depression

Exposure to Certain Flame-retardant Chemicals During Pregnancy May Be Associated with Behavioral Issues in Young Children

Posted on by Jodi Snare

Exposure to certain organophosphate esters (OPEs)—chemicals commonly used as flame retardants and plastic softeners in a variety of household and industrial products—during pregnancy was associated with more behavioral issues in young children, according to a new ECHO Cohort study led by Jiwon Oh, PhD and Deborah Bennett, PhD of the University of California, Davis.

Previous research has linked exposure to OPEs during pregnancy with potential adverse effects on child brain development, but more evidence is needed. In this study, researchers investigated the association between prenatal exposure to OPEs and child behaviors. The study included 2,948 mother-child pairs from 12 ECHO Cohort study sites across the U.S., and the investigators used the Child Behavior Checklist for ages 1½–5 to assess each child’s behavior during early childhood.

Among the nine OPEs measured, diphenyl phosphate (DPHP) was detected in almost all pregnant women (99.5%) and had the highest median concentration.  Other frequently detected OPEs included dibutyl phosphate/di-isobutyl phosphate (DBUP/DIBP), bis (1,3-dichloro-2-propyl) phosphate (BDCPP), bis(2-chloroethyl) phosphate (BCETP), bis(2-butoxyethyl) phosphate (BBOEP), and bis(1-chloro-2-propyl) phosphate (BCPP).

“This research builds on a growing body of evidence of potential harm caused by exposures to OPEs,” said Dr. Bennett.

Key Takeaways include:

  • Prenatal exposure to BBOEP (at moderate concentrations rather than high concentrations) was associated with more internalizing behaviors (e.g., anxiety, depression), externalizing behaviors (e.g., aggression, hyperactivity), and total behavior issues in young children.
  • Exposure to BCPP was associated with more externalizing behaviors and total behavior issues.
  • Detectable dipropyl phosphate (DPRP) was associated with fewer externalizing behaviors.
  • Boys showed more behavior issues associated with prenatal BDCPP and BCPP exposure.
  • Children from highly vulnerable neighborhoods—defined by community-level demographics, socioeconomic status, housing, access to transportation, and other factors—exhibited more behavior issues associated with prenatal BCPP exposure.

“While further research is needed, our findings suggest that reducing exposure to this chemical class during pregnancy may help mitigate emotional and behavioral problems in young children,” said Dr. Oh.

This collaborative research, titled “Prenatal Exposure to Organophosphate Ester Flame Retardants and Behavioral Outcomes in Early Childhood in the Environmental influences on Child Health Outcomes (ECHO) Cohort,” is published in Environment International.

Read the research summary.

Exposure to Common Flame-retardant Chemicals During Pregnancy May Be Associated with Behavioral Issues in Young Children, ECHO Study Finds

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Exposure to Common Flame-retardant Chemicals During Pregnancy May Be Associated with Behavioral Issues in Young Children, ECHO Study Finds

Author(s): Jiwon Oh, 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.

 

Why was this study needed?

Organophosphate esters (OPEs) are chemicals commonly used as flame retardants and plastic softeners in a variety of household and industrial products, including furniture, electronics, infant products, and fabrics. Previous research has linked exposure to OPEs during pregnancy with potential adverse effects on child brain development, but more evidence is needed. In this study, researchers investigated the association between prenatal exposure to OPEs and child behaviors.

 

What were the study results?

Among the nine OPEs measured, diphenyl phosphate (DPHP) was detected in almost all pregnant women (99.5%) and had the highest median concentration. Other frequently detected OPEs included dibutyl phosphate/di-isobutyl phosphate (DBUP/DIBP), bis (1,3-dichloro-2-propyl) phosphate (BDCPP), bis(2-chloroethyl) phosphate (BCETP), bis(2-butoxyethyl) phosphate (BBOEP), and bis(1-chloro-2-propyl) phosphate (BCPP).

