Abstract
Evidence has linked maternal exposure to stress during pregnancy with poor offspring health and neurodevelopmental outcomes. However, the precise mechanism by which this may occur has not been fully elucidated. In this study, we examined whether maternal perceived stress during pregnancy was associated with newborn blood DNA methylation (DNAm) in hypothalamic–pituitary–adrenal axis-related genes (NR3C1, FKBP5, and HSD11B2) in single CpG site and gene-based analyses. We analysed a subset of 661 mother–child pairs from the Environmental Influences on Child Health Outcomes cohort study that met our analytic inclusion criteria. Maternal perceived stress was measured during pregnancy using the perceived stress scale, and newborn DNAm was measured using the Illumina 450K and EPIC Beadchips in cord blood and dried blood spots. Single-site associations were evaluated using linear regression models, and gene-based associations were evaluated using mean burden and variance component tests, adjusted for sociodemographic and lifestyle covariates. Sex-stratified models were used to evaluate sex differential effects. Prenatal perceived stress was statistically significantly associated with newborn DNAm in one CpG site (cg06613263) in NR3C1 and with aggregate DNAm in NR3C1 and FKBP5. Aggregate DNAm in FKBP5 was more strongly associated with prenatal perceived stress in female infants. These results may have important implications for improving offspring health and well-being by providing molecular targets that can be used to identify high-risk individuals and as a basis for developing and evaluating effective behaviour and pharmaceutical interventions.
Keywords: perceived stress, pregnancy, DNA methylation, HPA axis
Introduction
Exposure to prenatal stress is a concerning public health problem among women in the USA. Data from the Pregnancy Risk Assessment Monitoring System shows that 70% of women reported experiencing at least one stressful life event (SLE) in the year prior to their infant’s birth, and prior studies have reported high rates of psychosocial stress among pregnant women in the USA [1–3]. Maternal stress exposure during pregnancy has been linked to various offspring health outcomes, including preterm birth, low birthweight, sleep disorders, and neurodevelopmental disorders [4–8]. However, the underlying biological mechanisms by which these associations may occur are not fully characterized [9, 10]. Understanding these mechanisms may provide a means of identifying at-risk individuals or to facilitate the development and evaluation of interventions that mitigate the potential harms of maternal stress exposure during pregnancy.
Foetal DNA methylation (DNAm) may be an important biological mechanism in the link between prenatal stress and offspring health and development. The epigenome acts as an interface between genes and the environment, and DNAm is among the most extensively studied forms of epigenetic modification [7, 11–14]. DNAm involves the reversible addition or removal of a methyl group to the cytosine nucleotides in the CpG sites of a gene, leading to increases or decreases in gene expression. The gestational period is one of large-scale, dynamic DNAm change, and this developmental window is marked by a heightened sensitivity to environmental stimuli, leading to changes in DNAm state [11]. In a process known as foetal programming, these DNAm changes lead to functional and organizational changes in various biological systems, including the central nervous, autonomic nervous, neuro-endocrine, and immune systems [7, 11]. Foetal programming may prime the individual for future environmental insults and also may lead to an increased susceptibility to adverse health outcomes across a range of life stages such as preterm birth, neuropsychiatric disorders in childhood, and chronic diseases in adulthood [7, 11, 15]. Indeed, DNAm changes have been associated with preterm birth and neurodevelopmental conditions [16–18]. It is important to consider these factors in analyses, as we do here, that examine prenatal perceived stress exposure associations with DNAm patterns in offspring.
The foetal hypothalamic–pituitary–adrenal (HPA) axis is likely an important target of these processes. The HPA axis plays a critical role in stress response and glucocorticoid regulation, and the foetal HPA axis has shown marked sensitivity to the intrauterine environment [7, 10, 11]. Maternal prenatal experiences of stress marked by persistently elevated maternal glucocorticoid levels create dysregulation of the foetal HPA axis, including greater offspring cortisol response to an environmental stressor and changes in basal cortisol levels, through a variety of processes, including DNAm changes in HPA axis-associated genes in the foetus [9, 10, 19, 20]. HPA dysregulation has in turn been linked to neuropsychiatric outcomes, including attention deficit hyperactivity disorder and depression in children and adolescents [21, 22].
A growing number of studies have examined associations between maternal stress during pregnancy and newborn DNAm in HPA axis-associated genes, using both single CpG site and gene-based methylation analyses [7, 23]. These studies have almost exclusively examined, and have largely found significant associations between, the Nuclear Receptor Subfamily 3 Group C Member 1 (NR3C1) gene, which is critical to HPA functioning by controlling the amount of cortisol in the body, and maternal stress during pregnancy [7, 23–28]. Comparatively, only a few studies have examined other relevant genes implicated in foetal HPA axis functioning and overall stress reactivity, including hydroxysteroid 11-beta dehydrogenase 2 (HSD11B2), which converts cortisol to inactive cortisone [29], and FK506-binding protein 5 (FKBP5), which modulates glucocorticoid receptor activity in response to stress [30]. Additionally, these studies have reported largely inconsistent results likely due to several factors, including small study sizes, choice of covariates, and choice of prenatal stress measure [31–34].
Much of this prior research has been conducted in small study populations with little racial, ethnic, or socioeconomic diversity. Many of these studies examined fewer than 200 parent–child pairs, and the largest to date examined 482 dyads. This introduces issues related to power and the generalizability of study results [27, 31]. Much of this prior work has also focused on self-report measures of objective stressors, and related psychopathology, such as maternal depression and anxiety, rather than measures of perceived stress or distress [24–26, 33, 35]. Perceived stress, however, may be a more useful measure of maternal stress than SLEs in these investigations. In proposed models of the stress process, perceived stress is considered more proximal to the body’s peripheral stress response and so may be more predictive of illness outcomes than SLEs [36, 37]. This is because the pathogenic effects of stressful events likely stem from the emotional, subjective response to the event, rather than from the event itself [38]. Furthermore, the same event can lead to differences in perceived stress between individuals with different personal or social contexts, including social support, family structure, and cultural values and norms, and as such measures of objective stress may imperfectly capture the stress response and its impact on foetal development [38].
Additionally, as stated previously, most such studies have prioritized DNAm in NR3C1 genes, limiting our understanding of the effect of prenatal maternal stress on DNAm across various HPA axis-relevant genes. Sex-specific effects are also largely understudied in these investigations, despite evidence of sex differences in foetal development and offspring susceptibility to adverse outcomes due to prenatal maternal stress exposure [7, 23]. Finally, studies that have examined the association between maternal stress during pregnancy and offspring gene-level DNAm have primarily used burden tests that use mean or median methylation levels to capture aggregate DNAm across the region of interest [31]. These methods facilitate gains in power by removing the need to correct for multiple testing as in single-site analyses. Additionally, as individual CpG sites are unlikely to act alone in regulating gene expression, aggregate methods may identify more functionally relevant changes in DNAm than single CpG analysis. However, these methods may fail to account for different directions and magnitude of effect among CpG sites, thus resulting in loss of power and a potential masking of associations [39].
In the current study, we aim to address these limitations using a large, racially and ethnically diverse, US population-based cohort by examining the association between maternal stress during pregnancy and neonatal blood DNAm in the HPA axis-associated genes, NR3C1, HSD11B2, and FKBP5, as well as sex-specific effects through both site and gene-based analyses using flexible and computationally efficient variance component tests like the sequence kernel association test (SKAT) primarily used in rare genetic variant analyses to facilitate gains in power [39–41]. Unlike the aggregate methods described previously, SKAT models methylation at CpG sites more flexibly across a gene, allowing different directions and magnitudes of effect at each site in a gene. This flexibility is advantageous when examining gene-level DNAm changes associated with an exposure of interest because methylation levels influence downstream gene expression differently depending on its location in a gene. For example, methylation at CpGs located in a gene promoter region typically decreases gene expression, and methylation at CpGs in the gene body typically increases gene expression. Therefore, by facilitating different direction and magnitudes of effect between sites, SKAT overcomes assumptions of simpler aggregate methylation tests that each CpG methylation site in a gene contributes equally to an outcome and in the same direction, which does not align with biologic expectations. In these analyses, we use data from the Environmental Influences on Child Health Outcomes (ECHO) Program and focus on prenatal perceived stress as a measure of psychological distress to capture the subjective, cognitive appraisal of life stress. We hypothesize that higher levels of maternal perceived stress during pregnancy will be associated with increases in newborn blood DNAm levels in NR3C1, HSD11B2, and FKBP5 genes and that effects will differ by child’s sex.
