pregnancy

Pregnancy Diet Patterns and their Associations with Birth Outcomes Differ Across Racial and Ethnic Groups

Posted on by Jodi Snare

Dietary patterns during pregnancy can affect maternal blood sugar levels and birth outcomes, with important differences depending on racial and ethnic backgrounds, according to a recent ECHO Cohort study led by Luis E. Maldonado, PhD, MPH, of the University of Southern California.

Which combination of foods most influences blood sugar and birth outcomes during pregnancy remains unclear, especially across different racial and ethnic groups. Studying these differences is important because, although diet is known to affect birth outcomes, variations in dietary patterns may help explain disparities—for example, Hispanic women in the U.S. face higher rates of preterm birth and low birthweight compared to non-Hispanic White women.

“Our findings show it’s important to look at how diet affects birth outcomes in different racial and ethnic groups separately, especially in diverse communities,” said Dr. Maldonado. “Combining all racial and ethnic groups into one might hide important differences in how diet relates to birth outcomes for each group.”

Researchers analyzed data from over 980 pregnant women—420 Hispanic and 564 non-Hispanic White participants—from two ECHO Cohort study sites. Their aim was to identify how different combinations of food related to blood sugar and birth outcomes such as preterm birth and low birthweight.

Key takeaways

  • Diets high in refined grains (like white bread or white rice) and low in whole grains were linked to babies being born earlier, smaller, or with low birthweight.
  • Analyzing dietary patterns within specific racial and ethnic groups revealed stronger associations with negative birth outcomes than when looking at the combined group.
  • Among non-Hispanic White women, whole grains were most strongly associated with better blood sugar control.
  • Fruit was linked to higher blood sugar levels among Hispanic participants.
  • Solid fats and nuts and seeds were associated with lower blood sugar levels in both groups.

The study underscores the value of considering dietary patterns separately within racial and ethnic groups to better understand how diet affects pregnancy outcomes. Future research can build on these findings by continuing to explore culturally relevant dietary patterns in diverse populations, helping uncover associations that may be missed in broader, combined analyses.

This collaborative research, titled “Racial/Ethnic-Derived Maternal Diets Predict Birth Outcomes Better than a Diet Derived from a Combined Sample among Hispanic/Latina and non-Hispanic White Pregnant Individuals in the ECHO Cohort,” in Nutrition.

Exposure to Phenols During Pregnancy Associated with Changes in Non-nutritive Suck Patterns in Infants, an Early Indicator of Brain Development

Posted on by Jodi Snare

Exposure to phenols—chemicals used in a variety of consumer products and industrial processes that can disrupt hormones—during pregnancy was associated with changes in patterns of infant non-nutritive suck, according to ECHO Cohort research led by Megan Woodbury, PhD and Emily Zimmerman, PhD, CCC-SLP of Northeastern University, and Andréa Aguiar, PhD of University of Illinois Urbana-Champaign.

Non-nutritive sucking is a common behavior during infancy where a baby may suck on an object that cannot provide nutrients, such as a pacifier. Non-nutritive sucking is characterized by bursts of sucking separated by pauses to breathe. Researchers can measure the frequency, speed, and strength of non-nutritive sucking. Because sucking is a behavior present from birth that is controlled by neurons in the brainstem, it is an ideal indicator of early brain development.

During the study, researchers measured phenol exposure by analyzing phenol levels in maternal urine samples collected during pregnancy. Non-nutritive sucking was evaluated in 1- to 8-week-old infants using a custom pacifier for approximately 5 minutes.

