pregnancy stress

Perceived Stress During Pregnancy Associated with Autism-related Traits in Children

Posted on by Jodi Snare

Higher perceived stress during pregnancy may be associated with greater severity of autism-related traits in children, according to a recent ECHO Cohort study led by Luke Grosvenor, PhD, of Kaiser Permanente Northern California.

Many mothers experience higher levels of stress and other mental health challenges during pregnancy. Previous studies have found that pregnancy stress may be associated with increased risk of autism spectrum disorder (ASD) in children, but these studies have mostly focused on the occurrence of isolated adverse or stressful events that occur in the mother’s life during pregnancy. Fewer studies have measured general perceived stress among mothers during pregnancy. To better understand whether this prenatal exposure may be associated with severity of autism-related traits in children, researchers collected information from over 4,000 mothers and their children enrolled in 20 ECHO Cohort Study Sites across the United States.

Key Takeaways include:

  • Higher perceived stress during pregnancy was associated with slightly more severe autism‑related traits in children.
  • At higher prenatal perceived stress levels, children showed slightly higher scores on tests measuring social and behavioral traits related to autism. Children whose mothers had either moderate or high categorical stress scored higher than those whose mothers reported low or no stress.
  • The link between pregnancy stress and autism‑related traits did not differ between boys and girls.
  • The relationship between prenatal stress and autism‑related traits remained consistent even when the researchers accounted for mothers’ co-occurring prenatal depressive symptoms.
  • Stress during pregnancy is normal and common to experience. While the results of this study indicate that there may be a small association between pregnancy stress and autism-related traits, they do not imply that stress during pregnancy causes autism spectrum disorder or autism-related traits to occur in children.

“This study provides evidence for small yet significant associations between higher prenatal perceived stress and greater severity of autism-related traits,” said Dr. Grosvenor. “These results could have implications for prenatal mental health screening and behavioral interventions aimed at improving child outcomes.”

Future studies could help researchers better understand the specific periods during pregnancy during which stress may have the greatest association with child health and development and how other related social and emotional factors may influence this effect.

This collaborative research, titled “Associations between Prenatal Perceived Stress and Child Autism-Related Traits in the ECHO Cohort,” is published in The Journal of Pediatrics.

Read the research summary.

 

Stress During Pregnancy & Adverse Experiences in Mom’s Own Childhood May Be Associated with Child Mental Health, ECHO Study Finds

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Stress During Pregnancy & Adverse Experiences in Mom’s Own Childhood May Be Associated with Child Mental Health, ECHO Study Finds

Authors: Shaikh Ahmad, Alexandra Sullivan, Marie Churchill, Rosa Crum, Nicole Bush, 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?

The global rise in pediatric mental health problems has highlighted the importance of identifying factors that may affect children’s mental health. Previous research has suggested that maternal stress—both adverse experiences during the mother’s own childhood and stress during pregnancy—may affect child mental health, but large-scale, diverse studies examining both exposures together, and their effects across childhood and adolescence, are needed to help researchers identify effective screening and intervention strategies.

 

What were the study results?

The study found that mothers’ own adverse childhood experiences (ACEs)—such as abuse or neglect—and experiences of stress during pregnancy were each independently associated with a higher risk of mental health problems in their children, suggesting that maternal stressors during each period may have contributed to the child’s risk in a potentially accumulative manner. These effects on children included both internalizing (e.g., anxiety, depression) and externalizing (e.g., ADHD, behavior problems) mental health issues. The effects of maternal ACEs and pregnancy stress on child mental health problems were similar for boys and girls and were seen throughout childhood and adolescence.

 

What was the study's impact?

The findings from this diverse nationwide study strengthen the evidence showing that maternal stress before and during pregnancy can increase the risk for child mental health problems. These results also highlight the potential benefits across generations of early screening and intervention related to maternal stress and childhood adversity—not only in improving maternal health, but also in reducing mental health problems in children and teens.

 

Who was involved?

The study included 6,513 mother-child pairs enrolled in 34 ECHO Cohort Study Sites across 19 U.S. states, Washington, D.C., and Puerto Rico. Children ranged in age from 1.5 to 18 years old. The sample was racially, socioeconomically, and geographically diverse.

 

What happened during the study?

