Collaborative ECHO research led by Giehae Choi, PhD and Jessie Buckley, PhD, both of Johns Hopkins University, along with Tracey Woodruff, PhD, MPH of the University of California, San Francisco, investigates whether pregnant women are exposed to potentially dangerous chemicals commonly found in a variety of household products, including plastics, disinfectants, and products that contain dyes or pigments. Two of these chemicals, melamine and cyanuric acid, were found in over 99% of study participants, and exposure to four different types of aromatic amines were also found in nearly all participants. Levels of these chemicals were higher among participants of color and those exposed to tobacco smoke. This research, titled “Exposure to melamine and its derivatives and aromatic amines among pregnant women in the United States: The ECHO Program,” is published in Chemosphere.

This research focused on melamine, along with related chemicals like cyanuric acid and aromatic amines. Even though these chemicals are found in a wide variety of household products, their exposures are not regularly monitored in human populations. In general, people can be exposed to harmful chemicals through the air, contaminated food, household dust, water, plastics, products that contain dyes and pigments, tobacco smoke, diesel fumes, and more. Melamine is known to cause health problems in children, but there is limited research on its effects in pregnant women, and in adults in general.

To address this gap, this study used new methods to measure the levels of 45 chemicals in urine samples from 171 pregnant participants across nine ECHO cohorts. 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. The researchers also examined data on the participants’ race and ethnicity, age, education, and marital status to determine whether chemical exposure was higher in different sociodemographic groups. Levels of most chemicals were higher among Black and Hispanic women. 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.

“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,” said Dr. Choi. “This raises concerns for the health of pregnant women and babies.”

Future research will expand this study to include over 1,700 pregnant participants and investigate whether higher exposure to these chemicals during pregnancy might be related to negative child health outcomes.

Read the research summary.

A recent review paper authored by Michael O’Shea, MD of the University of North Carolina at Chapel Hill, Monica McGrath, PhD of Johns Hopkins University, and Judy Aschner, MD of Hackensack University, and Barry Lester, PhD of Brown University’s Alpert Medical School provides an overview of the collaborative work ECHO has been doing to study and collect data on the effects of premature birth on child health outcomes. The article describes ECHO cohorts that have enrolled premature infants (born before 32 weeks of gestation) between April 2002 and March 2020, including three ECHO cohorts that are almost exclusively comprised of preterm infants. Researchers can use ECHO data to investigate the relationship between preterm birth, environmental exposures, and childhood chronic and developmental health conditions. This research, titled “Environmental influences on Child Health Outcomes: Cohorts of Individuals Born Very Preterm,” is published in Pediatric Research.

The ECHO Cohorts included in this review recruited almost 1,800 preterm infants from 14 states. ECHO researchers are collecting extensive data from these preterm infants, including data on learning and intellectual impairments, asthma, obesity, sleep health, and the effects of the COVID-19 pandemic. Researchers can use this data to address questions about 1) the effect of preterm birth on a child’s risk for chronic and developmental health conditions; 2) socioeconomic disparities in child health outcomes; and 3) the relationship between early life exposures and health outcomes later in life among individuals born preterm.

“Our goal is for this review article to serve as a ‘roadmap’ to aid child health researchers in their efforts to apply data from the ECHO preterm cohorts toward the broad goals of the ECHO program,” said Dr. O’Shea. “This resource provides researchers with many opportunities to improve their understanding of modifiable risk factors and mechanisms leading to chronic illness in children, pointing the way towards interventions that can optimize the well-being of children in the United States.”

Researchers not affiliated with the ECHO Program will be able to obtain de-identified data from very 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 through research that may help inform healthcare practices, programs, and policies.

Read the research summary.