pre- peri- and postnatal

NIH Study Suggests Maternal Inflammation Risk Factors Associated With Children’s Behavioral and Emotional Regulation

Posted on by Jodi Snare

Maternal inflammation risk factors may be associated with dysregulation in children, according to a study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health. “Dysregulation” in this context refers to children’s attention, anxiety and depression, and aggression being measurably different from what is typically expected at their age.

While inflammation is a normal bodily response to injury or infection, ECHO investigators wanted to learn whether factors linked to inflammation during pregnancy might be associated with dysregulation in children.

More youth with dysregulation (35%) were born to mothers with prenatal infections compared with 28% of youth without dysregulation. Other maternal factors studied, including being overweight before pregnancy, attaining less education, and smoking during pregnancy, were associated with higher likelihoods of childhood dysregulation. Children and adolescents who had a parent or sibling with a mental health disorder were also more likely to experience dysregulation.

“Addressing factors and treating conditions associated with behavior challenges may help improve outcomes for these children,” said Jean Frazier, MD, of the University of Massachusetts Chan Medical School and a leader of the study.

Researchers used the Child Behavior Checklist (CBCL) to measure aggressive behavior, anxiety/depression, and attention problems in children. Approximately 13.4 % of children and adolescents in the study met the criteria for the CBCL Dysregulation Profile.

This study included 4,595 participants (ages 6-18 years) from 18 ECHO research sites across the United States.

Dr. Frazier and Mike O’Shea, MD, of the University of North Carolina at Chapel Hill led this collaborative research published in the Journal of the American Academy of Child and Adolescent Psychiatry.

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About ECHO: ECHO is a nationwide research program supported by the NIH. Launched in 2016, ECHO aims to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

Media Contacts

For information or to request an interview, contact Rebekah Yeager,  rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact  NIHKidsandEnvironment@od.nih.gov.

Connect With Us

echo connectorCheck out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

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Follow @ECHOChildHealth for the latest ECHO Program updates on Twitter.

ECHO Researchers Investigate Association Between Maternal Inflammation Risk Factors and Dysregulation in Children

Posted on by Jodi Snare

Collaborative ECHO research led by Jean Frazier, MD, of the University of Massachusetts Chan Medical School and Mike O’Shea, MD, of the University of North Carolina at Chapel Hill investigated how factors linked with inflammation during pregnancy might be associated with dysregulation in children after birth. “Dysregulation” in this context refers to children’s attention, anxiety and depression, and aggression being measurably different from what is typically expected for children of their age.

Inflammation is a normal part of the body’s defense to injury or infection. The researchers found that several risk factors associated with inflammation, such as lower maternal educational attainment, pre-pregnancy obesity, prenatal infections, and prenatal tobacco use, were strongly correlated with dysregulation in offspring.

ECHO researchers collected data on maternal factors before and during pregnancy and then used the Child Behavior Checklist (CBCL) to identify children ages 6 to 18 with emotional, cognitive, and behavioral dysregulation. The assessments were collected between 2009 and 2021. The study involved 4,595 children and adolescents from 18 ECHO research sites across the United States.

About 13% of the children and adolescents studied were identified as having emotional and behavioral challenges. Children born to mothers with a prenatal infection had a higher risk for dysregulation later in childhood compared to children born to mothers without an infection. Lower maternal education levels, overweight before pregnancy, and smoking during pregnancy also were associated with a higher likelihood of childhood dysregulation. Children and adolescents who had a parent or sibling with a mental health disorder were more likely to experience dysregulation. Yet having a mother with gestational diabetes had no significant association with child dysregulation.

“Understanding how these factors can affect a child’s behavior can help guide interventions and support strategies to improve children’s well-being,” said Dr. Frazier.

The study highlights the importance of considering maternal inflammation risk factors when looking at children’s behavioral challenges. Future studies could explore the mechanisms linking maternal factors and childhood dysregulation, interventions for children guided by knowledge about inflammation experienced by their mother, and specific methods to prevent or mitigate the factors leading to maternal inflammation.

The research “Perinatal Factors and Emotional, Cognitive, and Behavioral Dysregulation in Childhood and Adolescence” was recently published in the Journal of the American Academy of Child and Adolescent Psychiatry.

