth

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

Who sponsored this study?

Research reported in this publication was supported by the Environmental influences on Child Health Outcomes (ECHO) Program, Office of The Director, National Institutes of Health (NIH).

What were the study results?

Pregnant participants who had higher levels of oxidative stress biomarkers during pregnancy were more likely to deliver preterm babies. This association was stronger for participants who experienced preterm birth that was sudden and unexpected or occurred prior to 34 weeks.

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 largest to date to look at the relationship between oxidative stress and preterm birth.

The study included a large group of racially, ethnically, and demographically diverse pregnant participants from across the mainland United States and Puerto Rico. The results from this study support prior findings that oxidative stress is higher among pregnant women who deliver preterm. The methods used in this study may help doctors identify pregnant women who may be at risk for preterm birth and plan targeted interventions.

Why was this study needed?

Oxidative stress is a process that can trigger cell damage and can play a role in the development of some diseases. Previous research has shown that oxidative stress in pregnant women may be linked to preterm birth. However, prior studies on this topic have involved small, primarily White populations, which does not reflect the diversity in the United States.

Who was involved?

This study involved 1,916 pregnant participants in the United States and Puerto Rico who were enrolled in one of four ECHO cohorts.

What happened during the study?

The researchers measured the levels of oxidative stress biomarkers from urine samples collected from participants during the second and third trimesters of pregnancy. They used these measurements to determine whether levels of oxidative stress were higher among participants who delivered their babies before 37 weeks (preterm birth).

What happens next?

Next, the researchers will study how exposure to environmental chemicals may lead to an increase in oxidative stress, ultimately leading to preterm birth. Future research will also identify what risk factors lead to higher oxidative stress during pregnancy.

Where can I learn more?

Access the full journal article, titled “A pooled analysis of four birth cohorts examining urinary oxidative stress biomarkers and preterm birth” in the American Journal of Obstetrics and Gynecology.

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

Published November 15, 2022

Access the associated article.

Download this summary

ECHO Study Suggests Oxidative Stress Contributes to Mother's Risk for Preterm Birth

ECHO Study Identifies Depression, Anxiety, and Other Drug Use as Risk Factors for Opioid Use During Pregnancy

<< Back to Research Summaries

ECHO Study Identifies Depression, Anxiety, and Other Drug Use as Risk Factors for Opioid Use During Pregnancy

Authors: Ruby H.N. Nguyen, Monica McGrath, 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 participants who used opioids were non-Hispanic White and had at least some college education. Opioid use was more common among people who used tobacco or illegal drugs, and those with a history of depression or anxiety. Additionally, opioid use during pregnancy in this study was rare—only 2.8% of participants used opioids during pregnancy, and the majority of opioid use originated from a prescription.

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 among the largest observational studies of opioid use during pregnancy thus far, and the diverse sample of pregnant participants is more representative of the U.S. population than previous studies. Results from this study strengthened evidence about the co-occurrence of opioid use in pregnancy with depression and use of multiple substances (such as tobacco and illegal drugs). These findings will help to inform further research on screening tools for opioid use during pregnancy. Additionally, the finding that most opioid use originated from prescriptions reinforces the need to reduce the amount of circulating prescription drugs and to better monitor over-prescription of opioids to pregnant women and provide them with alternative treatment solutions for pain management and opioid dependency.

Why was this study needed?

Opioids are a class of drugs used as prescription pain relievers that can cause dependence or addiction. The opioid crisis has disproportionately affected women, and use of these drugs can have detrimental effects on women of reproductive ages and on developing fetuses. Previous studies of opioid use during pregnancy have been limited to individuals in specific geographic locations or those with specific types of insurance. The stigmatization of this population has also complicated the collection of data on maternal opioid use during pregnancy. Using a large sample size, this study examined opioid use in a diverse population of pregnant women across the United States to investigate rare exposures – such as polysubstance use - and characteristics associated with opioid use during pregnancy.

Who was involved?

This study included over 20,000 pregnant participants from 32 ECHO cohorts across the U.S., creating a large and geographically diverse sample.

What happened during the study?