Prenatal exposure to BBOEP (at moderate concentrations rather than high concentrations) was associated with more internalizing behaviors (e.g., anxiety, depression, emotional reactivity), externalizing behaviors (e.g., aggression, inattention), and total behavior issues in young children. Exposure to BCPP was associated with more externalizing behaviors and total behavior issues. In contrast, detectable dipropyl phosphate (DPRP) was associated with slightly  fewer externalizing behaviors. Boys showed more behavior issues associated with prenatal BDCPP and BCPP exposure. Children from highly vulnerable neighborhoods—defined by community-level demographics, socioeconomic status, housing, access to transportation, and other factors—exhibited more behavior issues associated with prenatal BCPP exposure.

 

What was the study's impact?

Use of OPEs is increasing, with widespread exposure observed in pregnant women. While further research is needed, this study suggests that reducing exposure to certain chemicals during pregnancy may help mitigate emotional and behavioral problems in young children.

 

Who was involved?

The study included 2,948 mother–child pairs from 12 ECHO Cohort study sites across the United States. Non-Hispanic White (40.2%), non-Hispanic Black (28.6%), and Hispanic (21.3%) mothers were included in the study. Most participating mothers (85.2%) did not experience major pregnancy complications and most of their children (93.2%) were born after at least 37 weeks of pregnancy.

 

What happened during the study?

During the study, researchers collected urine samples from pregnant participants and analyzed them for nine chemical markers of OPE exposure. Later, researchers assessed the child’s behaviors using the Child Behavior Checklist for Ages 1½–5. The researchers then used statistical methods to examine associations between each OPE exposure during pregnancy and behavioral issues in children. The study also evaluated how other factors, like the child’s sex and their social vulnerability, may have influenced the effect of prenatal OPE exposure on their behavior.

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 could help researchers better understand the effects of prenatal OPE exposure on child brain development and determine whether reducing these exposures could be beneficial to children’s health and development.

 

Where can I learn more?

Access the full journal article, titled “Prenatal Exposure to Organophosphate Ester Flame Retardants and Behavioral Outcomes in Early Childhood in the Environmental influences on Child Health Outcomes (ECHO) Cohort,” in Environment International.

 

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

Published August, 2025

Read the related research alert.

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Exposure to Common Flame-retardant Chemicals During Pregnancy May Be Associated with Behavioral Issues in Young Children, ECHO Study Finds

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NIH Study Suggests Behavioral and Emotional Challenges More Common in Children with Autism Spectrum Disorder (ASD)

Posted on by Jodi Snare

Children with autism spectrum disorder (ASD) showed higher levels of emotional and behavioral problems, including depression, anxiety, and ADHD, compared to their peers without ASD, according to a new study funded by the National Institutes of Health (NIH) Environmental influences on Child Health Outcomes (ECHO) Program.

Key Takeaways:

  • Children with ASD had higher scores on the Child Behavior Checklist (CBCL)—a questionnaire that helps identify emotional and behavioral challenges in children and adolescents—showing they may experience more emotional and behavioral challenges overall.
  • Higher CBCL scores were linked to the likelihood of receiving an ASD diagnosis, particularly for children scoring in the top 30%.
  • Among children with ASD, girls experienced significantly higher levels of anxiety and depression compared to boys, with age-related differences in symptom severity.
  • Autism-related traits measured by the Social Responsiveness Scale (SRS) were associated with higher CBCL scores, suggesting that children with more autism traits may face additional emotional and behavioral challenges.

These findings highlight the importance of monitoring and addressing emotional and behavioral health in children with ASD to better inform early interventions. To learn more, access the study online.

Read the research summary.

ECHO Study Suggests Children with Autism Are More Likely to Experience Emotional & Behavioral Challenges Like Anxiety, Depression, & ADHD

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ECHO Study Suggests Children with Autism Are More Likely to Experience Emotional & Behavioral Challenges Like Anxiety, Depression, & ADHD

Authors: Heather E. Volk, et al.

 

Who sponsored this study?

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

 

Why was this study needed?

