Pregnant Women Exposed to Various Chemicals, Including Chemicals in Personal Care Products and Consumer Goods

Author(s): Brett Doherty and Megan Romano

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, and grant funding.*

What were the study results?

Researchers found 199 unique chemicals in the wristbands worn by women in the study. There were 16 chemicals, including chemicals in personal care products and consumer goods, which were found most often. Most women had comparatively low amounts of exposures to these chemicals but others had more unique combinations of chemical exposures. Education and behaviors, such as nail polish use, helped predict the level of chemical exposures.

What was the study's impact?

This work helps identify opportunities and challenges for using tools like silicone wristbands to understand chemical exposures during pregnancy. The research team also identified common exposures and exposure patterns within the study population, which may be studied in future research.

Why was this study needed?

Pregnant women are exposed to chemicals that may be bad for their health or their babies’ health. At the same time, the types of chemicals and their co-occurrence are not well understood. The researchers used silicone wristbands that capture chemicals in the environment to learn more about these exposures in a group of pregnant women in northern New England.

Who was involved?

This study included 255 women enrolled in the New Hampshire Birth Cohort Study (NHBCS) between 2017 and 2019. The NHBCS began in 2009 and includes more than 2,000 mother and child pairs.

What happened during the study?

During early pregnancy, the women wore the wristbands and went about their normal activities while chemicals in their environment became trapped in their wristbands. The women then returned the wristbands after one week and researchers measured the captured chemicals. This provided information about the chemicals in the women’s environments.

What happens next?

The team will connect the chemical exposure information collected from the silicone wristbands to maternal and infant health outcomes. This connection may show how chemicals influence human health and provide clues to prevent health problems. The team will also compare these wristband measurements to traditional measurements of chemical exposures. This will help scientists better understand the strengths and weaknesses of this new technology.

Where can I learn more?

Access the full journal article , titled “Assessment of Multipollutant Exposures During Pregnancy Using Silicone Wristbands” published in Frontiers in Public Health.

Additional details

This work included collaboration with Dr. John Pearce, who, like Dr. Romano, is an OIF Cycle 1 Awardee. Dr. Pearce provided expertise related to the statistical methods used in this research, which he developed through his project entitled “Developing exposure characterization tools to address complex exposures within ECHO” (EC0155).

*Award Numbers include U2COD023375 (Coordinating Center), U24OD023382 (Data Analysis Center), and UH3 OD023275, and the National Institute of Environmental Health Sciences under Award Number P42ES007373. Brett T. Doherty was supported by National Cancer Institute grant R25CA134286.

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

Published: September 29, 2020

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Pregnant Women Exposed to Various Chemicals, Including Chemicals in Personal Care Products and Consumer Goods

ECHO Researchers Identify Gaps in Prenatal Opioid Exposure Research

Posted on August 28, 2019June 7, 2023 by Jodi Snare

This week, Pediatrics published results from ECHO researcher Elisabeth Conradt and her team’s efforts to learn more about prenatal opioid exposure and its effects on child development. Conradt and her team reviewed 52 publications to summarize what is known and make suggestions on how to expand knowledge in this area. The resulting article includes perspectives on how the ECHO Program can help learn more about this important topic.

“The number one question mothers, fathers, and clinicians have when they see that a mother is using opioids while pregnant is ‘how will this opioid exposure affect the child’s health?’ We cannot answer that question right now with the existing data,” Conradt said.

The team analyzed existing publications on three age groups: birth, infancy, and 2 years and older. Because of inconsistent and limited data, Condradt’s team was not able to understand a connection between prenatal opioid exposure and how children’s minds develop throughout life. However, they predict that the effects of the exposure at birth and infancy are small and subtle, but may increase as children age and have more demands on their attention at home and school.

Current studies were limited because of small sample sizes and difficulty controlling for confounding factors such as where a person lives or how much money their family makes.

Moving forward, the team will use ECHO data to test how prenatal opioid exposure affects learning, understanding, behavior, and attention span in middle childhood. They will also consider other possible factors such as poverty. Conradt noted that the team will also look at whether newborns who have neonatal opioid withdrawal syndrome (NOWS) have worse effects compared with newborns exposed to opioids who do not have NAS/NOWS.

Read the study summary and full media release.

The ACT NOW Clinical Practice Survey: Gaps in the Care of Infants With Neonatal Opioid Withdrawal Syndrome

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The ACT NOW Clinical Practice Survey: Gaps in the Care of Infants With Neonatal Opioid Withdrawal Syndrome

Author(s): Jessica Snowden, Akshatha, Robert Annett, et al

What was done?