Methods
Overall study design
The ECHO Program is a multisite cohort study comprised of pregnancy and pediatric sites designed to understand how environmental factors from preconception to early childhood influence child health and development, with the goal of minimizing disease risk and promoting positive health and well-being [42]. The ECHO Program includes a diverse cohort of participants from all US states, the District of Columbia, Puerto Rico, and Native American Tribal Nations (see Knapp et al. [42] for more details) [43, 44].
Participants
To examine the association between prenatal perceived stress and newborn blood DNAm, we included a subset of ECHO participants in our analyses that met the following inclusion criteria: (1) the mother reported on perceived stress during pregnancy, (2) the pregnancy was a singleton gestation, and (3) the child had a high-quality (passed quality control; QC) blood-derived (umbilical cord blood or blood spot) DNAm measure on either the Illumina Infinium HumanMethylation450 or Infinium MethylationEPIC BeadChips. The final analytic sample consisted of 661 mother–child dyads (Supplementary Fig. 1) from four ECHO sites: Healthy Start, Autism Spectrum Disorder Enriched Risk Cohort (ASDER), Atlanta ECHO Cohort of Emory, and Madres. Site-specific recruitment methods and population characteristics are outlined in Supplementary Table 1.
Perceived stress during pregnancy
Prenatal Perceived stress was measured using the perceived stress scale (PSS) [45]. The PSS is the most widely used measure of perceived stress in epidemiologic research and captures the degree to which events in one’s life are considered stressful [38]. Two versions of the PSS were administered at ECHO sites included in these analyses: 10-item (PSS-10) and 14-item (PSS-14). Across scales, each item is scored on a 5-point Likert scale that ranges from never (0) to very often (4). Item response theory (IRT) was used to harmonize all available PSS data across participants to the perceived stress NIH toolbox T-score metric, which has a mean of 50 and a standard deviation of 10 in the general US population [46].
Some participants had multiple perceived stress T-score measurements during pregnancy, and prenatal perceived stress was measured between 8 and 38 weeks. As repeated measures were correlated in our sample (Pearson’s ⍴ = 0.63, P-value < .001), we generated a mean T score from all available time points to examine the effect of maternal perceived stress across the entire prenatal period. We treated perceived stress as both a continuous and a binary variable to evaluate the robustness of our findings. For binary perceived stress scores, population norms derived from a representative US sample were used to delineate T-score categories (low to medium (binary category 0): <60 and high (binary category 1): ≥60) [47].
DNAm measures
Sites used approved site-specific protocols to collect umbilical cord blood or newborn blood spots. DNAm was measured using the Illumina Infinium HumanMethylation450 or Infinium MethylationEPIC BeadChips. Raw participant data obtained from each site were run through the ECHO Illumina QC pipeline using the ‘minfi’ R/Bioconductor package, and β values (ranging from 0 for completely unmethylated to 1 for completely methylated) calculated for each probe and sample. Samples were filtered for locus-level technical failures, sex discrepancy, poor bisulfite conversion, high detection P-values (>1% probes with detP > .05), and low-quality probes (>1% probes beadC < 3). Similarly, probes for which >1% samples with detP > .05 and >1% of samples with beadC < 3, as well as those that were cross reactive or had a single nucleotide polymorphism (SNP) at the CpG site were removed. This processing was followed by normalization procedures using the normal-exponential out-of-band correction method. Cell type proportions were estimated using biospecimen type appropriate reference panels [48]. A total of 661 samples (524 on the 450K array and 137 on the EPIC array) that met study inclusion criteria passed QC across four study sites (Supplementary Fig. 1). From the 430 739 probes on the 450K BeadChip and 733 758 on the EPIC BeadChip that passed QC, we derived a set of 71 CpG sites found on both arrays located in the NR3C1, FKBP5, and HSD11B2 genes based on Illumina’s annotation files for the 450K and EPIC BeadChips that assign each CpG site to a UCSC known gene. Separately, we derived a second dataset of 66 CpG sites that passed QC annotated to the NR3C1, FKBP5, and HSD11B2 genes located on the EPIC array only to use in complementary analyses.
Covariates and effect modifiers
Covariates included maternal age at time of delivery, maternal education as an indicator for socioeconomic status, maternal prenatal depressive symptoms, prenatal alcohol consumption, maternal prenatal tobacco use, child’s sex, and cell type proportions. Maternal prenatal depressive symptoms, prenatal alcohol consumption, and maternal prenatal tobacco use may be mediators of the association between prenatal perceived stress and newborn DNAm. We add these factors as covariates in our models to examine the direct effect of perceived stress independent of these factors. We also analysed child’s sex as an effect measure modifier to evaluate sex-specific effects and examined the effects of preterm birth on results in sensitivity analyses. Notably, we do not adjust for ancestry principal components in our analyses as rather than conduct an epigenome-wide screen, we focus our analyses on three genes. As a result, there is less of a concern of confounding due to population stratification. Additionally, we do not adjust for self-reported race/ethnicity, as we do not expect these socially defined factors to confound the association between perceived stress during pregnancy and newborn blood DNAm.
Covariate information was obtained from demographic forms, registration data, medical record abstraction, lifestyle forms, and validated scales. Prenatal maternal depressive symptom scores were measured using the PROMIS v1.0—Depression 8a scored on the PROMIST-score metric (mean = 50, standard deviation = 10) [49]. Scores from other depression scales, including the Edinburgh postnatal depression scale, were converted to the PROMIST-score metric using crosswalk tables to facilitate the merging of data across studies as described previously [50]. Maternal alcohol consumption and tobacco use during pregnancy were assessed by self-report through ECHO lifestyle forms. Cell type proportions were estimated as described above. Finally, preterm birth was delineated as birth at ≥37 weeks’ gestation (binary category = 0) and birth at <37 weeks’ gestation (binary category = 1).
Statistical analysis
We conducted our analyses in R version 4.2.2 [51]. We calculated descriptive statistics of mother and child characteristics for the analytic sample using means (±SD) and proportions (%) where appropriate, overall and stratified by low-medium vs. high prenatal perceived stress. We imputed missing covariate data using random forest (‘missForest’ package in R) [52].
DNAm β-values (which represent the proportion of methylated sites in bulk tissues; 0 < β < 1) were log2 transformed to M-values for use in primary statistical analyses. We also conducted complementary analyses using DNAm β-values to estimate % change in DNAm to aid in interpretation.
Analyses were conducted in participants with 450K and EPIC BeadChip measures, separately and then meta-analysed. We used the comBat() function from the ‘sva’ R/Bioconductor package [53] to correct for known batch effects. Using the lmFit() function from the ‘limma’ R/Bioconductor package [54], we then used multivariate linear regression models to analyse the association between prenatal perceived stress treated as both a continuous and binary variable, and DNAm measures at each CpG site under study (71 overlapping sites and 66 EPIC array only sites), adjusting for maternal age at time of child’s birth, maternal depressive symptoms, maternal prenatal alcohol consumption, maternal prenatal tobacco use, maternal education, and child’s sex. We combined group-specific results through a fixed effects inverse variance weighted meta-analysis using the METAL software [55]. To investigate sex-specific effects, we also conducted our analyses in female-only and male-only samples and assessed statistical interaction between prenatal perceived stress and child sex. To account for multiple testing, we used a Bonferroni-corrected significance threshold of 0.05/number of sites.
Sensitivity analysis
We carried out sensitivity analyses to evaluate the impact of several factors on the results. To examine the effect of preterm birth, we re-ran analyses restricting to children born ≥37 weeks’ gestation as infants born preterm may have different DNAm profiles than infants carried to term [16, 17]. Additionally, we re-ran analyses to exclude ASDER, an autism spectrum disorder familial enriched site, to evaluate whether results were impacted by familial ASD risk. Finally, given the expected correlation between perceived stress during pregnancy and maternal depressive symptoms, we used Pearson correlation to evaluate the bivariate correlation between PSS and maternal prenatal depression and conducted sensitivity analyses in which we excluded maternal depressive symptoms from our models.