Key takeaways include:

  • Exposure to Bisphenol F, a common alternative to Bisphenol A or BPA found in some food packaging, was related to a lower non-nutritive suck frequency.
  • Exposure to Triclosan, an antimicrobial chemical found in some soaps, was associated with a higher non-nutritive suck frequency.
  • Exposure to other phenols used as preservatives and industrial processes (propylparaben, 2,4-dichlorophenol, and 2,5-dichlorophenol) was associated with weaker non-nutritive suck.
  • Exposure to some phenols used in sunscreens and industrial processes (benzophenone-3, 2,4-dichlorophenol, and 2,5-dichlorophenol) was related to more non-nutritive suck bursts per minute.
  • Propylparaben, a chemical used in some preservatives, was associated with more non-nutritive sucking per burst.

Previous studies linking changes in non-nutritive suck patterns to other exposures, such as maternal pregnancy stress and prenatal phthalate exposures, have also linked these exposures with decreased cognitive function in infants. The reasons these associations occur in the body are unknown but may be linked to hormone disruption during pregnancy.

“This study provides additional evidence that exposure to phenols may be related to developmental outcomes in children, demonstrating the need for continued research into how exposures during pregnancy impact infant health and development,” said Dr. Woodbury.

This collaborative research, titled “Examining the association between prenatal Phenol exposure and infant non-nutritive suck in two ECHO Cohorts,” was published in Environmental Epidemiology.

Vitamin D During Pregnancy May Play a Role in Children’s Cognitive Development, ECHO Study Suggests

Posted on by Jodi Snare

Higher vitamin D levels during pregnancy may be linked to better scores on cognitive tests, according to a new study by the Environmental influences on Child Health Outcomes (ECHO) Cohort.

Researchers found that children whose mothers had higher vitamin D levels while pregnant tended to perform better on cognitive tests assessing skills like problem-solving and processing new information at ages 7 to 12. However, vitamin D levels were not linked to skills based on learned knowledge, such as vocabulary. The association appeared strongest among children of Black mothers, and vitamin D levels measured earlier in pregnancy seemed most important for children’s brain development. Black people often have lower vitamin D levels because their skin has more pigment, which makes it harder for the skin to produce vitamin D from sunlight.

“Our study provides important new evidence that early pregnancy may be a critical period when vitamin D has the greatest potential to support cognitive development, said Melissa M. Melough, PhD, RD of the University of Delaware, Newark. “This highlights a key opportunity for clinicians to enhance screening and support for vitamin D supplementation before and during pregnancy. “

Vitamin D deficiency is common during pregnancy and has been linked to early brain development, but few studies have examined whether these effects continue into later childhood or differ by racial group. The researchers emphasize that while these findings add to growing evidence on the role of vitamin D in pregnancy, further studies are needed to determine the optimal dose and timing of supplementation to support cognitive development.

This collaborative research was published in The American Journal of Clinical Nutrition.

ECHO Study Finds Exposure to Phenols During Pregnancy Associated with Changes in Non-Nutritive Suck Patterns in Infants

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ECHO Study Finds Exposure to Phenols During Pregnancy Associated with Changes in Non-Nutritive Suck Patterns in Infants

Authors: Megan Woodbury, Andréa Aguiar, Emily Zimmerman, 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?

During this study, researchers evaluated the relationship between exposure to phenols—chemicals used in a variety of consumer products and industrial processes that can disrupt hormones—during pregnancy and non-nutritive sucking patterns in infants. Non-nutritive sucking is a common behavior during infancy where a baby may suck on an object that cannot provide nutrients, such as a pacifier. Non-nutritive sucking is characterized by bursts of sucking separated by pauses to breathe. Researchers can measure the frequency, speed, and strength of non-nutritive sucking. Because sucking is a behavior present from birth that is controlled by neurons in the brainstem, it is an ideal indicator of early brain development. Previous studies have indicated that non-nutritive sucking patterns can be affected by environmental exposures during pregnancy. Understanding this relationship could provide insights into how prenatal chemical exposures impact early neurodevelopment.

 

What were the study results?