The researchers collected information from mothers on their childhood adverse experiences and stress during pregnancy. Later, a parent or caregiver provided information on the child’s mental health using either the preschool-age or school-age child behavior checklist (CBCL). Researchers then used statistical analyses to evaluate the relationship between maternal ACEs, pregnancy stress, and child mental health.

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 identify other factors that may influence the risk of child mental health problems (e.g., paternal ACEs) and factors that could buffer this risk. The authors of this paper also suggest that increased screening for ACE exposure and current social needs in pregnant populations and enhanced access to prenatal mental health support could help to improve mental health for both mothers and their children.

 

Where can I learn more?

Access the full journal article, titled “Maternal Adverse Childhood Experiences and Prenatal Stress: Intergenerational Transmission and Offspring Mental Health in the ECHO Cohort,” in Psychological Medicine.

 

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

Published March 11, 2026

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Stress During Pregnancy & Adverse Experiences in Mom’s Own Childhood May Be Associated with Child Mental Health, ECHO Study Finds

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Prenatal Stress and Maternal Adverse Childhood Experiences Linked to Higher Risk of Child Mental Health Problems

Posted on by Jodi Snare

Stress during pregnancy and a mom’s own adverse childhood experiences (ACEs) may be associated with higher risk of mental health problems for their children, according to a recent ECHO Cohort study led by Shaikh Ahmad, PhD, Alexandra Sullivan, PhD, and Nicole Bush, PhD of University of California, San Francisco, and Marie Churchill, MS and Rosa Crum, MD, MHS of Johns Hopkins Bloomberg School of Public Health.

The global rise in pediatric mental health problems has highlighted the importance of identifying factors that may affect children’s mental health. Previous research has suggested that maternal stress—both adverse experiences during the mother’s own childhood and stress during pregnancy—may affect child mental health. To better understand how these exposures affect child mental health, researchers collected information from over 6,000 mothers and their children enrolled in 34 ECHO Cohort Study Sites across the United States.

Key Takeaways include:

  • Mothers’ own ACEs and experiences of stress during pregnancy were each independently associated with a higher risk of mental health problems in their children, suggesting that maternal stressors during each period may have contributed to the child’s risk in a potentially accumulative manner.
  • These effects on children included both internalizing (e.g., anxiety, depression) and externalizing (e.g., ADHD, behavior problems) mental health issues.
  • The effects of maternal ACEs and pregnancy stress on child mental health problems were similar for boys and girls and were seen throughout childhood and adolescence.

“Using a large and diverse sample, this study highlights the potential two-generational benefits of early screening and intervention related to maternal stress and adversity—not only in improving maternal health, but also in reducing mental health problems in offspring,” said Dr. Ahmad.

Additional research could help researchers identify other factors that may influence the risk of child mental health problems (e.g., paternal ACEs) and factors that could improve support for pregnant women.

This collaborative research, titled “Maternal Adverse Childhood Experiences and Prenatal Stress: Intergenerational Transmission and Offspring Mental Health in the ECHO Cohort,” is published in Psychological Medicine.

Read the research summary.

Perceived Stress During Pregnancy Associated with Autism-related Traits in Children, ECHO Study Finds

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Perceived Stress During Pregnancy Associated with Autism-related Traits in Children, ECHO Study Finds

Authors: Luke Grosvenor, 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?

Many mothers experience higher levels of stress and other mental health challenges during pregnancy. Previous studies have found that pregnancy stress may be associated with increased risk of autism spectrum disorder (ASD) in children, but these studies have mostly focused on the occurrence of isolated adverse or stressful events that occur in the mother’s life during pregnancy. Fewer studies have measured general perceived stress among mothers during pregnancy. This study examined the potential association between perceived stress during pregnancy and autism-related traits in children and evaluated how that association may differ according to the child’s sex or the mother’s experience of depression during pregnancy.

 

What were the study results?

Higher perceived stress during pregnancy was associated with slightly more severe autism‑related traits in children. At higher prenatal perceived stress levels, children showed slightly higher scores on tests measuring social and behavioral traits related to autism. Children whose mothers had either moderate or high categorical stress scored higher than those whose mothers reported low or no stress. The link between pregnancy stress and autism‑related traits did not differ between boys and girls. The relationship between prenatal stress and autism‑related traits remained consistent even when the researchers accounted for mothers’ co-occurring prenatal depressive symptoms.