Gene-based tests
We conducted gene-based tests of the association between continuous prenatal perceived stress and neonatal blood DNAm in four regions using CpG sites shared between arrays and EPIC only CpG sites: (1) NR3C1 gene region, (2) FKBP5 gene region, (3) HSD11B2 gene region, and (4) all three genes together. Genes were delineated using Illumina’s annotation file for the 450K and EPIC BeadChips. Analyses were conducted in the full, female-only and male-only samples.
Mean DNAm level tests. Mean methylation levels were calculated across CpG sites in each of the four gene regions. We employed generalized linear regression models to regress mean methylation levels in each region onto prenatal perceived stress, adjusting for covariates.
SKAT. We used the SKA T function in the ‘SKAT’ R package to test for the cumulative effect of methylation across multiple sites simultaneously using the SKAT method [39]. SKAT is a computationally efficient variance component score test that evaluates the effect of multiple variants in a region on a phenotype [39]. Though traditionally used in rare variant associations studies, prior work has adopted the method for use in gene-based methylation tests due to improved power and accommodation of different directions of effect [40, 41]. We used four sets of SKAT parameters:
(Primary) Linear kernel with equal weights (each site assigned a weight of 1).
Quadratic kernel with equal weights (each site assigned a weight of 1).
Linear kernel with sites weighted based on the effect estimate obtained in individual site analyses (1 + abs (effect estimate)).
Quadratic kernel with sites weighted based on effect size obtained in individual site analyses (1 + abs (effect estimate)).
In secondary analyses, we reran SKAT using the SKAT-O or optimal test method to identify the optimal linear combination between SKAT and mean burden tests [56].
As above, we conducted analyses in participants with 450K and EPIC array measures separately, and the resulting effect estimates and P-values combined by meta-analysis. For gene-based tests, we used a significance threshold of P < .05.
Results
Analytic sample descriptive characteristics
A total of 661 mother–child dyads from four ECHO cohort sites met our inclusion criteria (Supplementary Table 1). In our analytic sample, ~10% of mothers reported high perceived stress levels (T-score ≥ 60) (Table 1). This proportion ranged from 3.6% at the MADRES cohort site to 12.5% at the ASDER cohort site (Supplementary Table 2). These mothers were less likely to identify as White (68% vs. 75%), less likely to identify as Hispanic (28% vs. 36%), more likely to report alcohol consumption (20% vs. 17%) and tobacco use (15.4% vs. 6.5%) during pregnancy, and they also had higher depressive symptom scores (mean = 54.48, SD = 5.52 vs. 46.20, SD = 7.58) than women who reported low or medium levels of prenatal perceived stress.
Table 1.
Descriptive characteristics of parent and child samples.
| Prenatal perceived stress a | ||||
|---|---|---|---|---|
| Covariate | Total (N = 661) | Low to medium perceived stress (N = 596) | High perceived stress (N = 65) | P-value |
| Maternal self-reported race % | ||||
| Black | 110 (16.6) | 97 (16.3) | 13 (20.0) | .098 |
| White | 492 (74.4) | 448 (75.2) | 44 (67.7) | |
| Other | 59 (8.9) | 51 (8.6) | 9 (13.8) | |
| Missing | 2 (0.3) | |||
| Self-reported Hispanic ethnicity (%) | ||||
| Hispanic | 233 (35.2) | 215 (36.1) | 18 (27.7) | .228 |
| Missing | 1 (0.2) | |||
| Maternal age at delivery | ||||
| Mean (SD) | 28.10 (6.01) | 28.26 (6.07) | 26.57 | .034 |
| Missing | 0 | (5.32) | ||
| Gestational weeks at delivery | ||||
| Mean (SD) | 38.97 (1.36) | 38.98 (1.38) | 38.88 | .152 |
| Missing | 0 | (1.17) | ||
| Preterm birth (%) | 29 (4.4) | 28 (4.7) | <5 (<5) | .389 |
| Missing | 0 | |||
| Child sex (%) | ||||
| Female | 325 (49.2) | 295 (49.5) | 30 (46.2) | .703 |
| Missing | 0 | |||
| Maternal depressive symptoms during pregnancy | ||||
| Mean (SD) | 47.02 (7.80) | 46.20 (7.58) | 54.48 | <.001 |
| Missing | 15 (2.3) | (5.52) | ||
| Prenatal alcohol consumption (%) | ||||
| Yes | 113 (17.1) | 100 (16.8) | 13 (20.0) | .630 |
| Missing | 41 (6.2) | |||
| Prenatal tobacco use (%) | ||||
| Yes | 49 (7.4) | 36 (6.5) | 10 (15.4) | .020 |
| Missing | 0 | |||
| Maternal education (%) | ||||
| Less than high school | 117 (17.7) | 104 (17.4) | 13 (20.0) | .877 |
| High school degree, GED or equivalent | 137 (20.7) | 124 (20.8) | 13 (20.0) | |
| Some college, no degree, and above | 407 (61.6) | 368 (61.7) | 39 (60.0) | |
| Missing | 3 (0.5) | |||
High perceived stress was defined as having a PSS T score of equal to or greater than 60. Medium/low was defined as having a PSS value below 60.
CpG site analysis
We used adjusted linear regression models to evaluate the association between continuous and binary prenatal perceived stress and DNAm measured in newborn blood samples at each of the 71 CpG sites located in the target genes measured on both the EPIC and 450K platforms (Supplementary Table 3; volcano plot is shown in Fig. 1). We observed suggestive associations (P < .05) at seven CpG sites located in the NR3C1 and FKBP5 genes (Table 2). At the top site, prenatal perceived stress levels were significantly (P < .0007) associated with blood DNAm at probe cg06613263 annotated to the NR3C1 gene, located in the gene body in the North Shore region within 2 kb upstream of the CpG island (Table 2). We observed a 0.021% increase in DNAm for every one-unit increase in prenatal perceived stress (P-value = .00027). Cg06613263 also emerged as the top site when perceived stress was treated as a binary variable (Supplementary Table 4). We observed a 0.27% (P-value = .011) increase in DNAm at cg06613263 in newborns whose mothers had high perceived stress levels over those whose mothers had low or medium perceived stress levels (Table 2).
Figure 1.
Volcano plot of association testing results for prenatal perceived stress and newborn blood DNAm in NR3C1, FKBP5, and HSD11B2. Each point represents a CpG site. The dashed line represents the Bonferroni-corrected significance threshold (P < .0007).
Table 2.
Association between prenatal perceived stress and newborn blood DNAm levels at P < .05.
| Probe ID | Gene symbol | Effecta | SEa | P-Valuea | BH-FDR adjusted P-valuea | % DNAm differencea | |
|---|---|---|---|---|---|---|---|
| EPIC and 450K sites (n = 71 CpGs measured); N = 661 samples | |||||||
| Continuous PSS | cg06613263 | NR3C1 | 0.0050 | 0.0014 | .00027 | .019 | 0.021% |
| cg00610228 | FKBP5 | 0.0042 | 0.0018 | .016 | .408 | 0 | |
| cg18849621 | NR3C1 | −0.0033 | 0.0014 | .020 | .408 | −0.0069 | |
| cg18019515 | NR3C1 | −0.0030 | 0.0013 | .025 | .408 | 0 | |
| cg00862770 | FKBP5 | −0.0030 | 0.0014 | .030 | .408 | −0.0069 | |
| cg06087101 | FKBP5 | 0.0061 | 0.0029 | .035 | .408 | 0.069 | |
| cg14558428 | NR3C1 | −0.0030 | 0.0014 | .040 | .409 | 0 | |
| Binary PSS (65 high PSS group) | cg06613263 | NR3C1 | 0.074 | 0.029 | .011 | .484 | 0.27 |
| cg07733851 | NR3C1 | 0.086 | 0.035 | .014 | .484 | 0.86 | |
| cg16545496 | HSD11B2 | −0.063 | 0.028 | .024 | .576 | −0.042 | |
| cg18849621 | NR3C1 | −0.061 | 0.031 | .051 | .781 | −0.15 | |
| EPIC only sites (66 CpGs measured); N = 137 samples | |||||||
| Continuous PSS | cg24052866 | NR3C1 | 0.0082 | 0.0026 | .0015 | .102 | 0.05910886 |
| cg25579735 | NR3C1 | −0.0061 | 0.0025 | .015 | .316 | −0.0228306 | |
| cg06409316 | FKBP5 | −0.0068 | 0.0029 | .021 | .316 | −0.0453399 | |
| cg24801588 | NR3C1 | −0.0058 | 0.0025 | .022 | .316 | 0.04393455 | |
| cg13514002 | NR3C1 | −0.0040 | 0.0019 | .032 | .316 | −0.0509034 | |
| cg07633853 | FKBP5 | 0.0052 | 0.0024 | .033 | .316 | −0.013942 | |
| cg21517946 | FKBP5 | −0.036 | 0.017 | .034 | .316 | 0.03 516 776 | |
| cg14438279 | NR3C1 | −0.0043 | 0.0021 | .043 | .556 | −0.1492263 | |
Adjusted for maternal age at delivery, maternal depression, prenatal alcohol consumption, prenatal tobacco use, maternal education, and child’s sex.