The researchers gathered data from pregnant women who were already participants in ECHO cohorts between 1991 and 2021. Medical records, laboratory tests, and self-reports were used to assess opioid use and potentially related factors, such as demographics, use of other substances, and history of anxiety or depression.

What happens next?

This study shows that further research is needed on the factors that may lead to use of multiple substances during pregnancy and the association between substance use and depression. This research can help inform the development of screening tools and procedures for identifying individuals who are potentially at risk for opioid use during pregnancy.

Where can I learn more?

Access the full journal article, titled “Characteristics of Individuals in the U.S. who Used Opioids during Pregnancy,” in the Journal of Women’s Health.

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

Published November 9, 2022

Access the associated article.

Download this summary

ECHO Study Identifies Depression, Anxiety, and Other Drug Use as Risk Factors for Opioid Use During Pregnancy

Exposure to Certain Phthalates During Pregnancy May Affect Brain Development in Infant Girls

<< Back to Research Summaries

Exposure to Certain Phthalates During Pregnancy May Affect Brain Development in Infant Girls

Authors: Leny Matthew, Craig Newschaffer, 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, researchers found that certain phthalates measured in the infant’s meconium, or first stool, were associated with lower scores on a common test that measures motor, visual, and language skills in girls under age 5.

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 suggests that prenatal exposure to certain types of phthalates may worsen early childhood learning outcomes for girls but have a neutral or slightly positive effect on boys. By studying meconium, instead of maternal urine, the researchers may be able to capture a longer timeframe of potential pre-natal exposure.

Why was the study needed?

Phthalates are widely used in personal care products, cosmetics, plastics, and other household items. These chemicals can cause the body to make substances that are thought to reduce a mother’s level of thyroid hormones, which are critical for fetal brain development. Phthalates are also associated with a reduction in the hormones necessary for sex-specific fetal brain development. Therefore, it is important to test the levels of prenatal phthalate exposure and the potential effects on developing fetuses.

Who was involved?

The study involved 956 mother and child pairs from two ECHO research sites—the Safe Passage study (SPS) and the Early Autism Risk Longitudinal Investigation (EARLI). Researchers focused on children who were higher risk for brain and nervous system disorders based on a family history of Autism or exposure to alcohol during pregnancy.

What happened during the study?

ECHO researchers measured phthalate levels in meconium from children who had a higher risk for developing brain and nervous system disorders. When the children were 12 months old, researchers tested their motor, visual, and language skills. Researchers used meconium samples rather than the mother’s urine to capture longer-term fetal exposure to phthalates.

What happens next?

Future prenatal phthalate exposure studies using meconium samples from newborn infants could investigate the differing effects of phthalate exposure on male versus female infants in order to better understand the reasons why these differences may occur.

Where can I learn more?

Access the full journal article, titled “The associations between prenatal phthalate exposure measured in child meconium and cognitive functioning of 12-month-old children in two cohorts at elevated risk for adverse neurodevelopment,” 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 November 2022

Download this summary

Exposure to Certain Phthalates During Pregnancy May Affect Brain Development in Infant Girls

Diabetes and Depression During Pregnancy May Be Linked to Higher Risk of Postpartum Depression in Mothers

<< Back to Research Summaries

Diabetes and Depression During Pregnancy May Be Linked to Higher Risk of Postpartum Depression in Mothers

Author(s): Lauren Shuffrey, 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 found that participants with gestational diabetes were more likely to be classified as having prenatal depression compared to those without gestational diabetes. Participants with both gestational diabetes and prenatal depression had an increased risk of developing postpartum depression. But gestational diabetes on its own, without prenatal maternal depression, was not linked to an increased risk of postpartum depression.

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?

These findings underscore the importance of universal depression screenings during pregnancy and for at least a year following birth.

Why was this study needed?

There is a lack of research into how the combination of gestational diabetes (a type of diabetes that develops during pregnancy) and prenatal depression affects a person’s risk for postpartum depression.

Who was involved?

This study included 5,822 participants from 16 ECHO cohorts across 13 U.S. states and Puerto Rico. A total of 4,606 participants had neither gestational diabetes nor prenatal depression, 416 had gestational diabetes only, 689 had prenatal maternal depression only, and 111 had both gestational diabetes and prenatal maternal depression.

What happened during the study?

