Many factors in pregnancy and childhood can affect health throughout a person’s lifetime, including exposure to environmental chemicals, household stress, diet, physical activity, depression, or anxiety.

Researchers at the Kaiser Permanente Division of Research (DOR) have been delving into some of these risk factors for the past 7 years by following the health of 2,130 Northern California mothers and their children.

This research is part of a multisite federal program called Environmental influences on Child Health Outcomes, or ECHO, supported by the National Institutes of Health (NIH).

This work can now continue for another 7 years after NIH recently announced $20 million in additional funding, along with another grant of up to $42 million for the recruitment of a new group of about 1,800 pregnant patients.

DOR studies supported by the initial ECHO funding have explored:

• Increased screen time for children during the pandemic
• Potential associations between autistic traits and environmental chemicals
• Association between maternal depression and autistic traits
• How a healthy lifestyle can lead to lower risk of preterm birth

“ECHO has been an important part of the women’s and children’s health research we do, and we are grateful to have this continued and expanded opportunity to continue it,” said DOR Research Scientist Assiamira Ferrara, MD, PhD, one of the project’s principal investigators.

The findings from this study are sure to have important public health implications as ECHO addresses critical gaps in knowledge about the long-term effects of environmental exposures during early life, said Kari Carlson, MD, associate executive director at The Permanente Medical Group. “I am excited to see this expansion of our role in a nationwide study of unparalleled size and diversity in the field of children’s health research.”

New funding supports new aims

The main research focus of the $42 million grant will be on childhood obesity, and neurodevelopment and associated prenatal and early-life lifestyle factors. The study will also consider social factors, such as economic and racial makeup of participants’ neighborhoods.

“The ECHO funding and collaboration opportunity has allowed us to explore many important issues around child health,” said Research Scientist Monique Hedderson, PhD, another principal investigator. “We look forward to both widening and deepening our research agenda over the next seven years.”

A main goal for study recruitment is expanding socioeconomic, racial, and ethnic diversity of participants. Recruitment is expected to start in Oakland and Richmond in early 2024.

The expanded ECHO project at DOR will also be led by research scientists Lisa Croen, PhD, Lyndsay Avalos, PhD, MPH, and Yeyi Zhu, PhD.

Additional ECHO investigators include DOR research scientists Stacey Alexeeff, PhD, Sylvia Badon, PhD, Ben Marafino, PhD, Susanna Mitro, PhD, Ousseny Zerbo, PhD, Jennifer Ames, PhD, and Luis Rodriguez, PhD, along with DOR research fellows Rana Chehab, PhD, and Alicia Peterson, PhD.

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