Note: The coefficients and P-values were generated based on methylation M-value. %DNAm difference was generated based on methylation beta value.
We also performed analyses to evaluate the association between maternal perceived stress during pregnancy and DNAm in each of the 66 CpG sites specific to the EPIC array (Supplementary Table 5). Eight of these were nominally associated with continuous prenatal perceived stress T score levels (Table 2). We observed decreased neonatal blood DNAm with increased prenatal perceived stress at all but the top site where blood DNAm increased with increased perceived stress (cg24052866 annotated to NR3C1, % change = 0.059%, P-value = .0015). However, none of these associations met a conservative Bonferroni threshold correcting for multiple testing.
In sex-stratified analyses, cg06613262 was also the top site in male only models where we observed a nominally significant association between DNAm and prenatal perceived stress (% difference = 0.028% per one-unit increase in prenatal perceived stress, P-value = .0029) (Supplementary Table 6). In female only models, we similarly observed a suggestive association at this site (% difference = 0.014% per one-unit increase in prenatal perceived stress, P-value = .031). In statistical interaction models, we found no evidence of interaction by sex at this site (Pinteraction value = .33). However, the lowest P-value was observed at cg07724674 annotated to the HSD11B2 gene (% difference = 0.021% per one-unit increase in prenatal perceived stress, P-value = .00096) (Supplementary Table 7). In male children, the association between maternal perceived stress during pregnancy and newborn DNAm was not significant and showed an opposite direction of effect at this site (% difference = −0.0069% per one-unit increase in prenatal perceived stress, P-value = .358). Additionally, statistical interaction models showed evidence of interaction by sex at this site (Pinteraction value = .069).
Sensitivity analysis
Sensitivity analyses were carried out to examine the effect of preterm birth or increased familial predisposition to autism on the association between prenatal perceived stress and newborn blood DNAm at cg06613262. These results are presented in Table 3. Across all models, effect estimates did not vary largely from that obtained in the main, fully adjusted model, though the model that excluded participants from an ECHO site that enrolled participants with high familial autism predisposition produced a smaller % difference in blood DNAm with increased perceived stress (% DNAm change per one-unit increase on perceived stress = 0.014%, P-value = .012) compared to the full model.
Table 3.
Sensitivity analyses showing the association between prenatal perceived stress and newborn blood DNAm levels, at probe cg06613263 (NR3C1).
| Analysis | Sample size | Effect | Standard error | P-value | BH-FDR adjusted P-valuea | % DNAm difference |
|---|---|---|---|---|---|---|
| Main analysis | 661 | 0.0050 | 0.0014 | .00027 | .019 | 0.021% |
| ≥37 weeks gestation | 632 | 0.0045 | 0.0015 | .0025 | .199 | 0.021% |
| Excluding autism cohort site | 637 | 0.0038 | 0.0015 | .012 | .257 | 0.014% |
| Excluding maternal prenatal depression from statistical model | 661 | 0.0027 | 0.0010 | .009 | .312 | 0.007% |
Adjusted for maternal age at delivery, maternal depression, prenatal alcohol consumption, prenatal tobacco use, maternal education, and child’s sex.
Note: The coefficients and P-values were generated based on methylation M-value. %DNAm difference was generated based on methylation beta value.
Additionally, we conducted sensitivity analyses to evaluate the effect of removing maternal prenatal depressive symptoms from our models assessing the association between prenatal perceived stress and newborn blood DNAm at cg06613262 (Table 3). We found a positive correlation between prenatal perceived stress and maternal prenatal depressive symptoms (r = 0.38, P-value < .001). Excluding maternal prenatal depressive symptoms from our models resulted in a smaller % difference in newborn blood DNAm with increased perceived stress (% DNAm change per one-unit increase on perceived stress = 0.007% P-value = .009) compared to the fully adjusted model, though the direction of effect remains consistent.
Gene-level tests
Mean methylation burden tests and SKAT were used to examine the association between prenatal perceived stress and offspring DNAm in each of four regions: (1) NR3C1, (2) FKBP5, (3) HSD11B2, and (4) all three genes together.
Mean methylation burden test
We calculated mean methylation for each participant within each gene region outlined above using the set of overlapping CpG sites between the 450K and EPIC arrays. A breakdown of each region and corresponding CpG sites is shown in Supplementary Table 8. We regressed mean DNAm in each region onto continuous perceived stress using fully adjusted linear regression models and found no evidence of association (Table 4). Models using mean methylation values calculated from EPIC-only CpG sites similarly returned null results (Supplementary Table 9).
Table 4.
Prenatal perceived stress and newborn mean methylation from shared CpG sites association testing results.
| Gene symbol | Number of sites | β (95% confidence interval) a | P-valuea |
|---|---|---|---|
| NR3C1 | 33 | −0.0001 (−0.0010, 0.0007) | .79 |
| FKBP5 | 26 | 0.0001 (−0.0008, 0.0010) | .81 |
| HSD11B2 | 12 | 0.0004 (−0.0008, 0.0015) | .52 |
| Overall | 71 | 0.0000 (−0.0007, 0.0007) | .97 |
Adjusted for maternal age at delivery, maternal depression, prenatal alcohol consumption, prenatal tobacco use, maternal education, and child’s sex.
SKAT
We then used SKAT, applying various kernel and weight combinations, to more flexibly model the association between aggregate newborn blood DNAm across overlapping 450K and EPIC CpG sites within each delineated region and prenatal perceived stress. These results are presented in Table 5. First, we used a linear kernel to model the additive effects of each CpG site and weighted all sites evenly (weights = 1 or unweighted). We observed a significant association between prenatal perceived stress and DNAm patterns in the NR3C1 (P-value = .040) and FKBP5 genes (P-value = .024), and across all 71 sites in the three HPA axis pathway genes (NR3C1, FKBP5, and HSD11B2) together (P-value = .022). Secondary analyses in which we applied a quadratic kernel to model potential interactions between sites yielded similar results, showing significant effects in NR3C1 (P-value = .040) and FKBP5 (P-value = .037), and the set of all sites across the three genes under study (P- value = .039). Weighting the models by effect estimates obtained in single-site analyses had no effect on the associations. Similar results were obtained when we restricted these analyses to the set of 66 CpG sites measured on the EPIC array only (Supplementary Table 10).
Table 5.
Continuous prenatal perceived stress and newborn DNAm gene-based SKAT results.
| Linear unweighted | Quadratic unweighted | Linear weighted | Quadratic weighted | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Gene symbols | Number of sites | Q | P-value | Q | P-value | Q | P-value | Q | P-value |
| NR3C1 | 33 | 609.68 | .040 | 904 900.60 | .040 | 609.68 | .040 | 904 900.60 | .040 |
| FKBP5 | 26 | 613.45 | .024 | 365 607.1 | .037 | 613.45 | .024 | 365 607.1 | .037 |
| HSD11B2 | 12 | 151.94 | .14 | 63 388.65 | .17 | 151.94 | .14 | 63 388.65 | .17 |
| All sites | 71 | 1375.07 | .022 | 368 891.00 | .039 | 1375.07 | .022 | 368 891.00 | .039 |
Note: Adjusted for maternal age at delivery, maternal depression, prenatal alcohol consumption, prenatal tobacco use, maternal education, and child’s sex.
Finally, to optimize between SKAT and burden test approaches, we reran SKAT using the SKAT-O or optimal test method using a linear kernel and weighting all sites equally (Supplementary Table 11). Resulting P-values were larger in all four regions compared with that produced in original SKAT analyses, with associations between prenatal perceived stress and DNAm in FKBP5 and across all sites only approaching significance (P-valueFKBP5 = .055, P-value All sites = .076). Correlations between CpG sites within each region were 0 for all but the HSD11B2 region where the correlation between sites was determined to be 0.75.