Researchers collected information from the participants including gestational diabetes diagnosis and self-assessments of depression symptoms during and after pregnancy. The researchers then used that data to evaluate the relationship between gestational diabetes, prenatal depression, and postpartum depression.

What happens next?

Future studies should examine potential mechanisms underlying the relationship between gestational diabetes, prenatal depression, and postpartum depression. The ECHO Program is currently working towards analyzing blood samples collected during pregnancy to identify potential factors involved in this relationship.

Where can I learn more?

Access the full journal article, titled “Gestational Diabetes Mellitus, Prenatal Maternal Depression, and Risk for Postpartum Depression: An Environmental Influences on Child Health Outcomes (ECHO) Study” in BMC Pregnancy and Childbirth.

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

Published October 8, 2022

Access the associated article.

Download this summary

Diabetes and Depression During Pregnancy May Be Linked to Higher Risk of Postpartum Depression in Mothers

During the COVID-19 Pandemic, Children’s Sleep Schedules Changed, But Their Time Asleep Stayed the Same

<< Back to Research Summaries

During the COVID-19 Pandemic, Children's Sleep Schedules Changed, But Their Time Asleep Stayed the Same

Authors: 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?

During the COVID-19 pandemic, children in the United States went to bed later, woke up later, and took longer to fall asleep, but their overall time spent asleep did not change. Interviews with caregivers revealed that they prioritized routines to maintain their children’s amount of sleep but were more flexible about bedtime. Across all time periods studied, children from racial and ethnic minority communities went to bed later, slept less, and napped more often.

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 investigating changes in childhood sleep habits in the United States during the COVID-19 pandemic using data collected before and during the pandemic. The researchers found significant changes in children’s sleep habits, as well as differences in children’s sleep behaviors between racial/ethnic groups. These results highlight potential areas for future research and support the need to examine and address root causes of racial/ethnic sleep disparities in childhood.

Why was this study needed?

Sleep health during childhood is important for overall health and brain development. Poor sleep can increase a child’s risk for chronic illnesses, behavioral problems, and poor memory. Factors that affect sleep health may have been significantly impacted by the COVID-19 pandemic due to lockdowns and curfews, increased stress, and changes in social support. Many studies have shown that, due to systemic and structural inequities, the pandemic has affected the health behaviors of children differently based on their socioeconomic status, race, and ethnicity. These differences may worsen existing gaps in children’s health.

Several studies have reported on how the pandemic has affected childhood sleep habits, but few of these studies involved children in the United States. Most previous studies have relied on self-reported or time-limited data and have focused primarily on early stages of the pandemic. The goal of this study was to investigate changes in nighttime sleep habits and frequency of daytime naps during the COVID-19 pandemic.

Who was involved?

This study included 528 children aged 4 to 12 from 14 ECHO cohorts across the United States. The caregivers of 38 participants provided additional information about how they thought their children’s sleep habits may have been affected by the COVID-19 pandemic.

What happened during the study?

The researchers compared data from before the pandemic with data collected at two different time periods during the pandemic. They used this data to examine the length of time it took children to fall asleep, time spent asleep at night during the week and on weekends, and the frequency of later bedtimes and daytime naps. They also collected sociodemographic information (child sex, age, race and ethnicity, maternal education) from self-reports and medical records.

What happens next?

ECHO researchers are currently analyzing and publishing results on changes in diet, physical activity, and screen time during the COVID-19 pandemic from the same cohort of children.

Where can I learn more?

Access the full journal article, titled “Impact of the COVID-19 pandemic on children’s sleep habits: an ECHO study,” in Pediatric Research.

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

Published October 4, 2022

Access the associated article.

Download this summary

During the COVID-19 Pandemic, Children's Sleep Schedules Changed, But Their Time Asleep Stayed the Same

ECHO Study Compares Cross-Cultural Patterns of Attention Linked to Underlying Behavior Problems in Children

<< Back to Research Summaries

ECHO Study Compares Cross-Cultural Patterns of Attention Linked to Underlying Behavior Problems in Children

Authors: Sara Nozadi, Andréa Aguiar, 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?