The study aimed to understand how common behavioral and emotional problems are in children with autism spectrum disorder (ASD), using a large national group of participants and looking at differences between boys and girls. It also explored whether children with greater difficulties in social communication related to ASD tend to have more behavioral and emotional challenges.

 

What were the study results?

Children with ASD had higher scores on the Child Behavior Checklist (CBCL)—a questionnaire that helps identify emotional and behavioral problems in children and adolescents. Higher CBCL scores among children with ASD indicate a possible connection to greater emotional and behavior problems overall—including depression, anxiety, and ADHD—compared to children without ASD. Conversely, higher CBCL scores were strongly linked to the likelihood of receiving an ASD diagnosis, especially for children scoring in the top 30%. Among children with ASD, girls showed significantly higher levels of anxiety and depression compared to boys, with differences depending on their age. As autism-related traits measured by the Social Responsiveness Scale (SRS) increased, CBCL scores also rose, suggesting that children with more autism-related traits might also experience other emotional or behavioral challenges.

 

What was the study's impact?

This study suggests that increased monitoring of behavioral and emotional problems may be beneficial for children with ASD. The results of this study indicate that children with ASD may be more likely to experience these issues throughout their early life.

 

Who was involved?

The study included 7,998 children from 37 ECHO Cohort Study Sites across the United States. This included 553 children who had a clinician diagnosis of ASD, including 432 boys and 121 girls.

 

What happened during the study?

The study surveyed parents of children aged 2.5 years to 18 years to collect information about their child's demographics, ASD diagnoses from a doctor, and scores from two behavior assessments: the SRS and the CBCL. Researchers compared average CBCL scores, which measure emotional and behavioral problems, based on whether the child had ASD and whether they were male or female. They also used statistical methods to see if children with ASD were more likely to have higher CBCL scores and to understand how SRS scores related to CBCL scores.

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?

Additional research could help researchers understand what kinds of support and interventions could be effective for children with ASD, who may be more likely to experience emotional and behavioral challenges.

 

Where can I learn more?

Access the full journal article, titled “Co-occurring Psychopathology in Children with and without Autism Spectrum Disorder (ASD): Differences by Sex in the ECHO Cohorts,” in Journal of Autism and Developmental Disorders.

 

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

Published January 6, 2025

Read the related research alert.

Download this summary

ECHO Study Suggests Children with Autism Are More Likely to Experience Emotional & Behavioral Challenges Like Anxiety, Depression, & ADHD

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ECHO Study Suggests Maternal Sleep During Second Trimester of Pregnancy May be Associated with ADHD Symptoms and Sleep Quality in Early Childhood

Authors: Claudia Lugo-Candelas, Tse Hwei, Seonjoo Lee, Cristiane Duarte, et al.

Patterns of Substance Use during Pregnancy Predict Child Behavior Problems

Authors: Sarah Maylott, et al.

How Does Phthalate Exposure During Pregnancy Affect Newborn Brain Development?

Authors: Authors: Leny Matthew, Craig Newschaffer, et al.

Does Prenatal PFAS Exposure Affect a Child’s Risk for Developing Autism-related Traits?

Authors: Jennifer Ames, Ghassan Hamra, et al.

 

New ECHO Research Finds Children with Autism at Higher Risk for a Range of Health Outcomes

Posted on by Jodi Snare

Collaborative ECHO research led by Elizabeth Kaplan-Kahn, PhD, Kristen Lyall, ScD of the A.J. Drexel Autism Institute at Drexel University and Heather Volk, PhD, MPH of the Bloomberg School of Public Health at Johns Hopkins University investigates the factors that influence the overall health and well-being of people on the autism spectrum. This research, titled “Describing Multidomain Health Outcomes in Autistic Children in the ECHO Program,” is published in the Journal of the American Academy of Child and Adolescent Psychiatry.

Approximately 3% of children in the United States have a diagnosis of autism spectrum disorder (or autism). A large proportion of autism research focuses on understanding the factors that influence the development of autistic traits. However, many people on the autism spectrum report that they would rather prioritize research into the factors that influence their overall health and well-being. This study addressed that priority by investigating the physical, emotional, and overall health outcomes of children on the autism spectrum.