The study found that phenol exposure during pregnancy was linked to changes in non-nutritive suck patterns in infants. Specifically, exposure to Bisphenol F, a common alternative to Bisephenol A or BPA found in some food packaging, was related to a lower non-nutritive suck frequency. Alternatively, exposure to Triclosan, an antimicrobial chemical found in some soaps, was associated with a higher non-nutritive suck frequency. Exposure to other phenols used as preservatives and industrial processes (propylparaben, 2,4-dichlorophenol, and 2,5-dichlorophenol) was associated with weaker non-nutritive suck. Exposure to some phenols used in sunscreens and industrial processes (benzophenone-3, 2,4-dichlorophenol, and 2,5-dichlorophenol) were related to more non-nutritive suck bursts per minute. Propylparaben, a chemical used in some preservatives, was associated with more non-nutritive sucking per burst.

 

What was this study's impact?

This study provides additional evidence that exposure to phenols may affect early brain development. Continued research into the effects of pregnancy exposures on infant health and development can help inform strategies for reducing potentially harmful exposures.

 

Who was involved?

The study included 215 mother-infant pairs from two ECHO Cohort study sites: the Illinois Kids Development Study (IKIDS) and ECHO in Puerto Rico (ECHO-PROTECT).

 

What happened during the study?

During the study, researchers measured phenol exposure by analyzing phenol levels in maternal urine samples collected during pregnancy. Non-nutritive sucking was evaluated in 1- to 8-week-old infants using a custom pacifier for approximately 5 minutes. Statistical methods were used to investigate how exposure to 11 different phenols and triclocarban—another chemical used as an antibacterial agent in some soaps—affected non-nutritive suck, adjusting for factors like study site, child sex and assessment age, and maternal age and education.

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 clarify why non-nutritive suck patterns change in response to certain pregnancy exposures and how these changes might affect the baby's brain development as they grow.

 

Where can I learn more?

Access the full journal article, titled “Examining the association between prenatal Phenol exposure and infant non-nutritive suck in two ECHO Cohorts,” in Environmental Epidemiology.

 

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

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ECHO Study Finds Exposure to Phenols During Pregnancy Associated with Changes in Non-Nutritive Suck Patterns in Infants

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Pre-, Peri-, and Postnatal

Prenatal Vitamin D Levels Associated with Children’s Brain Development, ECHO Study Suggests

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Prenatal Vitamin D Levels Associated with Children’s Brain Development, ECHO Study Suggests

Authors: Melissa Melough, 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?

Vitamin D deficiency is one of the most common nutrient deficiencies in the world. In the U.S., it affects 80% of Black pregnant women and nearly half of pregnant women with incomes below the federal poverty level. Low vitamin D during pregnancy may harm childhood brain development, leading to lower academic achievement in adolescence. This study aimed to clarify how vitamin D levels during pregnancy may influence children’s brain development, particularly in varied groups and into later childhood. While prior research suggests prenatal vitamin D plays an important role in early brain development, few studies have examined whether these effects persist beyond early childhood or vary across groups that may be at higher risk for vitamin deficiencies. For example, Black people often have lower vitamin D levels because their skin has more pigment, which makes it harder for the skin to produce vitamin D from sunlight. Researchers sought to build on previous evidence by studying a varied cohort of mothers and their children, followed until ages 7 to 12.

 

What were the study results?

Researchers found that children whose mothers had higher vitamin D levels while pregnant tended to perform better on cognitive tests assessing skills like problem-solving and processing new information at ages 7 to 12. However, vitamin D levels were not linked to skills based on learned knowledge, such as vocabulary. The link between vitamin D and thinking skills was stronger in children of Black mothers compared to other racial groups. Results also suggested that vitamin D levels early in pregnancy were most important for children’s brain development. The largest differences in children’s cognitive skills—between those with the highest and lowest scores—were linked to their mothers’ vitamin D levels early in pregnancy, suggesting this may be a critical time for brain development.

 

What was the study's impact?

The study provides evidence that early pregnancy may be a critical period when vitamin D has the greatest potential to support brain development. Interventions prior to or earlier in pregnancy, and those focused on Black women and others at high risk of deficiency, may have the greatest impact.