Read the research summary.

NIH Study Links Prenatal Per- and Polyfluoroalkyl Substance Exposure to Higher BMI & Obesity Risk in Children

Posted on by Jodi Snare

FOR IMMEDIATE RELEASE

 

Exposure to per- and polyfluoroalkyl substances (PFAS) during pregnancy was linked to slightly higher BMIs and an increased risk of obesity in children, according to new research funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

“There is a growing interest in understanding the effects of PFAS exposure on children’s health,” said Joseph Braun, PhD, of Brown University. “Studies like this one can help researchers and policymakers better understand the risks of PFAS to take effective actions to protect vulnerable populations.”

The researchers analyzed the levels of seven different PFAS in blood samples collected from mothers during pregnancy. These so-called “forever chemicals” are long-lasting substances that can be found in many household materials, as well as food and drinking water.

Researchers then calculated each child’s BMI, an approximate measure of body fat. Higher levels of PFAS in mother’s blood were related to slightly higher BMIs and increased risk of obesity were seen equally for male and female children.

The study used data collected over two decades from 1,391 children between the ages of 2 and 5 years and their mothers who were enrolled in eight ECHO research sites in California, Illinois, Massachusetts, Colorado, New Hampshire, Georgia, and New York.

Future studies will examine the associations between maternal PFAS exposure and obesity-related health outcomes in older children.

Dr. Braun and Yun Liu, PhD, ECHO Program investigators at Brown University, led this collaborative research published in Environmental Health Perspectives.

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About ECHO: ECHO is a nationwide research program supported by the NIH. Launched in 2016, ECHO aims to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

Media Contacts

For information or to request an interview, contact Rebekah Yeager,  rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact  NIHKidsandEnvironment@od.nih.gov.

Connect With Us

echo connectorCheck out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on Twitter.

Maternal PFAS Exposure During Pregnancy Increases Children’s Risk of Obesity

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Maternal PFAS Exposure During Pregnancy May Increase Children’s Risk of Obesity

Authors: Yun Liu, Joseph Braun, 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.

 

Why was this study needed?

Per- and polyfluoroalkyl substances (PFAS) are long-lasting chemicals that can be found in many household materials, as well as food and drinking water. Maternal PFAS exposure during pregnancy may be linked to increased weight and a higher risk of obesity among children and adolescents. However, existing studies looking at these associations have had inconsistent findings.

 

What were the study results?

The study found that higher levels of some PFAS were linked with slightly higher BMIs in children and an increased risk of obesity. This trend was seen across male and female children and wasn’t affected by the presence of other factors linked to childhood obesity.

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?

Recently, there has been growing interest in understanding the effects of PFAS exposure on children’s health and establishing policies to address PFAS pollution. The US Environmental Protection Agency (EPA) has created a Roadmap to address PFAS contamination. Studies like this one can help better understand the risks of PFAS to take effective actions to protect vulnerable populations.

 

Who was involved?

The researchers used data from 1,391 children between the ages of 2 and 5 years and their mothers who were enrolled in eight ECHO cohorts across United States from 1999 to 2019.

 

What happened during the study?

The researchers measured levels of seven different PFAS in maternal blood samples collected during pregnancy. The researchers also used data on children’s weight and height to calculate each child’s body mass index (BMI), an approximate measure of body fat.

 

What happens next?

Future studies are needed to examine potential links between maternal PFAS exposure during pregnancy and obesity-related health concerns in older children.

 

Where can I learn more?

Access the full journal article, titled “Associations of Gestational Perfluoroalkyl Substances Exposure with Early Childhood BMI Z-Scores and Risk of Overweight/Obesity: Results from the ECHO Cohorts,” in Environmental Health Perspectives.

 

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

Published June 7, 2023

Access the associated article.

See ECHO's PFAS research.