The study included over 4,500 children and adolescents at 29 ECHO research sites across the United States, including 286 participants with autism, with participants varying in age from 5 to 20 years old. The research team conducted an initial analysis on the 4,511 participants by comparing data on their health outcomes and demographic characteristics. They then used a subsample of 1,809 participants, of which 116 were autistic, to group children with similar physical health, emotional health, and overall well-being outcomes into one of three categories, “positive health,” “poorer health,” and “mixed health.”

These profiles were categorized based on data from the research team’s primary outcome measures—multiple Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health scores, the Child Behavior Checklist (CBCL) Dysregulation score, the Social Responsiveness Scale, Second Edition (SRS-2), and standardized Body Mass Index (BMI). These measures evaluated participants’ peer relations, life satisfaction, behavior dysregulation, sleep disturbances, physical activity, etc. The three profiles of participants were then further analyzed to study differences in health outcomes between children on the autism spectrum to non-autistic children.

The study results indicate that autistic children are at higher risk than non-autistic children for poorer health outcomes indicated by lowest scores in Global Health and highest dysregulation scores (e.g. attention problems, aggressive behavior, and anxious-depressive symptoms). However, there is variability in health outcomes within autistic youth as shown by a group of autistic participants who showed high scores on positive health outcomes across domains. Additionally, compared to non-autistic children, more autistic children were born prematurely, had diagnoses of intellectual disability and ADHD, and had a sibling with autism.

“The results of this study offer a glimpse into the range of emotional, physical, and overall health outcomes for children on the autism spectrum,” Dr. Kaplan-Kahn said. “A deeper understanding of the range of health outcomes children with autism experience, and the factors that can affect these outcomes, may help families and practitioners identify and target areas for support or intervention.”

Future work may focus on understanding the factors that influence poor or positive health for children with autism and how those factors change over time. This work might identify opportunities to support these children and promote positive health outcomes.

Read the research summary.

New ECHO Research Suggests Harsh Parenting and High Socioeconomic Stress May Be Associated With Higher Internalizing Problems in Children

Posted on by Jodi Snare

Collaborative ECHO research led by Lue Williams, MA, MS, Veronica Oro, PhD and Leslie Leve, PhD of the Prevention Science Institute at the University of Oregon investigates the relationship between two early childhood stress factors, harsh parenting and socioeconomic stress, and children’s development from childhood through adolescence. This research, titled “Influence of Early Childhood Parental Hostility and Socioeconomic Stress on Children’s Internalizing Symptom Trajectories from Childhood to Adolescence,” is published in Frontiers in Psychiatry.

Internalizing problems in childhood may be early indicators of problems associated with disorders such as depression and anxiety. Internalizing by children can be influenced by biological and environmental factors, including parent-child relationships and socioeconomic status. This study looked at how harsh parenting and socioeconomic stress were associated with internalizing problems in children. The researchers characterized harsh parenting, or “parental hostility,” as non-supportive and controlling parenting practices, displays of anger and disappointment in children, and discipline through punishment. Socioeconomic stress reflects disadvantages associated with factors like household income.

The study included two samples—a nationwide sample of 481 children who were adopted at birth and a sample of 1,053 children from six predominantly low-wealth, rural communities in eastern North Carolina and central Pennsylvania. Adopted children from the Early Growth and Development Study (EGDS) have lived in their adoptive homes since birth and were recruited into the study between 2003 and 2009. Children from the Family Life Project (FLP) were raised by their biological parents and were recruited into the study at birth, from September 2003 through 2004.

The researchers analyzed data collected from the EGDS and FLP, and observed that, within the study sample, children fell into three main groups based on the severity of their internalizing behaviors and how those behaviors progressed with age: low, moderate-increasing, and higher-increasing. Some of the internalizing behaviors reported include feeling anxious or depressed, being withdrawn, and complaining of aches and sickness. Parents who reported more negative interactions with children in early childhood had children who were more likely to be in the group with the highest internalizing behaviors.