 

Who was involved?

The study included 912 biological mother-child pairs from five ECHO Cohort research sites. Approximately 38% of participants were vitamin D-deficient.

 

What happened during the study?

Researchers measured vitamin D levels in pregnant women’s blood during pregnancy or in their babies’ cord blood at birth. They tested the children’s fluid and crystallized cognition when they were 7 to 12 years old using a standard set of cognitive tests. They analyzed how vitamin D levels during pregnancy were linked to children’s cognitive scores, while considering other factors that could affect the results. They also looked at whether certain times during pregnancy mattered more by comparing vitamin D levels across pregnancy in mothers of children with higher versus lower cognitive scores. This helped them identify when vitamin D might have the greatest impact on brain development.

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 research, including randomized trials, could help researchers identify the optimal dose and timing of vitamin D supplementation for children’s cognitive development.

 

Where can I learn more?

Access the full journal article, titled “Gestational vitamin D concentration and child cognitive development: a longitudinal cohort study in the Environmental influences on Child Health Outcomes Program,” in The American Journal of Clinical Nutrition.

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

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Prenatal Vitamin D Levels Associated with Children’s Brain Development, ECHO Study Suggests

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A Diet High in Refined Grains and Low in Whole Grains in Pregnancy Linked to Lower Birthweights and Pre-term Births

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A Diet High in Refined Grains and Low in Whole Grains in Pregnancy Linked to Lower Birthweights and Pre-term Births

Analyzing Diets Based on Racial and Ethnic Groups May Better Predict Outcomes

Authors: Luis E. Maldonado, 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?

Researchers wanted to understand how a pregnant person’s diet, especially in relation to their blood sugar levels (fasting blood glucose), affects birth outcomes—like the baby’s weight and whether the baby is born early. Higher fasting blood glucose during pregnancy is known to increase the risk of adverse birth outcomes. However, little is known about whether culturally influenced combinations of foods and beverages play a meaningful role across different racial and ethnic groups. This question is important because, in the U.S., Hispanic pregnant women are disproportionately affected by adverse birth outcomes, such as preterm birth and low birthweight (under 5.5 pounds). By examining dietary patterns within racial and ethnic groups, the researchers aimed to uncover more precise links between diet and birth outcomes. These links might be overlooked when analyzing the population as a whole, since average diets often reflect the eating patterns of the most represented groups in the study.

 

What were the study results?

Refined grains, such as white bread or white rice, showed the strongest association with higher fasting blood sugar levels among Hispanic and non-Hispanic White women. People who ate diets high in refined grains and low in whole grains were more likely to have babies born with low birthweight, smaller for gestational age, or born preterm.

When dietary patterns were analyzed by racial and ethnic group, the associations between diet, blood sugar, and birth outcomes were stronger than when using a single pattern for the full population. In the group that included non-Hispanic White and Hispanic participants, nuts, seeds, and solid fats such as butter and lard were linked to lower blood sugar. Among non-Hispanic White participants, whole grains and solid fats had the strongest association with improved blood sugar control. In contrast, among Hispanic participants, higher fruit consumption was associated with elevated blood sugar levels. These food-specific associations should be considered within the overall dietary pattern, as individual foods can influence blood sugar – beneficially or adversely – within the broader diet.

 

What was the study's impact?

The results of this study show the importance of looking at dietary patterns within racial and ethnic groups, particularly in studies with varying representation of different racial and ethnic populations. Analyzing a single, combined group may mask group-specific associations between diet and birth outcomes, as the effects of diet can differ across racial and ethnic backgrounds.

 

Who was involved?

The study included 420 Hispanic and 564 non-Hispanic White pregnant participants from two ECHO Cohort study sites.

 

What happened during the study?