Patterns of attention were similar across the two groups of children despite the differences in their cultures, demographics, or assessment settings. Overall, children paid more attention to emotional faces compared to neutral faces. They were particularly quick to identify angry faces, which might be an adaptive response to a perceived threat. These findings replicate previous research results with both adults and children.

Indigenous children with socially withdrawn behaviors avoided emotional faces—a response observed in children with higher levels of socially withdrawn behaviors from other populations.

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 work suggests that eye tracking can be used as an objective measure of attention patterns in children across different settings and cultures, which can help researchers and clinicians more reliably identify children with early behavior problems. Because eye tracking technology does not rely on clinical observations or parents’ reports, it can be used as an unbiased measure across different communities to validate data collected through clinical assessments and parent reports in hard-to-reach communities.

Why was this study needed?

Humans tend to give more attention to emotional information than neutral information. Past research indicates departures from this pattern typically occur in children with socially withdrawn behaviors. However, this research is limited because it has been conducted mostly in controlled settings among primarily White children from urban areas.

In this study, ECHO researchers examined the extent to which two eye-tracking–based measures could be used cross-culturally to assess attention biases and how these biases might relate to children’s socially withdrawn behaviors.

Who was involved?

To evaluate whether eye-tracking technology could be applied effectively across cultures, researchers compared information from two ECHO cohorts that were very different demographically, geographically, racially, and culturally.

The researchers analyzed data from 125 children from the Navajo Birth Cohort Study, a cohort of indigenous children with relatively low socioeconomic status (SES) living in rural tribal lands, and 70 children from the Illinois Kids Development Study (IKIDS), a primarily Non-Hispanic White and high-SES cohort living around the University of Illinois at Urbana-Champaign campus in central Illinois.

What happened during the study?

Children between the ages of 3.5 years to 5.5 years completed two eye-tracking tasks that measured their attention to photos of human faces with positive, negative, and neutral expressions. Indigenous children were assessed in different locations in the Navajo territory, whereas IKIDS children came to a research laboratory in the University campus. Mothers also reported on children’s socially withdrawn behaviors, such as avoiding eye contact, using the Child Behavioral Checklist—a survey commonly used in research and clinical settings to evaluate risk for behavioral and emotional problems in children.

What happens next?

The researchers will look at how the responses they see in these young children change with age and determine whether eye tracking continues to be an unbiased tool for assessing attention throughout development.

Where can I learn more?

Access the full journal article titled “Cross-Cultural Applicability of Eye-Tracking in Assessing Attention to Emotional Faces in Preschool-Aged Children” published in the Emotion Journal.

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

Published: September 15, 2022

Access the associated article.

Download this summary

ECHO Study Compares Cross-Cultural Patterns of Attention Linked to Underlying Behavior Problems in Children

ECHO Study Reveals Pregnant Women Are Exposed to Dangerous Chemicals Found in a Variety of Household Products

<< Back to Research Summaries

ECHO Study Reveals Pregnant Women Are Exposed to Dangerous Chemicals Found in a Variety of Household Products

Authors: Giehae Choi, Jessie Buckley, Tracey 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?

Melamine and cyanuric acid were found in over 99% of the study participants. Four types of aromatic amines were also found in nearly all pregnant participants. Levels of these chemicals were higher among Hispanic and non-Hispanic Black participants and in those exposed to tobacco smoke. For example, levels of 3,4-dichloroaniline—a chemical used in the production of dyes and pesticides—were more than 100% higher among Black and Hispanic women compared to White women.

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 first national study to reveal that pregnant women in the U.S. are widely exposed to melamine, cyanuric acid, and aromatic amines—chemicals that may be harmful to maternal health and child development. This raises concerns for the health of pregnant women and babies.

Why was this study needed?

Chemicals like melamine, cyanuric acid, and aromatic amines are commonly used to make a variety of household products. Melamine can be found in dishware, plastics, flooring, kitchen counters, and pesticides. Cyanuric acid can be found in disinfectants, plastics, and swimming pools. And aromatic amines can be found in hair coloring, mascara, tattoo ink, paints, tobacco smoke, and diesel fumes. People can be exposed to these chemicals through the air, contaminated food, household dust, water, plastics, products that contain dyes and pigments, and many other sources.