Children with more socioeconomic stress in their households were also most likely to be in the highest internalizing behaviors group, as compared with both the low- and moderate-internalizing symptoms groups. Researchers also observed that household socioeconomic stress directly predicted children’s mental health, but did not find any significant relationship between child sex assigned at birth and how likely they would be to show internalizing behaviors.

“Not many studies have examined early childhood predictors of internalizing behavior developments, so our research fills an important gap by examining the role of diverse risk factors in early life on patterns of internalizing symptoms later in childhood,” Williams said. “Our findings suggest that in addition to focusing on children’s symptoms when treating internalizing problems, health service providers may also wish to consider the broader context of caregiver behavior and access to resources for care.”

Future studies are needed to further support programming and research efforts by exploring how socioeconomic stress and parenting styles can influence children’s internalizing behaviors identified in the current study.

Read the research summary.

Harsh Parenting and High Socioeconomic Stress May Be Associated with Higher Internalizing Problems Like Anxiety in Children, ECHO Study Finds

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Harsh Parenting and High Socioeconomic Stress May Be Associated with Higher Internalizing Problems Like Anxiety in Children, ECHO Study Finds

Authors: Lue Williams, Veronica Oro, Leslie Leve, 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.

 

Why was this study needed?

Internalizing problems in childhood such as chronic internal distress may be early indicators of problems associated with disorders such as depression and anxiety. Internalizing by children can be influenced by biological and environmental factors, including parent-child relationships and socioeconomic status.

This study examined the relationship between two early childhood stress factors, harsh parenting and socioeconomic stress, and children’s development from childhood through adolescence. For this study, the researchers characterized harsh parenting, or “parental hostility” as non-supportive and controlling parenting practices, displays of anger and disappointment in children, and discipline through punishment. Socioeconomic stress reflects disadvantages associated with factors like household income. Few studies have examined early childhood predictors of internalizing behavior development, so this research fills an important gap by examining the role of diverse risk factors in early life, between the ages of 18 months and 5 years, on patterns of internalizing symptoms later in childhood. The study design, which used data collected from participants over a long period, also allowed the research team to explore the long-range impact of early life influences across critical stages of children’s physical, social, and psychological development.

 

What were the study results?

Researchers observed that, within the study sample, children fell into three main groups based on the severity of their internalizing behaviors and how those behaviors progressed with age: low, moderate-increasing, and higher-increasing. Some of the internalizing behaviors reported include feeling anxious or depressed, being withdrawn, and complaining of aches and sickness. Parents who reported more negative interactions with children in early childhood had children who were more likely to be in the group with the highest internalizing behaviors. Children with more socioeconomic stress in their households were also most likely to be in the highest internalizing behaviors group, as compared with both the low- and moderate-internalizing symptoms groups.

Researchers also observed that household socioeconomic stress directly predicted children’s mental health. Study investigators did not find any significant relationship between child sex assigned at birth and how likely they would be to show internalizing behaviors.

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 this study's impact?

The findings from this study suggest that in addition to focusing on children’s symptoms when treating internalizing problems, health service providers may also wish to consider the broader context of caregiver behavior and access to resources for care.

 

Who was involved?

The study included two samples—a nationwide sample of 481 children who were adopted at birth and a sample of 1,053 children from six predominantly low-wealth, rural communities in eastern North Carolina and central Pennsylvania. Adopted children from the Early Growth and Development Study (EGDS) have lived in their adoptive homes since birth and were recruited into the study between 2003 and 2009. Children from the Family Life Project (FLP) were raised by their biological parents and were recruited into the study at birth, between September 2003 and 2004. Results may not be representative of the general population.

 

What happened during the study?

The researchers analyzed data collected from children and families that participated in the EGDS and FLP. EGDS children and families completed assessments approximately every nine months when adoptees were under the age of 3, and every one to two years after that. FLP participant families completed an initial home visit assessment when children were 2 months old and participated in annual assessments thereafter.