During the study, participants shared details about what they ate over a 24-hour period. The researchers analyzed the diets, along with the mother’s blood sugar, to help determine which combinations of foods eaten together in an overall diet are most closely linked to changes in blood sugar levels. They then tested whether the links between diet and birth outcomes were different across racial and ethnic groups by comparing findings from diets derived using group-specific versus combined fasting blood glucose, which have also been previously shown to vary by racial and ethnic population.

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 research could continue exploring how dietary patterns affect birth outcomes in diverse populations, especially by identifying patterns that are specific to different racial and ethnic groups.

 

Where can I learn more?

Access the full journal article, titled “Racial/Ethnic-Derived Maternal Diets Predict Birth Outcomes Better than a Diet Derived from a Combined Sample among Hispanic/Latina and non-Hispanic White Pregnant Individuals in the ECHO Cohort,” in Nutrition.

 

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

Published June 12, 2025

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A Diet High in Refined Grains and Low in Whole Grains in Pregnancy Linked to Lower Birthweights and Pre-term Births

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Pregnancy and birth

Unusual Early Childhood Weight Patterns Associated with Higher Risk of Future Obesity

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Unusual Early Childhood Weight Patterns Associated with Higher Risk of Future Obesity

Authors: Chang Liu, Jody Ganiban, 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?

Childhood obesity is defined as having a body mass index (BMI) 0at or above the 95th percentile for age and sex. Without early support or intervention, children who show patterns of high BMI during childhood are more likely to become overweight or obese as teenagers and adults. This increases their risk for long-term health issues, including diabetes and heart disease. To prevent these outcomes, it's important to understand how children's BMI changes over time and identify early-life factors—especially those that can be changed—that influence childhood growth patterns. This study aimed to identify unusual BMI patterns (sometimes called atypical BMI trajectories) in early childhood and understand which early-life factors may contribute to them.

 

What were the study results?

In this study, researchers found two common patterns in how children’s BMI changes over time. Most children (89.4%) had a typical pattern where their BMI went down from ages 1 to 6, then slowly increased. A smaller group (10.6%) had an atypical pattern where their BMI stayed the same from ages 1 to 3.5, then showed rapid increases from ages 3.5 to 9. By age 9, these children were more likely to develop obesity, with an average BMI higher than the 99th percentile.  Some factors that associated with the risk of a child developing obesity included high birthweight, maternal smoking during pregnancy, high maternal BMI before pregnancy, and greater maternal weight gain during pregnancy.

 

What was this study's impact?

The study highlights key prenatal risk factors and early childhood growth trajectories related to childhood obesity, offering opportunities for early prevention and intervention to help children stay on a healthy growth path and reduce their chances of becoming obese.

 

Who was involved?

The study included 9,483 children from diverse racial, geographical, and socioeconomic backgrounds from the ECHO Cohort.

 

What happened during the study?

Researchers looked at data collected over time about children’s weight and height from medical records, measurements taken by staff, reports from caregivers, or measurements taken at home. They tracked how children's BMI changed as they grew and looked for patterns.

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 understand the biological mechanisms and social/environmental factors linked to childhood obesity, helping to develop targeted intervention programs that can redirect unhealthy BMI trajectories.

 

Where can I learn more?

Access the full journal article, titled “Early-Life Factors and Body Mass Index Trajectories Among U.S. Children in the ECHO Cohort,” in JAMA Network Open.

 

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

Published May 22, 2025

 

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Unusual Early Childhood Weight Patterns Associated with Higher Risk of Future Obesity

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Obesity

Early Childhood Weight Patterns May Signal Future Obesity Risk, NIH Study Finds

Posted on by Jodi Snare

Happy boy eating apple while communicating with his teacher during lunch time.Researchers identified growth patterns and early-life factors linked to higher obesity risk at age 9.

Not all children grow the same way. A new study from the Environmental influences on Child Health Outcomes (ECHO) Program suggests that body weight changes in early childhood may be associated with later obesity risk.

