ECHO Study Maps Environmental Exposures During Pregnancy to Molecular Changes Associated with Key Health Processes

Authors: Brett T. Doherty, Megan E. Romano, 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, under Award Numbers U2COD023375 (Coordinating Center), U24OD023382 (Data Analysis Center), and UH3 OD023275, and NIH NIEHS P42ES007373. Additional supporting entities include the Dartmouth Center for Molecular Epidemiology NIGMS, P20 GM104416) and the RTI Children’s Health Exposure Analysis Resource (CHEAR) Exposure Assessment Hub (NIEHS, U2CES026544, Fennell PI), among others

What were the study results?

Some of the chemical exposures were related to changes in the amounts of certain small molecules in the blood. Specifically, chemical exposures had the most impact on the amounts of a certain amino acids, which are the building blocks of many proteins that are important to both mother and child. When considered together, these molecule changes suggest that some of the chemical exposures may impact key health processes.

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 the study's impact?

This study used new tools to study how chemical exposures can affect important small molecules during pregnancy. The study results provide clues to the potential impact of these chemical exposures on the health of both mother and baby. In the future, further investigation of these chemical exposures may reveal more about their link to specific health endpoints.

Why was this study needed?

Pregnant women are exposed to chemicals in their environment. It is important to know how these chemicals might impact their health and the health of their babies. New tools can help us study how these chemicals affect health.

Who was involved?

This study included pregnant women in the New Hampshire Birth Cohort Study (NHBCS), who lived in north-central New England. A total of 177 women participated in this specific study within NHBCS.

What happened during the study?

During early pregnancy, women wore silicone wristbands for one week that captured chemicals in their environment. About three months later, the same women provided a blood sample, which was used to measure important molecules in their blood. Researchers looked at the link between environmental chemicals and the amounts of different molecules in the blood in order to better understand the health effects of these chemical exposures.

What happens next?

Going forward, it may be helpful to look for a link between the changes in molecules and related health processes and outcomes. Researchers may also want to reproduce these findings in other cohorts to better understand these environmental effects.

Where can I learn more?

Access the full journal article, titled “Chemical co-exposures assessed via silicone wristbands and endogenous plasma metabolomics during pregnancy,” is published in the Journal of Exposure Analysis and Environmental Epidemiology.

Learn about silicone wristbands at the MyExposome website.

Learn about small molecules and the methods to measure them through The UNC Nutrition Obesity Research Center (NORC) Metabolism and Metabolomics Core.

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

Published October 26, 2021

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ECHO Study Maps Environmental Exposures During Pregnancy to Molecular Changes Associated with Key Health Processes

The Effect of Phthalate Exposure on Placental Function and Gene Expression

Posted on September 13, 2021December 5, 2023 by Jodi Snare

Phthalates are man-made chemicals that are commonly found in plastics, solvents, and personal care products like perfumes, nail polishes, soaps, and hair sprays. Because they are found in so many household products, people can be exposed to them often. Unfortunately, there is little research on how exposure to phthalates can affect a pregnant woman’s health and the health of the developing baby. Investigating how exposures to phthalates affect the placenta, an organ that delivers oxygen and nutrients to the baby, can reveal more about the relationship between these chemical exposures and infant health.

To explore this research gap, Alison Paquette, PhD of Seattle Children’s Research Institute and the ECHO Pathways research team examined the association between phthalate exposure in the second and third trimester and gene expression in the placenta. This information provides insight into how phthalates may affect different placental functions.

To conduct this research, the team gathered urine samples from 760 women enrolled in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) study in Shelby County, TN. Their placentas were also collected after giving birth. Participants were between 16-40 years old, with relatively healthy pregnancies, and a majority were Black.

The team measured the levels of 16 different phthalates in each urine sample provided during the mother’s second and third trimesters and analyzed the levels of expression for every gene in the placenta after giving birth. Gene expression is a measure of how DNA is converted into proteins, which perform a variety of important cellular functions and play critical roles in development. For each gene, the researchers investigated the link between that gene’s expression and phthalate levels during pregnancy. The researchers used this information to analyze which biological pathways in the placenta are potentially affected by phthalate exposure.

The study found that several phthalates were associated with higher or lower placental gene expression for 38 genes. The team also identified some changes in gene expression that were only significant in male or female infants, indicating that phthalates may alter placental function differently for the different sexes. The team also found 27 specific biological pathways that may have been affected by phthalate exposure, including pathways essential to infant development. For example, the team found phthalate exposure was linked with decreased expression of the genes involved in the generation of fatty acids, which are essential building blocks for organ development. Changes in generating these fatty acids may impact how the fetus grows, particularly the brain, which may have a long-term impact on the child’s health.

“Placental gene expression is an important marker that can tell us if the placenta is performing all its normal jobs correctly. If the placenta is not functioning correctly, it may lead to pregnancy complications that threaten the health of both the mother and baby, or cause changes in fetal growth and development,” said Paquette. “By identifying how chemicals like phthalates alter placental function, it may help us understand the associations between phthalate exposure and some pregnancy complications.”