 

What happens next?

Future studies are needed to further support programming and research efforts by exploring mechanisms that underlie the relationship between socioeconomic stress, parenting styles, and children’s internalizing behaviors identified in the current study.

 

Where can I learn more?

Access the full journal article, titled “Influence of Early Childhood Parental Hostility and Socioeconomic Stress on Children’s Internalizing Symptom Trajectories from Childhood to Adolescence,” in Frontiers in Psychiatry.

 

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

Published April 16, 2024

Read the associated article.

Download this summary

Harsh Parenting and High Socioeconomic Stress May Be Associated with Higher Internalizing Problems Like Anxiety in Children, ECHO Study Finds

NIH Study Finds Association Between Elevated Phthalate Levels and Increased Risk of Postpartum Depression

Posted on by Jodi Snare

FOR IMMEDIATE RELEASE

In a new study from the NIH’s Environmental influences on Child Health Outcomes (ECHO) Program, higher prenatal phthalate levels were associated with a slightly increased risk of postpartum depression.

Postpartum depression affects up to 20% of new mothers, making it the most common pregnancy complication to occur after delivery. ECHO Cohort researchers wanted to examine how chemicals such as phenols, phthalates, and parabens—commonly found in plastics and personal care products—might play a role in postpartum depression symptoms, alongside other factors like genetics and stress. Exposure to these chemicals can affect hormone levels, potentially influencing the development of postpartum depression.

The presence of these man-made chemicals in people is common due to frequent exposure through diet, absorption through the skin, and inhalation. Researchers noted that among study participants all had parabens and nearly all had phthalates in their urine samples.

“Finding new ways to prevent postpartum depression is crucial because most of the known risk factors, like genetics and stressful life events, can’t be altered,” said Melanie Jacobson, PhD, MPH of New York University’s Grossman School of Medicine. “Therefore, focusing on prenatal exposure to these types of chemicals represents a novel interventional target.”

Researchers measured the concentrations of these chemicals in urine samples of 2,174 pregnant individuals at five ECHO Cohort Study Sites. Those same individuals also completed depression assessments between two weeks and 12 months after delivery to check for postpartum depression symptoms. Screening instruments indicated the presence or absence of postnatal depressive symptoms. Researchers then harmonized data to the Patient-Reported Measurement Information System (PROMIS) Depression scale.

The study found that higher levels of phthalates, in particular those found in products such as personal care items and plastic consumer products, were associated with an increased risk of postpartum depression. Those who met the criteria for postpartum depression were more likely to be Hispanic and from the ECHO study site in Puerto Rico, have attained less education, and substantially higher prenatal depression scores.

This collaborative research, which is believed to be the largest study to date examining the effects of environmental chemicals on depression, is published in JAMA Psychiatry.

Jacobson, M. et al. Prenatal exposure to nonpersistent environmental chemicals and postpartum depression. JAMA Psychiatry. DOI: 10.1001/jamapsychiatry.2023.3542.

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New ECHO Research Finds Association Between Some Prenatal Chemical Exposures and Postpartum Depression

Posted on by Jodi Snare

Collaborative ECHO research led by Melanie Jacobson, PhD, MPH of the NYU Grossman School of Medicine, investigates the role of prenatal synthetic chemicals in postpartum depression. This research, titled “Prenatal Exposure to Nonpersistent Environmental Chemicals and Postpartum Depression,” is published in JAMA Psychiatry.

Postpartum depression affects up to 20% of new mothers, making it the most common pregnancy complication to occur after delivery. Postpartum depression can impact a mother’s daily functioning, quality of life, and long-term health. Furthermore, it is associated with poor mother-child attachment, which can impact child health and development.

Factors like genetics and stress can make some people more likely to experience postpartum depression, but researchers are still trying to understand how synthetic chemicals might also play a role. Chemicals such as phenols, phthalates, and parabens can be found in plastics and personal care products. While these chemicals are nonpersistent, meaning that they don’t linger in the environment, their presence is widespread due to frequent exposure through diet, absorption through skin, and inhalation.