Funded by the National Institutes of Health (NIH), the study tracked children’s body mass index (BMI) from infancy through age 9 and found two distinct growth patterns. Most children followed a typical curve, with BMI decreasing in early childhood before gradually rising again. But a smaller group followed a trajectory marked by a sharp rise in BMI, which put them at higher risk of developing obesity by age 9.

Key takeaways:

  • Researchers found two main BMI growth patterns in children. Most children (89.4%) had a typical pattern where their BMI declined from ages 1 to 6, then rose slowly. A smaller group (10.6%) had an atypical pattern where their BMI stayed the same from ages 1 to 3.5, then increased rapidly from ages 3.5 to 9.
  • By age 9, children in the atypical group were more likely to develop obesity, with an average BMI higher than the 99th percentile.
  • Several early-life factors were associated with the child’s risk of developing obesity, including high birthweight, maternal smoking during pregnancy, high maternal BMI before pregnancy, and excessive maternal weight gain during pregnancy.

Childhood obesity—defined as having a BMI at or above the 95th percentile for a child’s age and sex—is often the result of excess body fat. Without support or intervention, children with higher BMI patterns in early life are more likely to carry that weight into adolescence and adulthood, increasing their chances of developing serious health conditions like diabetes and heart disease.

“The fact that we can identify unusual BMI patterns as early as age 3.5 shows how critical early childhood is for preventing obesity,” said ECHO researcher Chang Liu, PhD, of Washington State University.

The study included 9,483 children across the United States who are part of the ECHO Cohort. Researchers looked at weight and height data collected over time from medical records, caregiver reports, and in-person or at-home measurements. They tracked how children's BMI changed as they grew and looked for patterns related to experiences early in life.

“Our findings suggest there are important opportunities to reduce childhood obesity, such as helping pregnant women quit smoking and manage healthy weight gain, as well as closely monitoring children who show early signs of rapid weight gain,” said Liu.

This collaborative research is published in JAMA Network Open.

Liu, Chang, M., et al. (2025) Early-Life Factors and Body Mass Index Trajectories Among U.S. Children in the ECHO Cohort. JAMA Network Open. DOI: 10.1001/jamanetworkopen.2025.11835

 

About ECHO
The ECHO Cohort Consortium is a research program supported by the National Institutes of Health (NIH) with the mission to enhance the health of children for generations to come. ECHO Cohort investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

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.

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

ECHO Research Finds No Significant Association Between Prenatal Antibiotic Use and Wheezing Symptoms in Infants

Posted on by Jodi Snare

Wheezing symptoms occur in 20-40% of infants, contributing to a substantial impact on children’s quality of life and their use of healthcare. Multiple early exposures, such as prenatal exposure to cigarette smoking, have been associated with these wheezing symptoms. Previous studies have suggested a possible link between antibiotic exposure during pregnancy and an increased risk of wheezing and cough in children, caused by an imbalance in the birthing parent’s microbiome due to antibiotic use.

“It is unlikely that a randomized controlled trial could be done to try to answer this question, because antibiotics are necessary treatments for bacterial infections during pregnancy,” said ECHO Cohort investigator Rachel Greenberg, MD, MB, MHS of Duke University. “In the absence of trial data, large studies that observe individuals over time, like the ECHO Cohort, are essential to understand the impact of common interventions during pregnancy.”

This study included 4,721 pregnant participants and their 4,779 infants from 12 study sites in the ECHO Cohort Consortium. Overall, 36% of pregnant participants used at least one antibiotic while pregnant, and about 26% of infants had a report of wheezing.

