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.
Collaborative ECHO research led by Sheena Martenies, PhD, MPH of the University of Illinois at Urbana-Champaign investigates the combined effects of environmental hazards and social stressors on pregnancy and infant health. This research included information on more than 13,000 infants born between 2010 and 2019 from 41 ECHO cohorts located throughout the United States. In this study, researchers found that pregnant women living in neighborhoods with higher combined exposures had shorter pregnancies and smaller babies. This research, titled “Associations between combined exposure to environmental hazards and social stressors at the neighborhood level and individual perinatal outcomes in the ECHO-wide cohort,” is published in 
A collaborative research effort led by Stephanie Eick, PhD, MPH of Emory University’s Rollins School of Public Health and Rachel Morello-Frosch PhD, MPH of the University of California, Berkeley investigated the relationship between various biological, behavioral, and social factors and higher levels of oxidative stress in pregnant women, which is often associated with poor prenatal health outcomes. Pregnant participants who were 30+ years old and had a college degree had lower levels of oxidative stress. In contrast, levels of oxidative stress were higher among pregnant participants who were overweight or obese, or unmarried. Levels of oxidative stress biomarkers were also higher among pregnant participants who were current smokers or had less than a high school education.