 

What was the study's impact?

Stress during pregnancy is normal and common to experience. While the results of this study indicate that there may be a small association between pregnancy stress and autism-related traits, they do not imply that stress during pregnancy causes autism spectrum disorder or autism-related traits to occur in children.

 

Who was involved?

The study included 4,115 mother–child pairs from 20 ECHO Cohort Study Sites across the United States. Children ranged in age from about 2.5 to 18 years old.

 

What happened during the study?

Mothers reported their stress levels during pregnancy using a standard questionnaire. Later, parents reported on their children’s autism-related traits using a validated survey. Researchers analyzed the data using statistical models that accounted for factors such as child age, sex, and study site.

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 specific periods in pregnancy when stress may have the greatest association with child health and development and how other related social and emotional factors may influence this effect.

 

Where can I learn more?

Access the full journal article, titled “Associations between Prenatal Perceived Stress and Child Autism-Related Traits in the ECHO Cohort,” in The Journal of Pediatrics.

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

Published March 2, 2026

Access the associated article.

Download this summary

Perceived Stress During Pregnancy Associated with Autism-related Traits in Children, ECHO Study Finds

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Exposure to Certain PFAS Associated with Maternal Depression & Stress for Pregnant and Postpartum Mothers, ECHO Study Finds

Posted on by Jodi Snare

Exposure to certain per- and polyfluoroalkyl substances (PFAS)  was associated with changes in depression and stress for pregnant and postpartum mothers, according to a new ECHO Cohort study led by Susanna Mitro, PhD and Lyndsay Avalos, PhD, MPH of Kaiser Permanente Northern California.

PFAS are a large, complex group of synthetic chemicals found in some household products such as cookware and stain-resistant fabrics. These substances are often referred to as “forever chemicals” because they don’t break down easily, causing them to build up over time in water, soil, and air. Previous studies have shown that PFAS can negatively affect the brain, and there is conflicting evidence about their potential effects on depression and perceived stress during and after pregnancy. This study included 4,403 pregnant participants from 16 ECHO Cohort study sites across the United States. Researchers measured the levels of seven PFAS in the mother’s blood during pregnancy, and participants reported on their depression and stress symptoms before and after giving birth.

Key Takeaways include:

  • Higher levels of N-methyl perfluorooctane sulfonamido acetic acid (N-MeFOSAA) were associated with slightly higher depressive symptoms and perceived stress, especially postpartum, while higher perfluorodecanoic acid (PFDA) levels were associated with a lower risk of diagnosed depression and lower prenatal perceived stress.
  • Exposure to perfluorooctanesolfonic acid (PFOS) showed a mixed pattern where moderate exposure was associated with increased depression risk, but the highest exposure was associated with lower depression risk.
  • When looking at all seven PFAS types as a group, there was generally no strong link to depression diagnosis or severity, but the data did show higher stress at low to moderate exposures, but lower stress as high exposure.
  • The effects of PFAS were different depending on social factors. For example, people who were not born in the U.S. or who had higher social vulnerability sometimes showed stronger links between PFAS and depression or stress.

“This study adds to mounting evidence that PFAS exposure during pregnancy may have negative health impacts on the pregnant individual, reinforcing the importance of minimizing exposure to PFAS during this sensitive time,” said Dr. Mitro.

Overall, the associations observed in this study were small, so more research is needed to fully understand the effects of PFAS on pregnancy mental health. Future studies could also help researchers clarify the biological mechanisms linking PFAS exposure to depression and stress and explore the role of social factors in influencing these associations.

This collaborative research, titled “Gestational PFAS concentrations in association with maternal depression and perceived stress during pregnancy and postpartum in the ECHO cohort,” is published in Environmental Research.

ECHO Study Investigates Relationship Between Chemical Exposures, Pregnancy Stress, & Birth Outcomes

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ECHO Study Investigates Relationship Between Chemical Exposures, Pregnancy Stress, & Birth Outcomes

Authors: Stephanie Eick, Anne Dunlop, 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?