Download this summary

Maternal PFAS Exposure During Pregnancy May Increase Children’s Risk of Obesity

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ECHO Researchers Reveal Link Between PFAS Exposure During Pregnancy and Childhood Obesity Risk

Posted on by Jodi Snare

Collaborative ECHO research led by Yun Liu, PhD and Joseph Braun, PhD of Brown University investigates the relationship between maternal exposure to per- and polyfluoroalkyl substances (PFAS) during pregnancy and obesity risk among children and adolescents. The research team evaluated maternal PFAS levels during pregnancy and child body mass index (BMI) for 1,391 mother-child pairs across eight ECHO cohorts. The researchers found that higher levels of some PFAS during pregnancy were associated with higher BMIs and an increased risk of obesity in children. This research, titled “Associations of Gestational Perfluoroalkyl Substances Exposure with Early Childhood BMI Z-Scores and Risk of Overweight/Obesity: Results from the ECHO Cohorts,” is published in Environmental Health Perspectives.

This study included women who were pregnant between 1999-2019 in California, Illinois, Massachusetts, Colorado, New Hampshire, Georgia, and New York and their children who were evaluated between the ages of 2 and 5 years old. The researchers analyzed the levels of seven different PFAS in blood samples collected from mothers during pregnancy. They then used the children’s height and weight data to calculate their BMI, an approximate measure of body fat, while accounting for each child’s age and sex, as well as other factors related to PFAS exposure and body fat.

“There is growing interest in understanding the effects of PFAS exposure on children’s health,” said Dr. Braun. “Studies like this one will help researchers and policymakers better understand the risks of PFAS in order to take effective actions to protect vulnerable populations.”

Going forward, future studies will examine the associations between maternal PFAS exposure and obesity-related health outcomes in older children.

Read the research summary.

Prenatal Tobacco Exposure and Neurodevelopmental Outcomes in Middle Childhood

Posted on by Jodi Snare

A collaborative study led by ECHO researcher Liz Conradt, PhD of the University of Utah, examined the effects of simultaneous exposure to multiple substances—like tobacco, alcohol, and opioids—on outcomes in middle childhood. The team found that children ages 6 to 11 who were exposed prenatally to tobacco and multiple other substances were more likely to have below average verbal reasoning skills and higher levels of behavioral problems. Their research, titled “Prenatal Substance Exposure: Associations with Neurodevelopment in Middle Childhood,” is published in the American Journal of Perinatology.

To gather these results, the team collected data on prenatal exposure to substances such as alcohol, tobacco, marijuana, and opioids. A total of 256 mother-child pairs participated from two ECHO cohorts with locations in Rhode Island, Minnesota, Washington, California, and New York. When the children were between six and 11 years old, their caregivers were asked to report on the absence or presence of problem behaviors, such as aggression and anxiety. The team also collected data on verbal and nonverbal reasoning and problem solving skills.

Using this information, the researchers identified two specific groups—Group 1 had average verbal reasoning skills, average spatial reasoning skills, and normal levels of problem behavior. Children in this group were exposed to fewer substances before birth. Group 2 had below average verbal reasoning skills, but average spatial reasoning skills, and higher levels of problem behavior. The researchers found that children exposed to multiple substances prenatally, especially including tobacco, were more likely to be in Group 2. The effects of tobacco exposure on problem behavior and reasoning skills were stronger than expected.

“This study shows that children with prenatal tobacco exposure may be at risk for having higher levels of problem behaviors and more challenges with verbal reasoning during middle childhood,” said Conradt. “This is an important risk for pediatricians to keep in mind when conducting yearly check-ups on these children.”

The practice of grouping children based on problem behavior and reasoning skills was a novel approach and can be used in future studies to identify subgroups of children at risk for these outcomes.

Visit The Center for Parenting and Opioids and National Institute on Drug Abuse sites for more information on substance exposures and outcomes.

Read the Research Summary.

NIH Study Finds Prenatal Substance Exposure Linked to Child Behavior Problems

Posted on by Jodi Snare

Sarah Maylott, PhD

FOR IMMEDIATE RELEASE

 

Prenatal exposure to tobacco, alcohol, and illegal drugs may increase a child’s risk of displaying certain problem behaviors in later childhood, according to new research funded by the Environmental influences on Child Health Outcomes Program (ECHO) at the National Institutes of Health.

