ECHO Researchers Investigate Effects of Preterm Birth, Environmental Exposures on Child Health

Authors: Michael O’Shea, Monica McGrath, Judy Aschner, Barry Lester, 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?

ECHO researchers are collecting extensive data from very preterm infants, including data on learning and intellectual impairments, asthma, obesity, sleep health, and the effects of the COVID-19 pandemic. This article provides an overview of how data from ECHO cohorts are being used to address questions about the combined effects of preterm birth and environmental exposures on child health outcomes.

What was the study's impact?

Researchers can use the information in this review to enhance their knowledge of the ECHO Program’s resources to study preterm infants. Researchers can use ECHO data to investigate the relationship between preterm birth, environmental exposures, and childhood risk of chronic and developmental health conditions.

Why was this study needed?

Infants who are born premature (before 32 weeks of pregnancy) are at a high risk for multiple health disorders. This review paper outlines resources available within the ECHO Program for researchers seeking to study the effects of preterm birth and environmental exposures on child health outcomes.

Who was involved?

This review article includes ECHO cohorts that enrolled infants who were born premature. These cohorts enrolled almost 1,800 preterm infants across 14 states that were born between April 2002 and March 2020, including three ECHO cohorts that are almost exclusively comprised of preterm infants.

What happened during the study?

A team of experts reviewed the characteristics of the ECHO cohorts that are collecting data on preterm infants. Through this review, they sought to describe the research goals, participant selection criteria, key environmental exposures, and child health outcomes of each cohort.

What happens next?

ECHO researchers will continue to investigate early life factors and environmental exposures that may affect children’s health outcomes later in life. Researchers not participating in the ECHO Program will be able to obtain de-identified data from preterm children in the ECHO-wide Cohort, along with data from around 30,000 children born at term through a controlled-access public use database. This data will include information about a broad range of environmental exposures and outcomes related to chronic illness among children in the United States. Using this data, researchers can continue to build off of ECHO’s mission to enhance the health of children for generations to come.

Where can I learn more?

Access the full journal article, titled “Environmental influences on Child Health Outcomes: Cohorts of Individuals Born Very Preterm,” 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 August 10, 2022

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ECHO Researchers Investigate Effects of Preterm Birth, Environmental Exposures on Child Health

ECHO Study Suggests Air Pollution, Secondhand Smoke, Formaldehyde Exposure Affect Length of Time to Get Pregnant

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ECHO Study Suggests Air Pollution, Secondhand Smoke, Formaldehyde Exposure Affect Length of Time to Get Pregnant

Author(s): Eva Siegel, Linda Kahn, et al.

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, the Office of the Director, the National Institutes of Health, with co-funding from the Office of Behavioral and Social Sciences Research (OBSSR).

What were the study results?

The strongest evidence points to an association between exposures to traffic-related air pollution, secondhand smoke, and a chemical called formaldehyde—a common workplace exposure in construction sites and nail salons—and longer time to pregnancy. Specifically, exposure to particulate matter and nitrogen oxide gases lowered couples’ chances of becoming pregnant. Traffic and the burning of other types of materials besides gas and diesel create particulate matter and nitrogen oxide gases. Volatile organic compounds, which are used in manufacturing processes, did not appear to affect time to pregnancy.

What was the study's impact?

This review suggests that certain chemicals in the air may lengthen the time it takes for couples to become pregnant. More research is needed to better understand how these chemicals affect reproductive health. To collect this information, future studies can provide participants with personal air monitors that can let researchers know about the quality of air participants are actually breathing instead of relying on imprecise data from outdoor monitors or participant recall.

The research team also pointed out that there are remaining questions about whether the air people breathe around the time of conception is what matters most or whether there are certain life stages, such as puberty, when being exposed to air pollution may be especially damaging. The ECHO-wide Cohort, which allows researchers to access information from a large and diverse population, can serve as an important resource for answering these questions.

Why was this study needed?

Previous studies have looked at how air pollution may affect how long it takes to become pregnant. Time to pregnancy is a measure used to estimate a couple’s ability to conceive and is commonly used to diagnose infertility. In this paper, the authors review past studies on air pollution to identify types of air pollutants—including pollution from traffic, chemicals in the workplace, and secondhand smoke—that might affect how long it takes to get pregnant.