Moving forward, the research team will study how changes in the placenta are associated with other pregnancy complications, such as preterm birth, within the same population of women. Additional research, paired with new tools and technology, will also help them map out how phthalates may cause these changes in gene expression.

Read the research summary.

ECHO Study Identifies Demographics of Pregnant Women Least Likely to Get the Nutrients They Need

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ECHO Study Identifies Demographics of Pregnant Women Least Likely to Get the Nutrients They Need

Author(s): Katherine Sauder, 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.

What were the study results?

More than one in every five pregnant women did not eat enough of the vitamins D, E, K, and choline and the minerals magnesium and potassium, even when taking dietary supplements. The women most likely to not get enough vitamins and minerals were those aged 14-18 years, those who were Hispanic or Black, those who had less than a high school education, and those with obesity. Non-Hispanic women were the most likely to eat too much folic acid.

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 the study's impact?

The study showed that many pregnant women are at a high risk of not getting enough nutrients from food alone, so it is important for pregnant women to improve their diet quality and take dietary supplements when needed. The risk of not getting enough vitamins or minerals for women of various ages, races/ethnicities, education levels, or weights is often a problem, even when using dietary supplements.

This study shows that the dietary supplements women use today do not help them get all the nutrients they need in the right amounts. Pregnant women need guidance specific to their bodies to manage the vitamins and supplements they need. Different combinations and formulas of dietary supplements taken before getting pregnant may also help this problem and make sure women do not receive too much folic acid, iron, and zinc.

Why was this study needed?

One in three pregnant women in the United States eats too little or too many key vitamins and minerals. Prior studies do not tell us what groups are at the most risk for poor nutrition during pregnancy. Knowing who is at risk for poor nutrition can make it easier for doctors and public health workers to help pregnant women manage their nutrition.

Who was involved?

The researchers studied 9,801 women aged 14-50 years living across the United States who were pregnant between 1999 and 2019.

What happened during the study?

Pregnant women reported their daily food and dietary supplement intake during pregnancy. Researchers compared their daily intake of 19 vitamins and minerals to the Institute of Medicine recommendations for pregnant women.

What happens next?

The researchers will study how much vitamins and minerals women are getting from foods and compare this amount to the amount pregnant women should get. They will identify dietary supplements that can give women the right amounts of the vitamins and minerals they need.

Where can I learn more?

Access the full journal article, titled “Disparities in risks of inadequate and excessive intake of micronutrients during pregnancy” in Journal of Nutrition.

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

Published September 7, 2021

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ECHO Study Identifies Demographics of Pregnant Women Least Likely to Get the Nutrients They Need

ECHO Study Links Phthalate Exposure During Pregnancy With Genetic Changes in the Placenta

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ECHO Study Links Phthalate Exposure During Pregnancy With Genetic Changes in the Placenta

Authors: Alison Paquette, Sheela Sathyanarayana, 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.

What were the study results?

Researchers found that several phthalates were associated with changes in the expression of 38 genes within the placenta. Some of these changes in gene expression were only significant in male or female infants. This shows that phthalates may change how the placenta works in different ways for the two sexes. The team also studied which biological pathways were connected to these changes in gene expression. They found 27 specific pathways that may have been affected by phthalate exposure. These pathways involved important building blocks for the developing infant.

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 the study's impact?

Exposure to phthalate chemicals is related to changes in gene expression in placentas. This is important because these changes in gene expression may affect the growing baby.

Why was this study needed?

There is a lot we still don’t know about how phthalates affect the placenta. Phthalates are a group of chemicals used in plastics and household products. The placenta is an organ in pregnant women that provides their growing baby with oxygen and nutrients. It also helps mothers and babies share information. Exposure to phthalates during pregnancy may harm the placenta and affect how the baby develops. Looking at changes in how genes are expressed when exposed to phthalates during pregnancy can help researchers measure the effect on how the placenta works. Genes are expressed when DNA is converted into proteins, which perform a variety of important functions and play critical roles in development.

Who was involved?

The study involved pregnant women from Memphis, Tennessee who enrolled in the CANDLE study during their pregnancy. Researchers collected urine and placentas from mothers just after their babies were born. These participants were between 16-40 years old, mostly Black, and had relatively healthy pregnancies.

What happened during the study?

Researchers measured the amount of 16 phthalates in urine collected from the participants during the 2nd and 3rd trimester of pregnancy.

Researchers collected the placenta from the mother after having the baby and measured the expression of each gene in the placenta. For each gene, the researchers tried to figure out if higher phthalate concentrations were related to more or less gene expression in the placenta. This information was used to understand how phthalates may have affected how the placenta worked.

What happens next?

This research team will study how changes in the placenta are related to pregnancy complications like preterm birth within this same group of pregnant women. They will also use new tools and technologies to study how phthalates may cause these changes in gene expression.