In the fall of 2017, 54 sites within two research networks were surveyed. The sites were asked about the protocols and practices they used to treat NOWS infants. They were also asked how NOWS infants were diagnosed, what drugs they were given, what non-drug methods were used, and what areas of the hospital cared for NOWS infants.

What was found?

Sites could be divided into those that were NICUs (neonatal intensive care units) and those that were not ICUs (non-ICUs). NICUs were more likely to have protocols for screening mothers and diagnosing NOWs. They were also more likely to have protocols for how to give drugs for NOWS symptoms and encouraging breastfeeding. NICUs were more likely to use non-drug methods to treat NOWS infants.

Non-drug methods included swaddling, cuddling, massage, and low-stimulation environments. Morphine was the first drug of choice for NOWS symptoms at a majority of sites, regardless of their type.

What do the results mean?

Non-ICU sites need targeted training and standardized care plans for NOWS infants. However, it is not clear which practices are the most beneficial. Some variations in care may be best for some NOWS infants. The long-term effects of drug therapy and non-drug methods in these infants are unknown. The variations seen in this study show the need for multisite clinical trials in infants with NOWS. These studies will help define the best policies and practices to use with NOWS infants.

Why was this study conducted?

Neonatal opioid withdrawal syndrome (NOWS) often occurs when the mothers of unborn babies use opioids. The number of babies with NOWS has dramatically increased in the last 10 years due to the opioid crisis in the US. Doctors and hospitals have developed standard protocols on how best to care for these babies. The goal of this study was to collect information on how hospitals care for NOWS infants and to use this information for future clinical studies on the best methods to care for them.

Appreciation:

The authors especially thank the sites of the Institutional Development Award States Pediatric Clinical Trials Network and the Neonatal Research Network for contributing participating in the survey. The authors would also like to thank the Environmental Influences on Child Health Outcomes Program, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Center for Advancing Translational Sciences, and the National Institutes of Health for supporting this research.

You may learn more about this publication here: https://www.ncbi.nlm.nih.gov/pubmed/31324654

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

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The ACT NOW Clinical Practice Survey: Gaps in the Care of Infants With Neonatal Opioid Withdrawal Syndrome

ECHO Review Finds No Strong Link Between Non-Persistent Chemical Exposures Found in Consumer Products and the Time It Takes Couples to Get Pregnant

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ECHO Review Finds No Strong Link Between Non-Persistent Chemical Exposures Found in Consumer Products and the Time It Takes Couples to Get Pregnant

Author(s): Alison E. Hipwell, Linda G. Kahn, Pam Factor-Litvak, 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. This work was also supported by NIH grants P30 ES009089, R01ES013543, R01ES014393, R01ES08977, and T32ES023772.

What were the study results?

There were some signs that when either men, women, or both were exposed to certain chemicals, it took a longer for the couple to get pregnant. But more research needs to be done to truly understand those effects. There were also signs that certain chemicals did not have any effects.

*Results reported here are for a single review of specific studies during a 10-year period. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

The papers we reviewed did not show a strong link between non-persistent chemicals and how long it takes to get pregnant. But, because there are not many studies like this, we concluded that more research is needed. While we wait for more research, it does not hurt to try to avoid certain chemicals in case they could affect the chances of becoming pregnant. We suggest common-sense lifestyle changes for men and women who would like to have a child. These include trying to avoid contact with certain non-persistent chemicals. Some ways to do this would be to use fewer plastic food containers and look at ingredient lists on personal care and cleaning products in order to avoid phthalates, parabens, TCS, benzophenones, and glycol ethers.

Why was this study needed?

Many products that people use contain non-persistent chemicals that can disrupt hormones. Non-persistent chemicals are chemicals that are broken down fairly quickly in the environment and in the human body. Therefore, non-persistent chemicals are often used in everyday household products. Some studies show these chemicals may affect people’s chance to get pregnant or may cause problems in pregnancy. These chemicals may also affect how long it takes for a couple to become pregnant, but not many studies have tried to answer this question. The goals of this study were to:

Review and summarize what is known about possible links between non-persistent chemicals and the time it takes to get pregnant.
To identify what information is missing in existing studies about this topic.
To present our results in a way that might change health policies and future research about chemicals in products that people use.

Who was involved?

This review looked at existing studies of healthy men and women who were in the age range to get pregnant. The studies were done in several different countries and ranged in size from 137 to 10,512 participants.

What happened during the study?

We used several sets of data to do a large search of research papers published from 2007 to 2017. We searched for articles about both common non-persistent chemicals and time to get pregnant. Our search found 3,456 articles. Two authors reviewed each of the articles we found to make sure they included information we needed. We found that 15 papers from 12 different studies, and then we pulled information from those for our review.