Key takeaways include:

  • Exposure to antibiotics during pregnancy was not associated with infant wheezing during the first 18 months after birth.
  • Prenatal antibiotic exposure was also not associated with an increase in emergency room visits or hospitalizations for wheeze during infancy.
  • However, prenatal antibiotic use was associated with higher odds of medication use for wheeze or dry cough during infancy, which could imply more severe symptoms and a medical provider’s diagnosis.
  • An association between prenatal antibiotic exposure and medication use for wheeze or cough during infancy was only observed among children born via vaginal delivery and thus exposed to the birthing parent’s microbiota.
  • The researchers also observed an association between prenatal antibiotic exposure and wheeze in research sites that recruited participants who had a family history of asthma, suggesting that a genetic or environmental risk within these families may increase the likelihood of wheeze.

This collaborative research, titled “Association Between Prenatal Antibiotic Exposure and Infant Wheeze Outcomes” is published in Acta Paediatrica.

 

Obesity, Diabetes, & High Blood Pressure Before and During Pregnancy are Associated with Higher Blood Pressure in Children

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Obesity, Diabetes, & High Blood Pressure Before and During Pregnancy are Associated with Higher Blood Pressure in Children

Authors: Zhongzheng Niu, 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?

High blood pressure in childhood is linked to a higher risk of experiencing high blood pressure and other heart-related complications later in life. Preventing high blood pressure during childhood could be a promising strategy to improve cardiovascular health into adulthood. Growing evidence suggests that maternal health during pregnancy may be a contributor. For this study, researchers wanted to look at how three common cardiometabolic risk factors— pre-pregnancy obesity, gestational diabetes, and high blood pressure (hypertension) during pregnancy—are related to blood pressure in their children between ages 2 and 18.

 

What were the study results?

A new finding from this study is that when mothers had more than one health issue during pregnancy—especially when high blood pressure occurred alongside gestational diabetes or pre-pregnancy obesity—their children’s blood pressure was higher than when the mother had only one of these conditions. Of the mothers included in this study, 44% had at least one cardiometabolic risk factor during pregnancy. The most common was pre-pregnancy obesity at 26%, followed by high blood pressure at 14% and gestational diabetes at 7.3%. Children whose mothers had any of these health issues during pregnancy had higher average blood pressure when compared to those born to mothers who did not. This was true for the top (systolic) and the bottom (diastolic) numbers in a blood pressure reading, even after accounting for the child’s age, sex, and height. These children also showed an increased rate of blood pressure change between ages 2 and 18. The association was stronger for diastolic blood pressure in female children and for systolic blood pressure in non-Hispanic Black children whose mothers had gestational diabetes or high blood pressure during pregnancy.

 

What was this study's impact?

This study can help researchers and clinicians better understand how a mother’s heart and metabolic health during pregnancy may influence a child’s long-term cardiovascular health. This highlights the potential value of early-life interventions aimed at monitoring and managing blood pressure in children with prenatal exposure to these maternal risk factors.

 

Who was involved?

The research included 12,480 mother-child pairs from study sites in the ECHO program. The mother's average age at pregnancy was 30 years, and 47% of participating mothers were non-White. At least one maternal cardiometabolic risk factor was present in 44% of the mothers.

 

What happened during the study?

Researchers gathered information about mothers’ heart and metabolic health from medical records or surveys. They also collected blood pressure readings from their children, either during study visits or from their medical records. They used statistical methods to look at how a mother’s health before and during pregnancy might be linked to her child’s blood pressure—both at the youngest age and as the child grew from age 2 to 18. They also looked at whether these links were different depending on the child’s sex or race and ethnicity.

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?

More research could help researchers understand how combinations of maternal cardiometabolic risk factors influence children’s blood pressure over time. Future studies could also examine how structural and social factors contribute to maternal health during pregnancy and shape long-term cardiovascular health in children.

 

Where can I learn more?

Access the full journal article, titled “Maternal cardiometabolic risk factors in pregnancy and offspring blood pressure at age 2-18 years,” in JAMA Network Open.

 

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

Published May 08, 2025

 

Access the associated press release.

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Obesity, Diabetes, & High Blood Pressure Before and During Pregnancy are Associated with Higher Blood Pressure in Children

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Pre-, Peri-, and Postnatal