In sex-stratified analyses, aggregate newborn blood DNAm in the FKBP5 gene remained statistically significantly associated with prenatal perceived stress in female-only samples (P-value = .004), but not in male-only samples (P = .60) (Table 6). On the other hand, the association between DNAm in HSD11B2 and prenatal perceived stress showed stronger significance in male newborns (P-value = .064), compared to female newborns (P-value = .26).
Table 6.
Continuous prenatal perceived stress and newborn DNAm SKAT results (linear, unweighted) in female-only and male-only samples.
| Female samples (N = 325) | Male samples (N = 336) | ||||
|---|---|---|---|---|---|
| Region | Number of sites | Q | P-value | Q | P-value |
| NR3C1 | 33 | 107.26 | .53 | 286.12 | .22 |
| FKBP5 | 26 | 345.45 | .0042 | 153.66 | .60 |
| HSD11B2 | 12 | 46.21 | .26 | 107.68 | .074 |
| All sites | 71 | 498.92 | .080 | 547.45 | .28 |
Note: Adjusted for maternal age at delivery, maternal depression, prenatal alcohol consumption, prenatal tobacco use, and maternal education.
Discussion
Our findings contribute to the growing body of literature investigating the molecular processes involved in foetal response to maternal stress exposure during pregnancy. Prenatal stress has been linked to poor offspring physical and neurodevelopmental outcomes, though the underlying mechanisms remain unclear [7, 8]. Prior work has identified the HPA axis as a pathway of interest, and studies have examined associations between prenatal stress, largely focused on SLEs, and stress-related psychopathology like depression and anxiety. To our knowledge, this is one of the largest studies to date in a diverse US population that has examined the association between prenatal perceived stress and newborn DNAm in HPA axis-related genes (NR3C1, FKBP5, and HSD11B2) and one of the few that have examined potential sex differential effects in offspring.
In single-site analyses, we found evidence that higher prenatal perceived stress exposure on a continuous scale was associated with DNAm changes in various sites located in NR3C1 and FKBP5 genes. Specifically, maternal perceived stress during pregnancy was significantly associated with increased DNAm in cg06613263 located in the NR3C1 gene body in a CpG North Shore region. One prior study has identified an association between maternal financial difficulties at 8 months postnatal and offspring DNAm at this site at age 7 [57]. Similarly, when prenatal perceived stress was modelled as a binary exposure, high perceived stress during pregnancy was associated with increased offspring DNAm, compared to low and medium perceived stress, though this association was not significant after correcting for multiple testing. These results largely corroborate previous findings. Prior studies have reported associations between prenatal stressors (such as war-related stress, maternal depression, and anxiety) and newborn cord blood and placenta DNAm in NR3C1 CpG sites [24, 25, 32, 58]. A few studies, however, failed to find significant associations between prenatal maternal stress and newborn DNAm in this gene [26, 27]. Mansell et al. [27], e.g. found that while prenatal perceived stress was marginally associated with site-specific methylation in NR3C1 in infant cord blood, this association did not remain after correcting for multiple testing. This discrepancy in results may reflect lack of statistical power due to small sample sizes, differences in sites assessed and DNAm measurement methods, and differences in choice of covariates across studies.
In addition to single CpG analyses, a complementary gene-level test using both mean methylation burden tests and the SKAT method. SKAT facilitates a flexible modelling approach, overcoming the assumption that methylation at multiple CpGs shows similar magnitudes and directions of effect used in standard aggregate methylation tests. Single-site analyses provide high-resolution information of specific positions in the genome that are different among newborns of mothers who experienced different levels of perceived stress during pregnancy, which may be useful for downstream in vitro functional analyses and summary statistic gene-level meta-analytic approaches across future studies, e.g. comb-p [59]. Gene-level analyses provide a complementary approach because they can improve power to detect significant associations, given their reduced multiple testing burden compared to single CpG analyses, and because focusing on gene-level targets may provide broader mechanistic insight to inform gene-level intervention targets.
The two region-based methods employed in this study produced inconsistent results. In SKAT region-based analyses, we observed a significant association between prenatal perceived stress and newborn DNAm in NR3C1, FKBP5, and across the three genes together. However, mean methylation burden tests produced null results across all regions. Additionally, while single CpG site analyses identified statistically significant associations between prenatal perceived stress and newborn DNAm in NR3C1, there were no statistically significant sites in FKBP5. Monk et al. [31] showed that prenatal distress was associated with increased NR3C1, FKBP5, and HSD11B2 placental mean methylation using bivariate Spearman correlation, though failed to adjust for relevant covariates, introducing concerns about unmeasured confounding.
The discrepancy in results obtained in the current study likely stems from test characteristics. Mean methylation burden tests assume the same direction and a similar magnitude of effect across CpG sites, and so may result in loss of power and masking of associations [39]. However, variance components score tests, such as SKAT, allow for more flexible modelling of the aggregate effect of CpG sites in a region by assuming that each site is independent, resulting in gains in power and improved detection when sites are truly independent [39, 40, 56]. Therefore, our results suggest that sites across each region act independently with different directions and magnitudes of effect. Sensitivity analysis using the SKAT-O method substantiates these conclusions. The SKAT-O or optimal test creates the optimal linear combination of SKAT and burden tests to optimize power by determining and incorporating correlation between sites into statistical models [56]. In our analyses, SKAT-O results showed no correlation (⍴ = 0) in NR3C1 and HSD11B2 genes, indicating the SKAT method was optimal. This is in keeping with what we would expect biologically as CpG sites have different downstream effects that depend in part on where the site is located in the gene. For example, DNAm in the promoter region has been shown to be associated with transcriptional repression, and DNAm in gene bodies has been shown to result in transcriptional activation [60]. Furthermore, our finding that prenatal perceived stress was statistically significantly associated with newborn DNAm in FKBP5 in SKAT gene-level but not in single CpG site analysis may be attributed to power gained through this SKAT method.
Additionally, SKAT analyses using linear and quadratic kernel functions both revealed significant associations in FKBP5, suggesting both additive and synergistic effects between sites. However, given the smaller P-value obtained in the linear kernel model, there is greater statistical evidence in support of additive effects within these regions.
In sex-stratified analyses, the top site in female-only samples was located in HSD11B2 single-site analyses, while this site did not appear to be associated with maternal perceived stress during pregnancy in male-only samples. In sex-stratified SKAT models, prenatal perceived stress was most strongly associated with aggregate methylation in FKBP5 in females and HSD11B2 in males, though the association in males was only suggestive. While we found no prior evidence in the literature that showed that newborn FKBP5 methylation differences in response to prenatal maternal stress is more pronounced in female compared to male newborns, Appleton et al. [61] similarly showed that male infants had greater decreases in placental HSD11B2 mean methylation in response to lower maternal education, increased poverty, and increased maternal socioeconomic risk than female infants. Conversely, Sutherland et al. [62] showed that in girls only with low levels of placental DNAm in HSD11B2, increased prenatal maternal depressive symptoms were associated with increased infant baseline cortisol. Sex differences in newborn DNAm changes associated with maternal prenatal stress exposure are largely understudied. Evidence has highlighted sex differences in foetal development and suggests an increased susceptibility to an adverse early life environment among male compared to female foetuses [63]. Future work is needed to better evaluate the presence and mechanisms of timing and sex differences in newborn DNAm patterns in response to the prenatal environment.
The relatively large sample size (N = 661) and the inclusion of participants from traditionally underrepresented racial/ethnic groups are among the main strengths of this study, leading to gains in power and improved generalizability of study results to the general US population. Additionally, our relatively novel use of SKAT in gene-level tests allowed for more flexible modelling and gains in power that better enabled us to detect the aggregate effect of DNAm in CpG within a region over burden tests that has been used in previous studies.