Most previous research on the effects of chemical exposures on birth outcomes has focused on a small number of well-established chemicals, such as bisphenol A (BPA) and certain phthalates. However, there are over 350,000 chemicals registered for global use, and the impact of many emerging or understudied chemicals on birth outcomes is not well understood. Additionally, prior studies have not adequately considered how different kinds of maternal stress (such as anxiety, depression, and adverse childhood experiences) might influence the effects of chemical exposures during pregnancy. This study examined a broader range of chemicals and evaluated the role of stress in influencing their associations with birth outcomes.

 

What were the study results?

Exposure to chemicals found in certain consumer and industrial products (such as phthalates, bisphenols, and insecticides) was associated with shorter pregnancies among women who experienced anxiety during pregnancy or in the early postpartum period. Depression modified how exposure to certain chemicals (such as phthalates, parabens, and insecticides) affected birthweight and length of pregnancy. Some chemicals positively correlated with length of pregnancy (duration) for mothers with more depression, while others were associated with lower birthweights when mothers had more depression symptoms. The study suggested that the effects of a mother’s stress on the relationship between chemical exposures and birth outcomes depended on the type of chemical and type of stressor experienced.

 

What was this study's impact?

This study found that exposure to chemicals commonly found in consumer products was associated with shorter pregnancies and lower among women experiencing anxiety during or after pregnancy. While the results were mixed, the researchers observed some patterns where effects of chemical exposures were strongest among mothers who experienced depression and anxiety. These findings suggest that screening for depression and anxiety during pregnancy could help identify women who may be at a higher risk of adverse birth outcomes.

 

Who was involved?

The study included 1,556 mother-child pairs from 11 ECHO Cohort Study Sites. 810 of these participants provided information on perceived stress, depression, and anxiety. Additionally, participants provided information on adverse childhood experiences.

 

What happened during the study?

Pregnant participants provided urine samples, which researchers analyzed for 113 chemicals from 10 chemical classes. Pregnant participants also reported on their stress, depression, anxiety, and adverse childhood experiences. Researchers collected information on each mother’s birth outcomes, including the length of their pregnancy (in weeks) and the baby’s birthweight. The researchers performed statistical analyses to examine associations between chemical exposures, stress, and birth outcomes.

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 studies looking at the combined effects of multiple combined exposures could help researchers better understand the role of these factors in influencing birth outcomes. Future research could also further investigate potential biological effects of maternal adverse childhood experiences.

 

Where can I learn more?

Access the full journal article, titled “Psychosocial Stressors as Modifiers of the Associations Between Well-Studied and Understudied Chemicals and Birth Outcomes in the ECHO Cohort,” in Environmental Pollution.

 

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

 

Published January 15, 2026

Read the associated article.

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ECHO Study Investigates Relationship Between Chemical Exposures, Pregnancy Stress, & Birth Outcomes

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Pre-, Peri-, and Postnatal

Pregnancy Stress Can Influence Relationship Between Chemical Exposures & Birth Outcomes, ECHO Study Finds

Posted on by Jodi Snare

Stress, anxiety, and depression during pregnancy and maternal adverse childhood experiences may influence the relationship between certain chemical exposures and birth outcomes, according to a new ECHO Cohort study led by Stephanie Eick, PhD, MPH and Anne Dunlop, MD, MPH of Emory University.

Most previous research on the effects of chemical exposures on birth outcomes has focused on a small number of well-established chemicals, such as bisphenol A (BPA) and certain phthalates. However, there are over 350,000 chemicals registered for global use, and the impact of many emerging or understudied chemicals on birth outcomes is not well understood. Additionally, prior studies have not adequately considered how different kinds of maternal stress (such as anxiety, depression, and adverse childhood experiences) might influence the effects of chemical exposures during pregnancy.

This study included 1,556 mother-child pairs from eleven ECHO Cohort Study Sites across the United States. Researchers analyzed urine samples from pregnant participants for 113 different chemicals from 10 chemical classes. Participants also reported on their stress, depression, anxiety, and adverse childhood experiences, allowing researchers to evaluate how these factors affect the relationship between different chemical exposures and birth outcomes.