Children ages 6 to 11 who were exposed to alcohol and tobacco before birth were more likely to display rule-breaking or aggressive behaviors, while children exposed to illegal drugs, such as cocaine, methamphetamine, or heroin, before birth were more likely to have higher rates of anxiety, depression, or withdrawn behaviors, according to findings published in the Journal of Pediatrics. However, ECHO researchers pointed out that not all children exposed to substances had behavioral problems.

“Our work shows that we may be able to identify children with certain behavioral challenges based on their mothers’ prenatal substance use profiles,” said Sarah Maylott, PhD of Duke University. “With further research, clinicians and researchers could use these results to identify and support children at higher risk for behavior problems.”

About 2,000 women from 10 ECHO cohorts across the country participated in the study from 2000-2020. The research team divided the women into two groups based on the types of substances used during pregnancy and then compared the behavior of both groups’ children.

Future large-scale studies can look at how the quantity and timing of substance use during pregnancy affect children’s risk for behavioral problems and how the home environment may contribute to that risk. Researchers can also explore what factors lead to resilient outcomes for children with prenatal substance exposure.

Dr. Maylott led this collaborative research published in the Journal of Pediatrics.

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About ECHO: ECHO is a nationwide research program supported by the NIH. Launched in 2016, ECHO aims to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

Media Contacts

For information or to request an interview, contact Rebekah Yeager,  rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact  NIHKidsandEnvironment@od.nih.gov.

Connect With Us

echo connectorCheck out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on Twitter.

Prenatal Substance Exposure Associated with Problem Behaviors in Middle Childhood

Posted on by Jodi Snare

Sarah Maylott, PhD

A collaborative research effort led by Sarah Maylott, PhD of Duke University, suggests that prenatal exposure to substances may increase a child’s risk for displaying problem behaviors in middle childhood. Specifically, children exposed to prenatal tobacco and alcohol were more likely to display rule-breaking or aggressive behaviors, while children exposed to illegal drugs, such as cocaine, methamphetamine, or heroin, were more likely to have higher rates of anxiety, depression, or withdrawn behaviors. However, not all children exposed to substances had behavioral problems, suggesting that some children may be more resilient than others.

This research, titled “Latent Class Analysis of Prenatal Substance Exposure and Child Behavioral Outcomes” is published in the Journal of Pediatrics.

The results outlined in Dr. Maylott’s work are particularly important, as approximately 1 in 5 women in the United States report use of legal or illegal substances while pregnant, varying from tobacco and alcohol to psychoactive drugs, such as opioids and cocaine. Previous studies have investigated how prenatal exposure to multiple substances may affect the health of young children, but less is understood about how polysubstance exposures may affect the neurodevelopment of older children.

Leveraging data from approximately 2,000 women from 10 ECHO cohorts across the country from 2000-2020, the research team used a statistical analysis technique to group women based on the types of substances used during pregnancy and compared these groups based on their child’s behaviors. On average, pregnant women were 28 years old when they gave birth, and child behaviors were assessed between ages 6 to 11 using the Child Behavior Checklist. The team hypothesized that children with prenatal polysubstance exposure would have more instances of problem behavior in middle childhood than those children with little to no prenatal substance exposure.

“Our work shows that it could be possible to identify children with certain behavioral challenges based on their mothers’ prenatal substance use profiles,” said Dr. Maylott. “With further research, clinicians and researchers may be able to use these results to identify and support children at higher risk for behavior problems.”

Subsequent large-scale studies are needed that look at how the quantity and timing of substance use during pregnancy affect children’s risk for behavioral problems and how the home environment may contribute to that risk. Researchers also need to find factors that may lead to resilient outcomes for children with prenatal substance exposure.

Read the research summary.

ECHO Study Suggests Prenatal Exposure to Tobacco, Other Substances Associated With Child Behavior, Reasoning

<< Back to Research Summaries

ECHO Study Suggests Prenatal Exposure to Tobacco, Other Substances Associated With Child Behavior, Reasoning

Authors: Liz Conradt, 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.

 

Why was this study needed?

Little is known about how a pregnant mother’s exposure to multiple substances, like tobacco, alcohol, or opioids, during pregnancy may be associated with outcomes for their children when they reach middle childhood. Most research looks at the effects of single-substance exposures or focuses on the effects of prenatal exposures on the child’s health exclusively during birth or early childhood. In this study, the research team evaluated the effects of prenatal exposure to multiple substances (alcohol, tobacco, marijuana, and opioids) on children’s reasoning skills and behavior during middle childhood.