This study also has some important limitations. Primarily, while we did our best to control for confounders, it is possible that other unmeasured covariates, which have not been accounted for in our models, may play some role in the association between prenatal perceived stress and newborn DNAm in glucocorticoid related genes. Measurement error may have been another limitation of this study, particularly for self-reported measures such as maternal alcohol consumption or tobacco use during pregnancy, potentially leading to based estimates. Additionally, it is possible that the association between maternal perceived stress during pregnancy and newborn DNAm may be modified by self-reported race, as experiences of stress among pregnant women have been shown to differ across sociodemographic categories, including race and ethnicity [35, 36]. However, given sample size limitations, we lacked the power to perform these sub-analyses. However, the primary goal of these analyses was to identify DNAm differences across racial/ethnic groups and so future well-powered studies that evaluate racial/ethnic differences may be valuable. It is also possible that the association varied across ECHO cohort sites, particularly given the difference in exposure distribution across sites. Due to insufficient sample sizes and inadequate power, we were unable to conduct cohort-specific analyses and elucidate potential cohort effects. However, as cohort site coincided with technical batch, batch correction may have minimized the effect of between cohort differences on our results.
This study and others have largely focused on the role of maternal experiences of acute SLEs and stress appraisal during pregnancy or perceived stress. We compared aggregate DNAm analysis methods, specifically mean DNAm burden tests and our SKAT-based approach. Our results suggest key advantages of the SKAT method, including gains in power that allowed us to identify statistically significant associations between prenatal perceived stress and newborn DNAm in NR3C1 and FKBP5. These results suggest that future studies seeking to examine aggregate gene methylation associations with exposures or health outcomes would benefit from the use of SKAT over more traditional mean DNAm burden tests.
Future work should also explore other measures of stress, including cumulative or chronic stressors or biological stress correlates, such as cortisol, to better model the biological pathway between prenatal stress and offspring DNAm. Additionally, this study established an association between maternal perceived stress during pregnancy and newborn DNAm HPA axis-associated genes. As prior work has demonstrated connections between maternal perceived stress during pregnancy and offspring health outcomes, future work that evaluates whether the DNAm changes we identified mediate specific perinatal and child health outcomes is necessary. Finally, future studies should explore the potential impact of postnatal factors on offspring DNAm in order to identify potential intervention measures.
Supplementary Material
Acknowledgements
The authors wish to thank our ECHO colleagues; the medical, nursing, and program staff; and the children and families participating in the ECHO cohort. The ECHO-wide Cohort Data Collection Protocol was approved by the central ECHO institutional review board (IRB) or by individual cohorts’ IRBs of record. Study protocols were approved by the individual Institutional Review Boards at each site. Written informed consent or parent’s/guardian’s permission was obtained along with child assent as appropriate for ECHO-wide Cohort Data Collection Protocol participation and for participation in specific cohorts.
Appendix
Table A.1.
Overview of Notation.
| First Name and Middle Initial(s) | Last Name | Suffix (e.g., Jr, III) | Academic Degrees | Department | Institution | Location (city, state/province, country) | Role or Contribution | ECHO Cohort Study Site or Core Name and Grant Number | Email Address |
|---|---|---|---|---|---|---|---|---|---|
| P Brian | Smith | MD, MPH, MHS | Division of Neonatology, Department of Pediatrics | Duke Clinical Research Institute, Duke University School of Medicine | Durham, North Carolina, USA | ECHO Coordinating Center Principal Investigator | U2COD023375 (Coordinating Center) | brian.smith@duke.edu | |
| L Kristin | Newby | MD, MHS | Division of Cardiology, Department of Medicine | Duke Clinical Research Institute, Duke University School of Medicine | Durham, North Carolina, USA | ECHO Coordinating Center Principal Investigator | U2COD023375 (Coordinating Center) | kristin.newby@duke.edu | |
| Linda | Adair | PhD | Department of Nutrition | Gillings School of Global Public Health, University of North Carolina at Chapel Hill | Chapel Hill, North Carolina, USA | ECHO Coordinating Center Principal Investigator | U2COD023375 (Coordinating Center) | linda_adair@unc.edu | |
| Lisa P. | Jacobson | ScD | Department of Epidemiology | Johns Hopkins University, Bloomberg School of Public Health | Baltimore, Maryland, USA | ECHO Data Analysis Center Principal Investigator | U24OD023382 (Data Analysis Center) | ljacobs1@jhu.edu | |
| Diane | Catellier | DrPH | N/A | Research Triangle Institute | Research Triangle Park, North Carolina, USA | ECHO Data Analysis Center Principal Investigator | U24OD023382 (Data Analysis Center) | dcatellier@rti.org | |
| Monica | McGrath | ScD | Department of Epidemiology | Johns Hopkins University, Bloomberg School of Public Health | Baltimore, Maryland, USA | ECHO Johns Hopkins University Data Analysis Center Director Co-Investigator | U24OD023382 (Data Analysis Center) | mmcgrat4@jhu.edu | |
| Christian | Douglas | DrPH | N/A | Research Triangle Institute | Research Triangle Park, North Carolina, USA | ECHO RTI Data Analysis Center Director Co-Investigator | U24OD023382 (Data Analysis Center) | christiand@rti.org | |
| Priya | Duggal | PhD | Department of Epidemiology | Johns Hopkins University, Bloomberg School of Public Health | Baltimore, Maryland, USA | ECHO Data Analysis Center Genetics Methods Lead, Co-Investigator | U24OD023382 (Data Analysis Center) | pduggal@jhu.edu | |
| Emily | Knapp | PhD | Department of Epidemiology | Johns Hopkins University, Bloomberg School of Public Health | Baltimore, Maryland, USA | ECHO Data Analysis Center Co-Investigator | U24OD023382 (Data Analysis Center) | eknapp2@jhu.edu | |
| Amii | Kress | PhD | Department of Epidemiology | Johns Hopkins University, Bloomberg School of Public Health | Baltimore, Maryland, USA | ECHO Data Analysis Center General Methods Co-Investigator | U24OD023382 (Data Analysis Center) | akress1@jhu.edu | |
| Courtney K. | Blackwell | PhD | Department of Medical Social Sciences | Feinberg School of Medicine, Northwestern University | Chicago, Illinois, USA | Measurement Core Co-Investigator | U24OD023319 with co-funding from the Office of Behavioral and Social Science Research (Measurement Core) | Ckblackwell@northwestern.edu | |
| Maxwell A. | Mansolf | PhD | Department of Medical Social Sciences | Feinberg School of Medicine, Northwestern University | Chicago, Illinois, USA | Measurement Core Co-Investigator | U24OD023319 with co-funding from the Office of Behavioral and Social Science Research (Measurement Core) | maxwell.mansolf@northwestern.edu | |
| Jin-Shei | Lai | PhD | Department of Medical Social Sciences | Feinberg School of Medicine, Northwestern University | Chicago, Illinois, USA | Measurement Core Co-Investigator | U24OD023319 with co-funding from the Office of Behavioral and Social Science Research (Measurement Core) | js-lai@northwestern.edu | |
| Emily | Ho | PhD | Department of Medical Social Sciences | Feinberg School of Medicine, Northwestern University | Chicago, Illinois, USA | Measurement Core Co-Investigator | U24OD023319 with co-funding from the Office of Behavioral and Social Science Research (Measurement Core) | emily-ho@northwestern.edu | |
| David | Cella | PhD | Department of Medical Social Sciences | Feinberg School of Medicine, Northwestern University | Chicago, Illinois, USA | Measurement Core Principal Investigator | U24OD023319 with co-funding from the Office of Behavioral and Social Science Research (Measurement Core) | d-cella@northwestern.edu | |
| Richard | Gershon | PhD | Department of Medical Social Sciences | Feinberg School of Medicine, Northwestern University | Chicago, Illinois, USA | Measurement Core Principal Investigator | U24OD023319 with co-funding from the Office of Behavioral and Social Science Research (Measurement Core) | gershon@northwestern.edu | |
| Michelle L. | Macy | MD | Department of Pediatrics | Feinberg School of Medicine, Northwestern University and Ann & Robert H. Lurie Children's Hospital of Chicago | Chicago, Illinois, USA | Measurement Core Co-Investigator | U24OD023319 with co-funding from the Office of Behavioral and Social Science Research (Measurement Core) | mmacy@luriechildrens.org | |
