Cohort profile: the ECHO prenatal and early childhood pathways to health consortium (ECHO-PATHWAYS)
Paul Moore,
Jennifer Powell,
Emily Barrett,
Shanna H Swan,
Sheela Sathyanarayana,
Kaja Z LeWinn,
Catherine J Karr,
Marnie Hazlehurst,
Kecia Carroll,
Christine Loftus,
Ruby Nguyen,
Adam A Szpiro,
Alison Paquette,
Elizabeth Spalt,
Lisa Younglove,
Alexis Sullivan,
Trina Colburn,
Nora Byington,
Lauren Sims Taylor,
Stacey Moe,
Sarah Wang,
Alana Cordeiro,
Aria Mattias,
Tye Johnson,
Amanda Norona-Zhou,
Alex Mason,
Nicole R Bush
Affiliations
Paul Moore
Division of Allergy, Immunology, and Pulmonology and the Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Jennifer Powell
Center for Child Health, Behavior, and Development, Seattle Children`s Research Institute, Seattle, Washington, USA
Emily Barrett
Department of Biostatistics and Epidemiology, Environmental and Occupational Health Sciences Institute (EOHSI), Rutgers School of Public Health, Rutgers University, Piscataway, New Jersey, USA
Shanna H Swan
Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
Sheela Sathyanarayana
Center for Child Health, Behavior, and Development, Seattle Children`s Research Institute, Seattle, Washington, USA
Kaja Z LeWinn
Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California San Francisco, San Francisco, California, USA
Catherine J Karr
Department of Environmental and Occupational Health Sciences and Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
Marnie Hazlehurst
Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
Kecia Carroll
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Christine Loftus
Department of Environmental Health and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
Ruby Nguyen
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota System, Minneapolis, Minnesota, USA
Adam A Szpiro
Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington, USA
Alison Paquette
Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington, USA
Elizabeth Spalt
Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
Lisa Younglove
Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
Alexis Sullivan
Center for Health and Community, School of Medicine, University of California San Francisco, San Francisco, California, USA
Trina Colburn
Center for Child Health, Behavior, and Development, Seattle Children`s Research Institute, Seattle, Washington, USA
Nora Byington
Center for Child Health, Behavior, and Development, Seattle Children`s Research Institute, Seattle, Washington, USA
Lauren Sims Taylor
Department of Preventive Medicine, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
Stacey Moe
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota System, Minneapolis, Minnesota, USA
Sarah Wang
Center for Child Health, Behavior, and Development, Seattle Children`s Research Institute, Seattle, Washington, USA
Alana Cordeiro
Center for Health and Community, School of Medicine, University of California San Francisco, San Francisco, California, USA
Aria Mattias
Department of Envrionmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
Tye Johnson
Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York, USA
Amanda Norona-Zhou
Center for Health and Community, School of Medicine, University of California San Francisco, San Francisco, California, USA
Alex Mason
Department of Preventive Medicine, College of Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
Nicole R Bush
Department of Psychiatry and Behavioral Sciences and the Department of Pediatrics, School of Medicine, University of California San Francisco, San Francisco, California, USA
Purpose Exposures 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.Participants The 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 date Early 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 plans The 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.