Melamine was globally recognized as toxic after baby formula poisoning incidents in 2007 to 2008, which resulted in health problems in children including kidney stones, kidney failure, and in some cases, death. Research suggests that melamine may also be linked to reduced brain development. There is limited research on the effects of melamine on adults, although preliminary evidence suggests that it may be linked to cancer and other negative health outcomes. Prior studies on melamine were only conducted among pregnant women in Asian countries or limited to non-pregnant women in the U.S. Despite melamine’s potential harm and common use in household products, population-level exposure is not regularly monitored in the U.S.

Who was involved?

This study included 171 pregnant participants from nine ECHO cohorts located in California, Georgia, Illinois, New Hampshire, New York, and Puerto Rico. Of these participants, 40% were Hispanic, 34% were White, 20% were Black, 4% were Asians, and the remaining 2% were from other or multiple racial groups.

What happened during the study?

Researchers measured the levels of 45 chemicals in urine samples collected from participants during pregnancy. They used new methods to capture the levels of these chemicals in the urine samples, even those present in small amounts. Then, the researchers compared chemical levels across participants with different sociodemographic backgrounds.

What happens next?

Researchers are expanding on this study to look at the effects of higher exposures to these chemicals during pregnancy in over 1,700 pregnant participants and investigate whether these exposures are linked with child health outcomes.

Where can I learn more?

Access the full journal article, titled “Exposure to melamine and its derivatives and aromatic amines among pregnant women in the United States: The ECHO Program,” in Chemosphere.

Published August 30, 2022

Access the associated article.

Download this summary

ECHO Study Reveals Pregnant Women Are Exposed to Dangerous Chemicals Found in a Variety of Household Products

During the COVID-19 Pandemic, Children’s Screen Time Increased

<< Back to Research Summaries

During the COVID-19 Pandemic, Children's Screen Time Increased

Authors: Traci Bekelman, 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 found that overall children’s screen time increased significantly during the pandemic with Hispanic children and non-Hispanic Black children having the most noticeable increase in screen time. The study didn’t find any significant increase in the amounts of sugary drinks and unhealthy snack foods children consumed during the pandemic, but it did find a more noticeable increase among Hispanic children and older children. The amount of time children spent asleep increased but only among children whose sleep time was below the recommended range before the 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?

This study shows how the disruptions caused by the COVID-19 pandemic affected children’s daily lives. The results of this study suggest that the pandemic may have worsened sociodemographic disparities for some child health behaviors, particularly in relation to the amount of time children spent looking at screens. This research suggests that families may need more support to re-establish healthy routines and reduce the negative effects of the pandemic on their children’s health behaviors.

Why was this study needed?

For many children, public health measures to mitigate the spread of the COVID-19 pandemic disrupted their daily routines, and prevented them from using community resources, such as parks and organized sports. During the first few months of the pandemic, there were changes in children’s health behaviors—such as diet, screen time, physical activity, and sleep habits. However, there are limited data on what happened to children’s health behaviors after the earliest, most restrictive lockdown period. This is an important topic because children’s health behaviors have been linked to their overall mental and physical health, academic achievement, and quality of life.

Who was involved?

The study included 347 children between the ages of 4 to 12 years and their caregivers recruited from ECHO cohorts in California, Colorado, North Dakota, and New Hampshire. Of those participants, 47% percent were female, and 62% were non-Hispanic White.

What happened during the study?

ECHO researchers collected data on children’s diet, physical activity, screen time, and sleep habits before and during the pandemic. The researchers also surveyed caregivers on how they thought their children’s health behaviors had changed during the pandemic. This study also explored how sociodemographic factors affected children’s health behaviors to identify children who are more likely to experience less recommended changes in behaviors.

What happens next?

This research may help us identify ways to support families with children in future public health emergencies. The ECHO Program is currently working to study changes in other related health behaviors. This includes changes in how well children follow national dietary guidelines, use of social media, and bedtimes/wake-up times.

Where can I learn more?

Access the full journal article, titled “Health Behavior Changes during the COVID-19 Pandemic: A Longitudinal Analysis among Children,” 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 August 19, 2022

Access the associated article.

Download this summary

During the COVID-19 Pandemic, Children's Screen Time Increased