| Suman R. | Das | PhD | Division of Infectious Diseases, Department of Medicine | Vanderbilt University Medical Center | Nashville, Tennessee, USA | ECHO Laboratory Core Principal Investigator | U24OD035523 (Lab Core) | suman.r.das@vumc.org | |
| Jane E. | Freedman | MD | Division of Cardiovascular Medicine, Department of Medicine | Vanderbilt University Medical Center | Nashville, Tennessee, USA | ECHO Laboratory Core Principal Investigator | U24OD035523 (Lab Core) | jane.freedman@vumc.org | |
| Simon A. | Mallal | MBBS | Division of Infectious Diseases, Department of Medicine | Vanderbilt University Medical Center | Nashville, Tennessee, USA | ECHO Laboratory Core Principal Investigator | U24OD035523 (Lab Core) | s.mallal@vumc.org | |
| John A. | McLean | PhD | Department of Chemistry | Vanderbilt University | Nashville, Tennessee, USA | ECHO Laboratory Core Principal Investigator | U24OD035523 (Lab Core) | john.a.mclean@vanderbilt.edu | |
| Ravi V. | Shah | MD | Division of Cardiovascular Medicine, Department of Medicine | Vanderbilt University Medical Center | Nashville, Tennessee, USA | ECHO Laboratory Core Principal Investigator | U24OD035523 (Lab Core) | ravi.shah@vumc.org | |
| Meghan H. | Shilts | MHS | Division of Infectious Diseases, Department of Medicine | Vanderbilt University Medical Center | Nashville, Tennessee, USA | ECHO Laboratory Core Principal Investigator Admin Designee | U24OD035523 (Lab Core) | meghan.h.shilts@vumc.org | |
| Akram N. | Alshawabkeh | PhD | College of Engineering | Northeastern University | Boston, Massachusetts, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023251 (Akram Alshawabkeh) | a.alshawabkeh@northeastern.edu | |
| Jose F. | Cordero | MD | College of Public Health, Department of Epidemiology & Biostatistics | University of Georgia | Athens, Georgia; USA | ECHO Cohort Study Site Co-Director | UG3/UH3OD023251 (Akram Alshawabkeh) | jcordero@uga.edu | |
| John | Meeker | ScD | Environmental Health Sciences, School of Public Health | University of Michigan | Ann Arbor, Michigan; USA | ECHO Cohort Study Site Co-Director | UG3/UH3OD023251 (Akram Alshawabkeh) | meekerj@umich.edu | |
| Leonardo | Trasande | MD, MPP | Departments of Pediatrics and Population Health | NYU Grossman School of Medicine | New York, New York, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023305 (Leonardo Trasande) | leonardo.trasande@nyulangone.org | |
| Carlos A. | Camargo | Jr. | MD, DrPH | Department of Emergency Medicine | Massachusetts General Hospital, Harvard Medical School | Boston, Massachusetts, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023253 (Carlos Camargo) | ccamargo@mgb.org |
| Kohei | Hasegawa | MD, PhD | Department of Emergency Medicine | Massachusetts General Hospital, Harvard Medical School | Boston, Massachusetts, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023253 (Carlos Camargo) | khasegawa@mgh.harvard.edu | |
| Zhaozhong | Zhu | ScD | Department of Emergency Medicine | Massachusetts General Hospital, Harvard Medical School | Boston, Massachusetts, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023253 (Carlos Camargo) | zzhu5@mgh.harvard.edu | |
| Ashley F. | Sullivan | MS, MPH | Department of Emergency Medicine | Massachusetts General Hospital, Harvard Medical School | Boston, Massachusetts, USA | ECHO Cohort Study Site Award Project Director | UG3/UH3OD023253 (Carlos Camargo) | afsullivan@mgb.org | |
| Dana | Dabelea | MD, PhD | Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center | University of Colorado Anschutz Medical Campus | Aurora, Colorado, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023248 and UG3OD035526 (Dana Dabelea) | dana.dabelea@cuanschutz.edu | |
| Wei | Perng | PhD, MPH | Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center | University of Colorado Anschutz Medical Campus | Aurora, Colorado, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023248 (Dana Dabelea) | wei.perng@cuanschutz.edu | |
| Traci A. | Bekelman | PhD, MPH | Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center | University of Colorado Anschutz Medical Campus | Aurora, Colorado, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023248 (Dana Dabelea) | traci.bekelman@cuanschutz.edu | |
| Greta | Wilkening | PhD, MPH | Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center | University of Colorado Anschutz Medical Campus | Aurora, Colorado, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023248 (Dana Dabelea) | Greta.Wilkening@childrenscolorado.org | |
| Sheryl | Magzamen | PhD | Environmental and Radiological Health Sciences | Colorado School of Public Health, Colorado State University | Fort Collins, Colorado, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035526 (Dana Dabelea) | Sheryl.Magzamen@colostate.edu | |
| Brianna F. | Moore | PhD, MS | Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center | University of Colorado Anschutz Medical Campus | Aurora, Colorado, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035526 (Dana Dabelea) | brianna.f.moore@cuanschutz.edu | |
| Anne P. | Starling | PhD | Epidemiology | University of North Carolina at Chapel Hill | Chapel Hill, North Carolina, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035526 (Dana Dabelea) | anne.starling@unc.edu | |
| Deborah J. | Rinehart | PhD | Center for Health Systems Research | Denver Health and Hospital Authority | Denver, Colorado, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035526 (Dana Dabelea) | deborah.rinehart@dhha.org | |
| Daphne | Koinis Mitchell | Ph.D | Department of Pediatrics | Rhode Island Hospital, The Alpert Medical School of Brown University | Providence, Rhode Island, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023313 (Daphne Koinis Mitchell) | dkoinismitchell@lifespan.org | |
| Viren | D'Sa | MD | Department of Pediatrics | Rhode Island Hospital, The Alpert Medical School of Brown University | Providence, Rhode Island, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023313 (Daphne Koinis Mitchell) | viren_Dsa@brown.edu | |
| Sean C.L. | Deoni | PhD | Division of Gender Equality, Maternal, Newborn & Child Health Discovery & Tools Team | Bill & Melinda Gates Foundation | Seattle, Washington, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023313 (Daphne Koinis Mitchell) | Sean.Deoni@gatesfoundation.org | |
| Hans-Georg | Mueller | PhD | Department of Statistics | University of California, Davis | Davis, California, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023313 (Daphne Koinis Mitchell) | hgmueller@ucdavis.edu | |
| Cristiane S. | Duarte | PhD, MPH | Division of Child and Adolescent Psychiatry | Columbia University - NYSPI | New York, New York, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023328 (Cristiane Duarte) | Cristiane.Duarte@nyspi.columbia.edu | |
| Catherine | Monk | PhD | Department of Obstetrics & Gynecology | Columbia University - NYSPI | New York, New York, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023328 (Cristiane Duarte) | cem31@cumc.columbia.edu | |
| Glorisa | Canino | PhD | Behavioral Sciences Research Institute | University of Puerto Rico, School of Medicine | Rio Piedras, Puerto Rico | ECHO Cohort Study Site Principal Investigator | UH3OD023328 (Cristiane Duarte) | glorisa.canino@upr.edu | |
| Jonathan | Posner | MD | Child & Family Mental Health & Community Psychiatry Division | Duke University School of Medicine, Duke Psychiatry & Behavioral Sciences | Durham, North Carolina, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023328 (Cristiane Duarte) | jonathan.posner@duke.edu | |
| Tenneill | Murray | MPH | Division of Child and Adolescent Psychiatry | Columbia University - NYSPI | New York, New York, USA | ECHO Cohort Study Site Co-Director | UH3OD023328 (Cristiane Duarte) | tenneill.murray@nyspi.columbia.edu | |
| Claudia | Lugo-Candelas | PhD | Division of Child and Adolescent Psychiatry | Columbia University - NYSPI | New York, New York, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023328 (Cristiane Duarte) | claudia.lugo@nyspi.columbia.edu | |
| Anne L. | Dunlop | MD, MPH | Department of Gynecology and Obstetrics | Emory University School of Medicine | Atlanta, Georgia, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023318 (Anne Dunlop) | amlang@emory.edu | |
| Patricia A. | Brennan | PhD | Department of Psychology | Emory University | Atlanta, Georgia, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023318 (Anne Dunlop) | pbren01@emory.edu | |
| Christine | Hockett | PhD | N/A; Department of Pediatrics | Avera Research Institute; University of South Dakota School of Medicine | Rapid City, South Dakota, USA; Sioux Falls, South Dakota, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023279 (Amy Elliott) | christine.hockett@avera.org | |
| Amy | Elliott | PhD | N/A; Department of Pediatrics | Avera Research Institute ; University of South Dakota School of Medicine | Sioux Falls, South Dakota, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023279 (Amy Elliott) | amy.elliott@avera.org | |