Who was involved?

This review includes all papers published in English on this topic from January 1, 1990 to February 11, 2021. The analysis covered 33 articles, of which eight looked at outdoor air quality, six looked at secondhand smoke exposure, and 19 looked at air quality in the workplace.

What happened during the study?

The research team searched six leading science libraries and identified 33 human studies related to exposure to outdoor and indoor air pollutants and time to pregnancy. The team read each article, assigned it a score based on the quality of the study design, and created summary tables containing the most important findings of each study. They then compared the consistency of results between studies, especially among high-quality papers, about whether certain types of air pollution affected time to pregnancy.

What happens next?

This is the third review this team of authors has written on chemicals and time to pregnancy. Individual authors will continue to fill in the research gaps previously mentioned, including conducting studies where women will be wearing personal air monitors.

Where can I learn more?

Access the full journal article, titled “Indoor and outdoor air pollution and couple fecundability: a systematic review” in Human Reproduction Update.

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

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Published July 27, 2022

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ECHO Study Suggests Air Pollution, Secondhand Smoke, Formaldehyde Exposure Affect Length of Time to Get Pregnant

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

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

Author(s): Sheena Martenies, et al.

Who sponsored this study?

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

What were the study results?

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

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

What was the study's impact?

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

Why was this study needed?

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

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

Who was involved?

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

What happened during the study?

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

What happens next?

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

Where can I learn more?

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

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

Published July 21, 2022

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

During the Pandemic, Children Whose Parents Had Flexible Work Schedules and More Financial Security Were More Likely to Have Less Screen Time and More Sleep

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During the Pandemic, Children Whose Parents Had Flexible Work Schedules and More Financial Security Were More Likely to Have Less Screen Time and More Sleep

Authors: Traci Bekelman, Katherine Sauder, et al.

Who sponsored this study?

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

What were the study results?

Children with parents who were able to change their work schedule to care for their children during the pandemic had less screen time and slept longer at night. Children with parents who were stressed about money and access to food and therefore unable to change their work schedule, drank more sugary drinks, were less active, and slept less at night. Similar to pre-pandemic study results, what children ate and their level of physical activity differed by their age and sex.

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 children’s diet, physical activity, and sleep behaviors during the pandemic were linked to the work schedules and stress of their parents. Parents stressed about money may need help getting their kids to be more active, eat better, use technology less, and sleep more.

Why was this study needed?

The COVID-19 pandemic changed family habits and financial situations for many. ECHO researchers wanted to know how parents' coping strategies, stress, and financial situations affected their children’s health behaviors during the first seven months of the pandemic.

Who was involved?

This study included 3,315 children between 3 and 17 years from 50 ECHO cohorts across the United States. Information about the children’s sex, age, race, and ethnicity were reported by a parent or found in their medical records.

What happened during the study?

Parents answered questions about their child’s diet, physical activity, screen time, and sleep during the first seven months of the COVID-19 pandemic. The parents also described how they were personally coping with the pandemic and what they were most stressed about.

What happens next?

ECHO researchers will continue to look at how financial stress and parents’ work schedules affect children’s health behaviors. This will help guide future strategies to encourage healthy behaviors among children even during stressful times like a pandemic.

Where can I learn more?

Access the full journal article, titled “Sociodemographic Variation in Children's Health Behaviors During the COVID-19 Pandemic,” in Childhood Obesity.

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

Published July 19, 2022

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During the Pandemic, Children Whose Parents Had Flexible Work Schedules and More Financial Security Were More Likely to Have Less Screen Time and More Sleep

During the COVID-19 Pandemic, Children Gained Weight Faster

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During the COVID-19 Pandemic, Children Gained Weight Faster

Authors: Emily Knapp, Aruna Chandran, 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?

Results from this study show that during the COVID-19 pandemic, children gained weight at an increased rate compared to the years before the pandemic. Children who had obesity before the pandemic gained weight at a faster rate during the pandemic compared to children who were in a healthy weight range pre-pandemic. Children in higher income households were at a lower risk of excess weight gain during 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 highlights the need for programs and services to prevent and reduce the physical and mental health effects of the COVID-19 pandemic on children.

Why was this study needed?