 

What were the study results?

The team identified two groups of children based on their reasoning skills and problem behavior scores. Group 1 had average verbal reasoning skills, average spatial reasoning skills, and normal levels of problem behavior. Children in this group were exposed to fewer substances before birth. Group 2 included children with multiple substance exposures before birth. This group had below average verbal reasoning skills, but average spatial reasoning skills, and higher levels of problem behavior.  Children in Group 2 were significantly more likely to be exposed to tobacco before birth. The effects of tobacco exposure on problem behavior and reasoning skills were stronger than expected.

 

What was the study's impact?

This study suggests that children exposed to tobacco and other substances before birth may be at increased risk for problem behaviors and lower verbal reasoning skill scores during middle childhood. These findings will help pediatricians identify children who are at risk for behavior problems and poorer reasoning skill scores. If replicated, this information might help pregnant women and their doctors to recognize how prenatal tobacco, especially in the context of other substance exposure, might affect their child’s verbal reasoning and behavior in middle childhood.

 

Who was involved?

This study involved pairs of mothers and their biological children. There were 256 mother-child pairs from two ECHO research sites with locations in Rhode Island, Minnesota, Washington, California, and New York. Children were ages six to 11 at the time of the behavioral and reasoning skills assessments.

 

What happened during the study?

Researchers collected data on prenatal exposure to substances including alcohol, tobacco, marijuana, and opioids. When the children were between six and 11 years old, their caregivers reported on the presence of problem behaviors such as aggression and anxiety. The researchers also collected data on problem solving skills with words, pictures, and diagrams (verbal and nonverbal reasoning).

 

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?

Moving forward, the team wants to improve their measures of prenatal substance exposure and expand their sample size to include more ECHO participants.  Grouping children that have been exposed to substances prenatally can help identify subgroups of children at risk for problem behaviors and low reasoning skill scores.

 

Where can I learn more?

The Center for Parenting and Opioids and National Institute on Drug Abuse have additional helpful resources.

The full journal article, titled “Prenatal Substance Exposure: Associations with Neurodevelopment in Middle Childhood” is published in the American Journal of Perinatology.

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

Published May 10, 2023

 

Access the associated article.

Download this summary

ECHO Study Suggests Prenatal Exposure to Tobacco, Other Substances Associated With Child Behavior, Reasoning

New ECHO Research Investigates Link Between Maternal Health, Newborn Metabolism, and Childhood BMI

Posted on by Jodi Snare

Collaborative ECHO research led by Britt Snyder, PhD, and Tina Hartert, MD, MPH, of Vanderbilt University Medical Center, and James Gern, MD, of the University of Wisconsin School of Medicine and Public Health, investigates the links between maternal health characteristics and the concentrations of various metabolites in newborns. In addition to identifying these links, the study also demonstrated that some metabolites were linked to childhood body mass index (BMI) at ages 1–3 years. The researchers collected data from 3,492 infants and their mothers and found that certain maternal health factors such as higher BMI before pregnancy or maternal age at delivery seemed to increase the levels of some key metabolites in newborns. This research, titled “The Associations of Maternal Health Characteristics, Newborn Metabolite Concentrations, and Child Body Mass Index among US Children in the ECHO Program,” is published in Metabolites.

This study expanded on previous research investigating links between a variety of maternal characteristics and metabolite levels in newborns and also explored the link between these metabolites and child growth patterns. The researchers also investigated how maternal factors and related chemical changes in utero could possibly contribute to the link between newborn metabolism and childhood BMI. To address these questions, the researchers collected data on maternal health characteristics from self-reported questionnaires, birth certificates, and medical records. They then collected child BMI from medical records and study visits and used statistical tools to evaluate possible links between maternal health characteristics and newborn metabolism.

“These findings provide additional insights on potential in utero pathways through which maternal health characteristics may affect newborn metabolism and later child growth patterns,” said Dr. Snyder.

Future studies are needed to further explore these pathways and understand the relationship between maternal health characteristics and child health.

Read the Research Summary.