It is also important to look at the effect of phthalates on other groups of women and see how these changes in placental function impact infant and childhood health.

Where can I learn more?

Read more information about how people are exposed to phthalates and how to decrease exposures.

Access the full journal article, titled “A Comprehensive Assessment of Associations between Prenatal Phthalate Exposure and The Placental Transcriptomic Landscape” 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 September 3, 2021

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ECHO Study Links Phthalate Exposure During Pregnancy With Genetic Changes in the Placenta

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

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

Author(s): Brett Doherty and Megan Romano

Who sponsored this study?

Research reported in this publication was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health, and grant funding.*

What were the study results?

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

What was the study's impact?

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

Why was this study needed?

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

Who was involved?

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

What happened during the study?

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

What happens next?

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

Where can I learn more?

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

Additional details

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

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

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

Published: September 29, 2020

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

Catherine Monk: Pregnant Women’s Mental Health and Its Influence on the Next Generation: Implications for ECHO Science

Pregnant Women’s Mental Health and Its Influence on the Next Generation: Implications for ECHO Science

Speaker:

Catherine Monk, PhD

Columbia University Medical Center

Speaker Bio: Dr. Catherine Monk holds dual appointments as a Professor of Medical Psychology in the Departments of Obstetrics & Gynecology, and Psychiatry, and is Director of Research at the Women’s Program at Columbia University Irving Medical Center, and Research Scientist VI at the New York State Psychiatric Institute. Originally trained as a clinical psychologist treating children and adults in a program that emphasized the developmental origins of psychopathology, Dr. Monk’s research brings together the fields of perinatal psychiatry, developmental psychobiology, and neuroscience to focus on the earliest influences on children’s developmental trajectories — those that happen in utero and how to intervene early to help pregnant women and prevent risk for mental health disorders in the future children.

Outcome Areas: Pre-, peri, and postnatal

Date: Wednesday, May 8, 1 to 2pm

Slides

Discussion:

Q: How do conceptualize stress? What are the challenges in measuring stress?

A: Stress is so used that it can lose precise meaning, but it is about the person-context experience and about perception. Stress can be measured by physical manifestations (allostatic load) or mental (subjective experience). The challenge in measuring is the difficulty in reliably linking high stress to high cortisol.

Q: One of the implications of the work was social support and its impact on outcomes. What would it look like to do a study of this as part of ECHO?

A: Social support has often been a co-variant or a moderator in past studies, but it actually accounts for large differences between groups, so it’s important to focus on in the future. ECHO could mine the data to create a hypothesis about the role of social support in creating positive outcomes. Loneliness is a factor that has been studied minimally, but would be fascinating to look at more closely, especially as it is differentiated from stress (women can be depressed or stress, but have social support).

Q: A type of research that you could look at that controls just for social support is the studies done on women having a doula at their birth. Has this been researched?

A: There is some data out there about the positive effect of doulas, but it’s not rigorous, so we could certainly bring in that perspective. Also, depending on where a woman gives birth, doulas may or may not be as welcomed and included in the process.

Q: In what ways would you study contributions of fathers in social support that might impact child outcomes?

A: “Belonging” is fairly general at this point, and not really distinguished as belonging with family, friends, or baby’s father, but we want to learn more about fathers/partners, and their roles in social support.

Q: Is there any data on pre-pregnancy stress and pregnancy and neurodevelopmental outcomes?

A: This is a main question of local cohort’s ECHO research.

Q: I’m wondering about the populations being investigated: low income, moderate income, and/or special populations, i.e., mothers and children in homeless shelters.

A: The part of New York (Washington Heights) where this cohort is includes a diverse group of women, with a large representation from Latina and low-income women. This includes women in homeless shelters.

Q: Is there any data comparing maternal non-treated depression vs. treated depression (use of medication) on health outcomes for the child?

A: Treating women’s psychiatric issues during pregnancy was not enough; parenting issues and risk factors that contributed to these issues were not impacted by the direct treatment of depression, and had to be addressed separately.

Q: In addition to fathers, teams should consider asking pregnant women about specific support from mother or other family/family-like individual. Particularly in minority communities and those of low-income, if biological fathers are not maintaining partnership with mothers, these individuals can play a critical role (our Memphis focus groups pointed this out to us too late for us to assess this). Our questionnaires don’t typically ask about this, and instead ask about partners.

A: That’s a great point, and I agree this needs to be broadened.

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

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

Author(s): Alison E. Hipwell, Linda G. Kahn, Pam Factor-Litvak, et al

Who sponsored this study?

This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health. This work was also supported by NIH grants P30 ES009089, R01ES013543, R01ES014393, R01ES08977, and T32ES023772.

What were the study results?

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

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

What was the study's impact?

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

Why was this study needed?

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

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

Who was involved?

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

What happened during the study?

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

What happens next?

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

Where can I learn more?

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

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

Published: January 1, 2019

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