Environmental influences on child health outcomes: cohorts of individuals born very preterm

Abstract

The National Institutes of Health’s Environmental influences on Child Health Outcomes (ECHO) Program was designed to address solution-oriented research questions about the links between children’s early life environment and their risks of pre-, peri-, and post-natal complications, asthma, obesity, neurodevelopmental disorders, and positive health. Children born very preterm are at increased risk for many of the outcomes on which ECHO focuses, but the contributions of environmental factors to this risk are not well characterized. Three ECHO cohorts consist almost exclusively of individuals born very preterm. Data provided to ECHO from cohorts can be used to address hypotheses about (1) differential risks of chronic health and developmental conditions between individuals born very preterm and those born at term; (2) health disparities across social determinants of health; and (3) mechanisms linking early-life exposures and later-life outcomes among individuals born very preterm. Impact The National Institutes of Health’s Environmental Influences on Child Health Outcomes Program is conducting solution-oriented research on the links between children’s environment and health. Three ECHO cohorts comprise study participants born very preterm; these cohorts have enrolled, to date, 1751 individuals born in 14 states in the U.S. in between April 2002 and March 2020. Extensive data are available on early-life environmental exposures and child outcomes related to neurodevelopment, asthma, obesity, and positive health. Data from ECHO preterm cohorts can be used to address questions about the combined effects of preterm birth and environmental exposures on child health outcomes.

Health Care Utilization During the COVID-19 Pandemic Among Individuals Born Preterm

“…Figure 1 provides a study population flowchart. Six ECHO cohorts consisted of participants born very preterm (<32 weeks’ gestation) . After excluding cohorts and participants with missing key data, the final analytical data set included 42 cohorts of 1691 mother-offspring pairs, including 270 individuals born preterm and 1421 individuals born at term.…”

Phthalate exposure in the neonatal intensive care unit is associated with development of bronchopulmonary dysplasia

“…This study draws from the DINE cohort ( O’Shea et al, 2023 ), part of the Environmental Influences on Child Health Outcomes (ECHO) program ( Blaisdell et al, 2022 ; Gillman and Blaisdell, 2018 ). DINE combined sites from four existing preterm cohorts: the Prematurity and Respiratory Outcomes Program (PROP) ( Pryhuber et al, 2015 ), the Trial of Late Surfactant (TOLSURF) study ( Ballard et al, 2016 ), the Preterm Erythropoietin Neuroprotection Trial (PENUT) ( Juul et al, 2015 ), and the NICU Hospital Exposures and Long-Term Health (NICU-HEALTH) study ( Stroustrup et al, 2019 ).…”

A global perspective of correlation between maternal blood lead levels and risks of preeclampsia: An updated systematic review and meta-analysis

“…Interestingly, gender differences were found in 949 mother-child pairs research. Male neonates were at higher risk of preterm delivery even if maternal lead exposure was low (56,57). In an Iranian study, a negative correlation between intrauterine lead exposure and neonatal birth weight was reported recently (58).…”

“…Thirdly, high maternal BLL may lead to local changes in miRNA profiles based on research focusing on the cervix (31). As lead can freely cross the placenta, maternal lead exposure during pregnancy could lead to higher in-utero lead levels (56). The high levels of umbilical cord blood lead can further trigger changes in fetal miRNA profiles, making it more susceptible to developing maternal preeclampsia and fetal preterm birth or stillbirths.…”