Advancing Understanding of Chemical Exposures and Maternal-child Health Through the U.S. Environmental Influences on Child Health Outcomes (ECHO) Program: A Scoping Review.

Emily S Barrett,Jennifer L Ames,Stephanie M Eick,Alicia K Peterson,Zorimar Rivera-Núñez,Anne P Starling,Jessie P Buckley,Barbara O‟Brien,Lisa Peterson,Patrick Parsons,Kannan Kurunthacalam,Manish Arora,Timothy R Fennell,Susan J Sumner,Xiuxia Du,Susan L Teitelbaum,Robert O Wright,Heather M Stapleton,P Lee Ferguson,Akram Alshawabkeh,Judy Aschner,Clancy Blair,Leonardo Trasande,Carlos Camargo,Dana Dabelea,Daphne Koinis Mitchell,Cristiane Duarte,Anne Dunlop,Amy Elliott,Assiamira Ferrara,James Gern,Carrie Breton,Irva Hertz-Picciotto,Alison Hipwell,Margaret Karagas,Catherine Karr,Barry Lester,Leslie Leve,Debra Mackenzie,Scott Weiss,Cynthia Mcevoy,Kristen Lyall,Thomas O‟Connor,Emily Oken,Mike O‟Shea,Jean Kerver,Julie Herbstman,Susan Schantz,Joseph Stanford,Leonardo Trasande,Rosalind Wright,Sheela Sathyanarayana,Anne Marie Singh,Annemarie Stroustrup,Tina Hartert,Jennifer Straughen,Qi Zhao,Katherine Rivera-Spoljaric,Emily S Barrett,Monique Marie Hedderson,Kelly J Hunt,Sunni L Mumford,Hong-Ngoc Nguyen,Hudson Santos,Rebecca Schmidt,Jonathan Slaughter,For The Echo Cohort Consortium

doi:10.1007/s40572-024-00456-5

Abstract

Environmental chemical exposures may disrupt child development, with long-lasting health impacts. To date, U.S. studies of early environmental exposures have been limited in size and diversity, hindering power and generalizability. With harmonized data from over 60,000 participants representing 69 pregnancy cohorts, the National Institutes of Health's Environmental influences on Child Health Outcomes (ECHO) Program is the largest study of U.S. children's health. Here, we: (1) review ECHO-wide studies of chemical exposures and maternal-child health; and (2) outline opportunities for future research using ECHO data. As of early 2024, in addition to over 200 single-cohort (or award) papers on chemical exposures supported by ECHO, ten collaborative multi-cohort papers have been made possible by ECHO data harmonization and new data collection. Multi-cohort papers have examined prenatal exposure to per- and polyfluoroalkyl substances (PFAS), phthalates, phenols and parabens, organophosphate esters (OPEs), metals, melamine and aromatic amines, and emerging contaminants. They have primarily focused on describing patterns of maternal exposure or examining associations with maternal and infant outcomes; fewer studies have examined later child outcomes (e.g., autism) although follow up of enrolled ECHO children continues. The NICHD's Data and Specimen Hub (DASH) database houses extensive ECHO data including over 470,000 chemical assay results and complementary data on priority outcome areas (pre, peri-, and postnatal, airway, obesity, neurodevelopment, and positive health), making it a rich resource for future analyses. ECHO's extensive data repository, including biomarkers of chemical exposures, can be used to advance our understanding of environmental influences on children's health. Although few published studies have capitalized on these unique harmonized data to date, many analyses are underway with data now widely available.

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