What happens next?

We are doing another review that will study whether there is a connection between chemicals that stay in the body for a long time and the time it takes to become pregnant.

Where can I learn more?

Access the full journal article titled, “Exposure to non-persistent chemicals in consumer products and fecundability: a systematic review” in Human Reproduction Update.

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

Published: January 1, 2019

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ECHO Review Finds No Strong Link Between Non-Persistent Chemical Exposures Found in Consumer Products and the Time It Takes Couples to Get Pregnant

ECHO Study Suggests Exposure to Opioids During Pregnancy May Have Subtle Effects on Child Health Outcomes

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ECHO Study Suggests Exposure to Opioids During Pregnancy May Have Subtle Effects on Child Health Outcomes

Author(s): Elisabeth Conradt, Sheila Crowell and Barry Lester

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?

We were not able to learn what the short and long-term results of prenatal opioid exposure were because of the limitations with the existing information. Our best working hypothesis is that the effects of prenatal opioid exposure at birth and in infancy are small and subtle, but that the effects may grow as children age and have more demands on their attention at home and at school.

What was the study's impact?

We are still trying hard to learn about the short and long-term developmental effects of prenatal opioid exposure. We think that the effects of prenatal opioid exposure at birth and in infancy are subtle, and that they could be also be caused by the effects of other things such as poverty and early life stress. The effects in childhood may be stronger, but they could also be due to long-term stress exposure. More high-quality research is needed to answer the question, “how does prenatal opioid exposure affect the child?”

Why was this study needed?

We have very little information about how a mother’s use of opioids during pregnancy (prenatal opioid exposure) can affect child development. The information we have thus far is limited by not having many people to study and not being able to study other factors that may have an effect on child development, such as poverty. For this study, we reviewed what information we know so far and also made suggestions for how to improve knowledge of prenatal opioid exposure.

Who was involved?

This publication was a review of information that had already been published. After review, we came together as a group and decided what should be done next to answer the question, “how does prenatal opioid exposure affect the child?”

What happened during the study?

We reviewed over 50 studies to try to come up with some answers about how being exposed to opioids during pregnancy affects a child over short and long periods of time. We then discussed the limitations of the study and developed a list of what can be done in the future to fix these limitations. We concluded by describing how ECHO can help provide more information about this research topic.

What happens next?

We will use the ECHO data that are already collected to test how prenatal opioid exposure affects knowledge/understanding, behavior, and attention span in middle childhood. We will consider other possible factors such as poverty. We will also look at whether newborns who have Neonatal Abstinence Syndrome/Neonatal Opioid Withdrawal Syndrome (NAS/NOWS) have worse effects compared to newborns exposed to opioids who do not have NAS/NOWS.

Where can I learn more?

Access the full journal article, titled "Early life stress and environmental influences on the neurodevelopment of children with prenatal opioid exposure," published in Neurobiology of Stress.

Visit NIDA’s website to learn more about opioid use and prenatal opioid exposure: https://www.drugabuse.gov/drugs-abuse/opioids

Access the Harvard Center on the Developing Child website to understand how to reduce the negative effects of early life stress exposure: https://developingchild.harvard.edu/

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

Published: August 15, 2018

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ECHO Study Suggests Exposure to Opioids During Pregnancy May Have Subtle Effects on Child Health Outcomes

NIH-Funded Study to Focus on Newborns Affected by Opioids

Posted on October 2, 2017April 2, 2025 by Jodi Snare

Experts plan clinical trial to test treatments for withdrawal syndrome.

The National Institutes of Health is funding a new study to evaluate treatment options for newborns with opioid withdrawal syndrome, a condition caused by exposure to opioids during pregnancy. Currently, health care providers in the United States lack standard, evidence-based treatments for neonatal opioid withdrawal syndrome, despite states reporting more cases in recent years. The study, called Advancing Clinical Trials in Neonatal Opioid Withdrawal Syndrome (ACT NOW), aims to inform clinical care of these infants.

ACT NOW is funded by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the NIH Office of the Director’s Environmental Influences on Child Health Outcomes (ECHO) Program.

Opioids are a class of drugs commonly prescribed for pain relief. Prescriptions for these drugs have quadrupled since 1999 in the United States, putting more reproductive-age women at risk of developing opioid use disorder. Use of these drugs during pregnancy can affect the health and well-being of women and lead to withdrawal symptoms in newborns. Symptoms often include tremors, excessive crying, sleep deprivation and swallowing difficulties.

Read the full press release here to learn more about this study.