Childhood obesity is a serious health condition that can affect long-term health and quality of life. There was concern among researchers and doctors that the COVID-19 pandemic may cause incidence of childhood obesity to increase due to the closure of schools and cancellation of recreational activities, leading to less physical activity and changes in eating habits.

Who was involved?

This study included 1,966 participants ages 2 through 18 years old from 38 ECHO cohorts across the United States.

What happened during the study?

The researchers compared annual changes in children’s body mass index (BMI)—a measure used to estimate body fat—before and during the pandemic. The researchers also took into account child’s age, sex, race and ethnicity, pre-pandemic BMI, mother’s education, and household income.

What happens next?

Future studies should explore strategies to support families during the COVID-19 pandemic. As the pandemic continues to alter children’s lives, it will be important to monitor changes in health outcomes among children and use these data to build programs to reduce health inequities.

Where can I learn more?

Access the full journal article, titled “Changes in BMI during the COVID-19 Pandemic” in Pediatrics.

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

Published June 30, 2022

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During the COVID-19 Pandemic, Children Gained Weight Faster

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

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

Author(s): Maristella Lucchini, et al.

Who sponsored this study?

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

What were the study results?

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

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

What was the study's impact?

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

Why was this study needed?

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

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

Who was involved?

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

What happened during the study?

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

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

What happens next?

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

Where can I learn more?

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

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

Published June 21, 2022

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

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

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

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

Who sponsored this study?

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

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

What were the study results?

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

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

What was the study's impact?

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

Why was this study needed?

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

Who was involved?

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

What happened during the study?

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

What happens next?

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

Where can I learn more?

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

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

Published June 16, 2022

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

ECHO Study Links Poor Neighborhood Conditions With Higher Risk of Asthma in Children

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ECHO Study Links Poor Neighborhood Conditions With Higher Risk of Asthma in Children

Author(s): Antonella Zanobetti, Patrick H. Ryan, 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?

Of the 5,809 children studied, 46% experienced wheezing in their first year of life, with 26% having wheezing through age 11. Diagnosis of asthma by age 11 varied by cohort, with an overall median prevalence of 25%. Children in neighborhoods with more people, and with more families with lower incomes, experienced more asthma and early and persistent wheezing. Black and Hispanic children remained at higher risk for asthma than White children, even in wealthier neighborhoods.

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 neighborhood characteristics at birth and race/ethnicity play a role in the development of childhood wheezing and asthma. This information can help inform strategies to reduce childhood asthma, including strategies that address the socioeconomic factors that create higher risks for Black and Hispanic children.

Why was this study needed?

In the United States, Black and Hispanic children have higher rates of asthma compared to White children and more often live in communities where households struggle to meet their basic needs. The objective of this study was to explore how much neighborhood-level socioeconomic factors, like income and education, contribute to differences in childhood wheezing and asthma between Black, White, and Hispanic children.

Who was involved?

Almost 6,000 children across the United States born between the 1980s and 2010s.

What happened during the study?

The team used questionnaires and interviews to collect information such as wheezing and asthma occurrence, medical history, and demographics. Each child’s home address was matched to U.S. Census data for the decade closest to their birth year. Researchers studied how children’s race/ethnicity and their mother’s education level and smoking habits, plus their neighborhood socioeconomic conditions, were related to wheezing – a symptom involving whistling breathing sounds due to narrowed airways – and asthma.

Where can I learn more?

Access the full journal article, titled “Childhood Asthma Incidence, Early and Persistent Wheeze, and Neighborhood Socioeconomic Factors in the ECHO/CREW Consortium” in JAMA Pediatrics.

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

Published May 23, 2022

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ECHO Study Links Poor Neighborhood Conditions With Higher Risk of Asthma in Children

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

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

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

Who sponsored this study?

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

What were the study results?

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

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

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

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

What was the study's impact?

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

Why was this study needed?

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

Who was involved?

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

What happened during the study?

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

What happens next?

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

Where can I learn more?

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

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

Published May 10, 2022

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

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

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

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

Who sponsored this study?

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

What were the study results?

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

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

What was the study's impact?

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

Why was this study needed?

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

Who was involved?

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

What happened during the study?

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

What happens next?

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

Where can I learn more?

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

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

Published April 29, 2022

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