Researchers used data from 2,174 pregnant individuals across five study sites to examine the extent to which exposure to these chemicals might be associated with postpartum depression symptoms. They measured the concentrations of nonpersistent chemicals in urine samples during pregnancy and collected data using self-reported postnatal depression assessments after delivery completed by the same individuals.

The study found that prenatal phthalate concentrations were associated with increased odds of slightly higher postpartum depression scores. Of the many synthetic chemicals investigated, only phthalate concentrations were associated with increased odds of postpartum depression. This suggests that finding ways to reduce prenatal exposure to phthalates might reduce the frequency of postpartum depression. Researchers also observed that postpartum depression was more likely in people who were Hispanic, had lower educational attainment, and had prenatal depression.

“From a public health perspective, any way to help prevent postpartum depression would be important, since most known risk factors such as genetics, psychiatric history, and stressful life events, cannot be easily changed,” Dr. Jacobson said. “Therefore, focusing on prenatal exposure to these types of chemicals represents a novel interventional target.”

While this is believed to be the largest study to date examining the effects of environmental chemicals on postpartum depression, future studies are needed to replicate this research with larger sample sizes in diverse populations.

Read the research summary.

ECHO Cohort Researchers Find Association Between Some Prenatal Chemical Exposures and Postpartum Depression

<< Back to Research Summaries

ECHO Cohort Researchers Find Association Between Some Prenatal Chemical Exposures and Postpartum Depression

Authors: Melanie Jacobson, 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.

 

Why was this study needed?

Postpartum depression affects up to 20% of new mothers, making it the most common pregnancy complication to occur after delivery. Postpartum depression can impact a mother’s daily functioning, quality of life, and long-term health. Furthermore, it is associated with poor mother-child attachment, which can impact child health and development.

Factors like genetics and stress can make some people more likely to experience postpartum depression, but researchers are still trying to understand how synthetic chemicals might also play a role. Chemicals such as phenols, phthalates, and parabens can be found in plastics and personal care products. While these chemicals are nonpersistent, meaning that they don’t linger in the environment, their presence is widespread due to frequent exposure through diet, absorption through skin, and inhalation. The investigators in this study wanted to examine the extent to which exposure to these chemicals might be associated with postpartum depression symptoms.

 

What were the study results?

Prenatal phthalate concentrations were associated with increased odds of slightly higher postpartum depression scores, and the condition was observed to be more likely in people who were Hispanic, had lower education levels, and had prenatal 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?

Of the many synthetic chemicals investigated, only prenatal phthalate concentrations were associated with increased odds of postpartum depression. This suggests that finding ways to reduce prenatal exposure to phthalates might reduce the frequency of postpartum depression.

 

Who was involved?

Researchers used data from 2,174 pregnant individuals across five study sites. This information included data on urinary chemical concentrations from at least one point during the pregnancy and a self-reported postnatal depression assessment between two weeks and 12 months after delivery.

 

What happened during the study?

Researchers measured the concentrations of nonpersistent chemicals in urine samples. Researchers also collected, between two weeks and 12 months after delivery, data using self-reported postnatal depression assessments completed by the same individuals. Screening instruments indicated the presence or absence of postnatal depressive symptoms. Data was then harmonized to the Patient-Reported Measurement Information System (PROMIS) Depression scale.

 

What happens next?

While this is believed to be the largest study to-date examining the effects of environmental chemicals on postpartum depression, future studies are needed to replicate this research with larger sample sizes in diverse populations.

 

Where can I learn more?

Access the full journal article, titled “Prenatal exposure to nonpersistent environmental chemicals and postpartum depression,” in JAMA Psychiatry.

 

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

Published September 20, 2023

 

Access the associated article.

Download this summary

ECHO Cohort Researchers Find Association Between Some Prenatal Chemical Exposures and Postpartum Depression.

 

Read More Research Summaries

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