Key Takeaways include:

  • Exposure to chemicals found in certain consumer and industrial products (such as phthalates, bisphenols, and insecticides) was associated with shorter pregnancies among women who experienced anxiety during pregnancy or in the early postpartum period.
  • Depression modified how exposure to certain chemicals (such as phthalates, parabens, and insecticides) affected birthweight and length of pregnancy.
  • Some chemicals positively correlated with length of pregnancy (duration) for mothers with more depression, while others were associated with lower birthweights when mothers had more depression symptoms.
  • The effects of a mother’s stress on the relationship between chemical exposures and birth outcomes depended on the type of chemical and type of stressor experienced.

“These findings suggest that screening for depression and anxiety during pregnancy could help identify women who may be at a higher risk of adverse birth outcomes,” said Dr. Eick.

Additional studies looking at the combined effects of multiple combined exposures could help researchers better understand the role of these factors in influencing birth outcomes. Future research could also further investigate potential biological effects of maternal adverse childhood experiences.

This collaborative research, titled “Psychosocial Stressors as Modifiers of the Associations Between Well-Studied and Understudied Chemicals and Birth Outcomes in the ECHO Cohort,” is published in Environmental Pollution.

Read the research summary.

ECHO Study Finds Association Between Exposure to Certain PFAS and Maternal Depression & Stress During/After Pregnancy

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ECHO Study Finds Association Between Exposure to Certain PFAS and Maternal Depression & Stress During/After Pregnancy

Authors: Susanna D. Mitro, Lyndsay Avalos, 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?

Per- and polyfluoroalkyl substances (PFAS) are a large, complex group of synthetic chemicals found in some household products such as cookware and stain-resistant fabrics. These substances are often referred to as “forever chemicals” because they don’t break down easily, causing them to build up over time in water, soil, and air. Previous studies have shown that PFAS can negatively affect the brain, and there is conflicting evidence about their potential effects on depression and perceived stress during and after pregnancy. Depression and stress during these periods are common and linked to adverse health outcomes for both parents and children. This study aimed to clarify whether PFAS exposure during pregnancy is associated with an increased risk of depression and stress, and whether social factors affect these associations.

 

What were the study results?

Of the seven PFAS included in this study, some types were linked to changes in depression and stress for pregnant and postpartum participants. For example, higher levels of N-methyl perfluorooctane sulfonamido acetic acid (N-MeFOSAA) were associated with slightly higher depressive symptoms and perceived stress, especially postpartum, while higher perfluorodecanoic acid (PFDA) levels were associated with a lower risk of diagnosed depression and lower prenatal perceived stress. Exposure to perfluorooctanesolfonic acid (PFOS) showed a mixed pattern where moderate exposure was associated with increased depression risk, but the highest exposure was associated with lower depression risk.

When looking at all seven PFAS types as a group, there was generally no strong link to depression diagnosis or severity, but the data did show higher stress at low to moderate exposures, but lower stress as high exposure. The effects of PFAS were different depending on social factors. For example, people who were not born in the U.S. or who had higher social vulnerability sometimes showed stronger links between PFAS and depression or stress.

 

What was this study's impact?

Overall, the associations observed in this study were small, so more research is needed to fully understand the effects of PFAS on pregnancy mental health. This study adds to mounting evidence that PFAS exposure during pregnancy may have negative health effects during pregnancy, reinforcing the importance of minimizing exposure to PFAS during this sensitive time.

 

Who was involved?

The study included 4,403 pregnant participants from 16 ECHO Cohort study sites.

 

What happened during the study?

Researchers measured the levels of seven PFAS in the mother’s blood during pregnancy. Pregnant participants reported whether they received a diagnosis of depression during pregnancy and filled out surveys on their depression and stress symptoms before and after giving birth. The researchers then used statistical methods to evaluate potential associations between PFAS exposure and mental health outcomes and how social factors may have influenced these associations.

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 clarify the biological mechanisms linking PFAS exposure to depression and stress and explore the role of social factors in influencing these associations.

 

Where can I learn more?

Access the full journal article, titled “Gestational PFAS concentrations in association with maternal depression and perceived stress during pregnancy and postpartum in the ECHO cohort,” in Environmental Research.

 

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

 

Published December 1, 2025

Read the associated article.

Download this summary

ECHO Study Finds Association Between Exposure to Certain PFAS and Maternal Depression & Stress During/After Pregnancy

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Pre-, Peri-, and Postnatal