NIH awards more than $150 million for research on environmental influences on child health

The University of Alabama at Birmingham will help investigate the influence of environmental exposures on children’s health from conception through early childhood.

echo graphicThe University of Alabama at Birmingham has been awarded $1.2 million as a participant in a new seven-year initiative of the National Institutes of Health called the Environmental Influences on Child Health Outcomes program.

The ECHO program will investigate how exposure to a range of environmental factors in early development — from conception through early childhood — influences the health of children and adolescents. The NIH awarded $157 million in total funds for the first fiscal year of the project.

“The in utero environment is believed to play a major role in determining childhood and lifelong health outcomes,” said Joseph Biggio, M.D., director of the UAB Division of Maternal-Fetal Medicine. “The ECHO study provides us with an opportunity to examine childhood outcomes in a group of children whose mothers were followed closely during pregnancy with careful attention to exposures, pregnancy events and fetal growth — all of which may help provide insight into long-term health outcomes.”

UAB is part of the ECHO Pediatric Cohort Program called “Exposure Contributors to Child Health Originating from National Fetal Growth Study,” led by principal investigators at the Medical University of South Carolina, Charleston, and Columbia University, New York.

The ECHO pediatric cohort is designed to fund existing pediatric cohorts with a goal of enrolling more than 50,000 children from diverse racial, geographic and socioeconomic backgrounds to become part of the ECHO consortium. These cohort studies will analyze existing data as well as follow the children over time to address the early environmental origins of at least one of ECHO’s health outcome areas. Each cohort will participate with the others to combine data that are collected in a standardized way across the consortium, serving as a consortium resource for laboratory and statistical analyses of personal environmental exposures in existing and future collections of biological samples. The ECCHO-NFGS study team includes scientists from public health, obstetrics and pediatrics who will follow the children enrolled in the National Fetal Growth Study at 10 clinical centers throughout the United States, including UAB, MUSC and Columbia.

John Vena, Ph.D., professor and founding chairman of the MUSC Department of Public Health Sciences and co-principal investigator of ECCHO-NFGS, says the ECHO program is meant to provide significant information about what environmental factors might be affecting the health and wellness of the country’s children. From there, health care providers can pursue better, more customized treatments and interventions for pediatric patients and, in addition contribute to better health and wellness for all children.

“To have this many capable, brilliant researchers coming together in the interest of significantly determining what environmental risks are placing our children at most risk is a wonderful testament to the power of collective data and our determination to collaborate across institutions and state lines for the good of our nation’s children,” Vena said.

Experiences during sensitive developmental windows, including around the time of conception, later in pregnancy, and during infancy and early childhood, can have long-lasting effects on the health of children. These experiences encompass a broad range of exposures, from air pollution and chemicals in our neighborhoods to societal factors such as stress, to individual behaviors like sleep and diet. They may act through any number of biological processes, for example changes in the expression of genes or development of the immune system.

“This is a unique opportunity to gain insight into how the fetal in utero environment can impact later life,” said Ronald Wapner, M.D., ECCHO-NFGS co-principal investigator and Columbia University professor of obstetrics and gynecology, maternal fetal medicine, and reproductive genetics. “Over the last seven years, Columbia investigators have evaluated the trajectory of fetal growth as well as multiple maternal characteristics, such as nutrition, weight gain and environmental exposure. This work was sentinel in having this cohort chosen for this important study of childhood development.”

The awards announced today will build the infrastructure and capacity for the ECHO program to support multiple synergistic, longitudinal studies that extend and expand existing cohort studies of mothers and their children. ECHO research will focus on factors that may influence health outcomes around the time of birth as well as into later childhood and adolescence, including upper and lower airway health and development, obesity, and brain and nervous system development.

“Every baby should have the best opportunity to remain healthy and thrive throughout childhood,” said NIH Director Francis S. Collins, M.D., Ph.D. “ECHO will help us better understand the factors that contribute to optimal health in children.”

To learn more about ECHO and other program components, visit