Cohort profile: the ECHO prenatal and early childhood pathways to health consortium (ECHO-PATHWAYS)

Abstract

PurposeExposures early in life, beginning in utero, have long-term impacts on mental and physical health. The ECHO prenatal and early childhood pathways to health consortium (ECHO-PATHWAYS) was established to examine the independent and combined impact of pregnancy and childhood chemical exposures and psychosocial stressors on child neurodevelopment and airway health, as well as the placental mechanisms underlying these associations.ParticipantsThe ECHO-PATHWAYS consortium harmonises extant data from 2684 mother–child dyads in three pregnancy cohort studies (CANDLE [Conditions Affecting Neurocognitive Development and Learning in Early Childhood], TIDES [The Infant Development and Environment Study] and GAPPS [Global Alliance to Prevent Prematurity and Stillbirth]) and collects prospective data under a unified protocol. Study participants are socioeconomically diverse and include a large proportion of Black families (38% Black and 51% White), often under-represented in research. Children are currently 5–15 years old. New data collection includes multimodal assessments of primary outcomes (airway health and neurodevelopment) and exposures (air pollution, phthalates and psychosocial stress) as well as rich covariate characterisation. ECHO-PATHWAYS is compiling extant and new biospecimens in a central biorepository and generating the largest placental transcriptomics data set to date (N=1083).Findings to dateEarly analyses demonstrate adverse associations of prenatal exposure to air pollution, phthalates and maternal stress with early childhood airway outcomes and neurodevelopment. Placental transcriptomics work suggests that phthalate exposure alters placental gene expression, pointing to mechanistic pathways for the developmental toxicity of phthalates. We also observe associations between prenatal maternal stress and placental corticotropin releasing hormone, a marker of hormonal activation during pregnancy relevant for child health. Other publications describe novel methods for examining exposure mixtures and the development of a national spatiotemporal model of ambient outdoor air pollution.Future plansThe first wave of data from the unified protocol (child age 8–9) is nearly complete. Future work will leverage these data to examine the combined impact of early life social and chemical exposures on middle childhood health outcomes and underlying placental mechanisms.

A Multi-Cohort Examination of the Independent Contributions of Maternal Childhood Adversity and Pregnancy Stressors to the Prediction of Children’s Anxiety and Depression

“…Participants were 1389 mother-child dyads with outcome data who were enrolled in one of three prospective pregnancy cohorts participating in the U.S.-based NIH ECHO-PATHWAYS Consortium: TIDES, CANDLE, and GAPPS (LeWinn et al, 2022).…”

Association between maternal occupational exposure to cleaning chemicals during pregnancy and childhood wheeze and asthma

“…Our findings contribute to a very limited and mixed literature on maternal occupational exposures, specifically during the prenatal period, and child airway health. We were able to examine the association between prenatal exposure to occupationally associated cleaning chemicals and risk of developing childhood wheeze and asthma in a U.S. based cohort comprising several cities with robust adjustment for mother and child demographic, behavioral and socioeconomic covariates and potential confounders (29).…”

“…The study participants were mother-child pairs from two ECHO-PATHWAYS consortium pregnancy cohorts: the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) and The Infant Development and Environment Study (TIDES) (29).…”

Role of Air Pollution in the Development of Asthma Among Children with a History of Bronchiolitis in Infancy

“…ECHO-PATHWAYS cohorts have been described previously. [27][28][29][30] In brief, CANDLE recruited women aged 16-40 years and in the second trimester with singleton, low-medical-risk pregnancies between 2006 and 2011 within Shelby County (Memphis), Tennessee. 29 GAPPS recruited women aged 18 years or older who shared demographic and health information and biospecimens with the GAPPS biorepository.…”

“…29 GAPPS recruited women aged 18 years or older who shared demographic and health information and biospecimens with the GAPPS biorepository. 30 Participants were enrolled from 2011 to 2016 at two hospitals in Seattle, Washington and one hospital in Yakima, Washington with follow-up ending just after birth. TIDES recruited low-medical-risk pregnant women aged 18 years or older in the first trimester from obstetrical clinics located in Minneapolis, Minnesota; Rochester, New York; San Francisco, California; and Seattle, Washington between 2010 and 2012.…”