Associations of Maternal Stress, Prenatal Exposure to Per- and Polyfluoroalkyl Substances (PFAS), and Demographic Risk Factors with Birth Outcomes and Offspring Neurodevelopment: An Overview of the ECHO.CA.IL Prospective Birth Cohorts

Abstract

Background. Infants whose mothers experience greater psychosocial stress and environmental chemical exposures during pregnancy may face greater rates of preterm birth, lower birth weight, and impaired neurodevelopment. Methods. ECHO.CA.IL is composed of two cohorts, Chemicals in Our Bodies (CIOB; n = 822 pregnant women and n = 286 infants) and Illinois Kids Development Study (IKIDS; n = 565 mother-infant pairs), which recruit pregnant women from San Francisco, CA and Urbana-Champaign, IL, respectively. We examined associations between demographic characteristics and gestational age, birth weight z-scores, and cognition at 7.5 months across these two cohorts using linear models. We also examined differences in biomarkers of exposure to per- and polyfluoroalkyl substances (PFAS), measured in second-trimester serum, and psychosocial stressors by cohort and participant demographics. Results. To date, these cohorts have recruited over 1300 pregnant women combined. IKIDS has mothers who are majority white (80%), whereas CIOB mothers are racially and ethnically diverse (38% white, 34% Hispanic, 17% Asian/Pacific Islander). Compared to CIOB, median levels of PFOS, a specific PFAS congener, are higher in IKIDS (2.45 ng/mL versus 1.94 ng/mL), while psychosocial stressors are higher among CIOB. Across both cohorts, women who were non-white and single had lower birth weight z-scores relative to white women and married women, respectively. Demographic characteristics are not associated with cognitive outcomes at 7.5 months. Conclusions. This profile of the ECHO.CA.IL cohort found that mothers and their infants who vary in terms of socioeconomic status, race/ethnicity, and geographic location are similar in many of our measures of exposures and cognitive outcomes. Similar to past work, we found that non-white and single women had lower birth weight infants than white and married women. We also found differences in levels of PFOS and psychosocial stressors based on geographic location.

Effect of perfluoroalkyl exposure in pregnancy and infancy on intrauterine and childhood growth and anthropometry. Sub study from COPSAC2010 birth cohort

“…Others have reported differences by geographic location, but not urbanicity. 28 Also fish intake associates with maternal concentrations as shown previously. 29 In general, the environmental factors we studied did not explain much of the variation in PFOS and PFOA exposure between mothers, and we were unable to establish any link between presence in drinking water and maternal concentrations.…”

Dietary predictors of prenatal per- and poly-fluoroalkyl substances exposure

“…S1) and included race/ethnicity, maternal age, education, and nativity. These covariates have been associated with both our exposure and outcomes in our study population and in prior studies [28,[34][35][36]. As a sensitivity analysis, we included food insecurity as a covariate in adjusted models, as we hypothesized that it may be an additional measure of socioeconomic status (SES).…”

Neighborhood conditions and birth outcomes

“…Participants were enrolled in the Chemicals in Our Bodies (CIOB) study, an ongoing prospective birth cohort which has previously been described in detail elsewhere. 22 Participants included in the present analysis delivered between 2014 and 2020 and included all individuals with completed medical record abstraction at the time of our analysis (N = 817). CIOB was designed to examine the cumulative effects of chemical and nonchemical stressors on fetal growth and offspring neurodevelopment.…”