| Assiamira | Ferrara | MD, PhD | Division of Research | Kaiser Permanente Northern California | Oakland, California, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023289 (Assiamira Ferrara) | assiamira.ferrara@kp.org | |
| Lisa A. | Croen | PhD | Division of Research | Kaiser Permanente Northern California | Oakland, California, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023342 (Kristen Lyall), UG3/UH3OD023289 (Assiamira Ferrara) | Lisa.A.Croen@kp.org | |
| Monique M. | Hedderson | PhD | Division of Research | Kaiser Permanente Northern California | Oakland, California, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023289 (Assiamira Ferrara), UG3OD035540 (Monique Marie Hedderson) | Monique.M.Hedderson@kp.org | |
| John | Ainsworth | PhD | Centre for Health Informatics | University of Manchester | Manchester, United Kingdom | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern) | John.Ainsworth@manchester.ac.uk | |
| Leonard B. | Bacharier | MD | Department of Pediatrics, Monroe Carell Jr Children’s Hospital at Vanderbilt | Vanderbilt University Medical Center | Nashville, Tennessee, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern) | leonard.bacharier@vumc.org | |
| Casper G. | Bendixsen | PhD | National Farm Medicine Center | Marshfield Clinic Research Institute | Marshfield, Wisconsin, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern) | Bendixsen.casper@marshfieldresearch.org | |
| James E. | Gern | MD | Department of Pediatrics | University of Wisconsin School of Medicine and Public Health | Madison, Wisconsin, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern), UG3OD035509 (Anne Marie Singh) | gern@medicine.wisc.edu | |
| Diane R. | Gold | MD | The Channing Division of Network Medicine; Department of Medicine | Brigham and Women’s Hospital; Harvard Medical School | Boston, Massachusetts, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern) | redrg@channing.harvard.edu | |
| Tina V. | Hartert | MD, MPH | Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Department of Medicine, Department of Pediatrics | Vanderbilt University Medical Center | Nashville, Tennessee, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern), UG3OD035516 and UG3OD035517 (Tina Hartert) | tina.hartert@vumc.org | |
| Daniel J. | Jackson | MD | Department of Pediatrics | University of Wisconsin School of Medicine and Public Health | Madison, Wisconsin, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern) | djj@medicine.wisc.edu | |
| Christine C. | Johnson | PhD | Department of Public Health Sciences | Henry Ford Health | Detroit, Michigan, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern), UG3OD035518 (Jennifer Straughen) | CJOHNSO1@hfhs.org | |
| Christine L.M. | Joseph | PhD | Department of Public Health Sciences | Henry Ford Health | Detroit, Michigan, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern) | cjoseph1@hfhs.org | |
| Meyer | Kattan | MD | Department of Pediatrics | Columbia University Medical Center | New York, New York, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern) | mk2833@cumc.columbia.edu | |
| Gurjit K. | Khurana Hershey | MD, PhD | Division of Asthma Research | Cincinnati Children’s Hospital Medical Center | Cincinnati, Ohio, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern) | gurjit.hershey@cchmc.org | |
| Robert F. | Lemanske, Jr. | MD | Department of Pediatrics | University of Wisconsin School of Medicine and Public Health | Madison, Wisconsin, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern) | lemanske@wisc.edu | |
| Susan V. | Lynch | PhD | Department of Medicine | University of California | San Francisco, California, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern) | Susan.Lynch@ucsf.edu | |
| Rachel L. | Miller | MD | Department of Medicine; Division of Clinical Immunology | Icahn School of Medicine at Mount Sinai | New York, New York, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern), UG3/UH3OD023290 (Julie Herbstman) | Rachel.miller2@mssm.edu | |
| George T. | O’Connor | MD | Department of Pediatrics | Boston University School of Medicine | Boston, Massachusetts, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern) | goconnor@bu.edu | |
| Carole | Ober | PhD | Department of Human Genetics | University of Chicago | Chicago, Illinois, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern), UG3OD035509 (Anne Marie Singh) | c-ober@genetics.uchicago.edu | |
| Dennis | Ownby | MD | Department of Public Health Sciences | Henry Ford Health | Detroit, Michigan, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern) | downby@augusta.edu | |
| Katherine | Rivera-Spoljaric | MD | Department of Pediatrics | Washington University School of Medicine | St Louis, Missouri, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern), UG3OD035521 (Katherine Rivera-Spoljaric) | rivera_k@wustl.edu | |
| Patrick H. | Ryan | PhD | Department of Pediatrics and College of Medicine; Division of Biostatistics and Epidemiology | University of Cincinnati | Cincinnati, Ohio, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern), UG3OD035509 (Anne Marie Singh) | patrick.ryan@cchmc.org | |
| Christine M. | Seroogy | MD | Department of Pediatrics | University of Wisconsin School of Medicine and Public Health | Madison, Wisconsin, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern) | cmseroogy@wisc.edu | |
| Anne Marie | Singh | MD | Department of Pediatrics | University of Wisconsin School of Medicine and Public Health | Madison, Wisconsin, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern), UG3OD035509 (Anne Marie Singh) | amsingh@wisc.edu | |
| Robert A. | Wood | MD | Department of Pediatrics | Johns Hopkins University School of Medicine | Baltimore, Maryland, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern) | rwood@jhmi.edu | |
| Edward M. | Zoratti | MD | Division of Allergy and Clinical Immunology | Henry Ford Health | Detroit, Michigan, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023282 (James Gern), UG3OD035518 (Jennifer Straughen) | ezoratt1@hfhs.org | |
| Rima | Habre | ScD, MSc | Department of Population and Public Health Sciences | University of Southern California | Los Angeles, California, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023287 (Carrie Breton) | habre@usc.edu | |
| Shohreh | Farzan | PhD | Department of Population and Public Health Sciences | University of Southern California | Los Angeles, California, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023287 (Carrie Breton) | sffarzan@usc.edu | |
| Frank D. | Gilliland | MD, MPH, PhD | Department of Population and Public Health Sciences | University of Southern California | Los Angeles, California, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023287 (Carrie Breton) | gillilan@usc.edu | |
| Irva | Hertz-Picciotto | PhD | MIND Institute and Department of Public Health Sciences | University of California, Davis | Davis, California, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023365 (Irva Hertz-Picciotto), UG3OD035550 (Rebecca Schmidt) | iher@ucdavis.edu | |
| Deborah H. | Bennett | Ph.D | Department of Public Health Sciences | University of California, Davis | Davis, California, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023365 (Irva Hertz-Picciotto), UG3OD035550 (Rebecca Schmidt) | dhbennett@ucdavis.edu | |
| Julie B. | Schweitzer | Ph.D | Department of Psychiatry and Behavioral Science and the MIND Institute | University of California, Davis | Davis, California, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023365 (Irva Hertz-Picciotto) | jschweitzer@ucdavis.edu | |
| Rebecca J. | Schmidt | Ph.D | MIND Institute and Department of Public Health Sciences | University of California, Davis | Davis, California, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023365 (Irva Hertz-Picciotto), UG3/UH3OD023342 (Kristen Lyall), UG3OD035550 (Rebecca Schmidt) | rjschmidt@ucdavis.edu | |
| Janine M. | LaSalle | PhD | Medical Microbiology and Immunology; MIND Institute | University of California, Davis | Davis, California, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023365 (Irva Hertz-Picciotto), UG3OD035550 (Rebecca Schmidt) | jmlasalle@ucdavis.edu | |
| Alison E. | Hipwell | PhD, ClinPsyD | Psychiatry and Psychology | University of Pittsburgh | Pittsburgh, Pennsylvania, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023244 (Alison Hipwell) | hipwae@upmc.edu | |
| Kate E. | Keenan | PhD | Psychiatry and Behavioral Neuroscience | University of Chicago | Chicago, Illinois, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023244 (Alison Hipwell) | kekeenan@uchicago.edu | |
| Catherine J. | Karr | MD, MS, PhD | Department of Pediatrics, School of Medicine; Department of Environmental and Occupational Health Sciences; School of Public Health | University of Washington | Seattle, Washington, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023271 and UG3OD035528 (Catherine Karr) | ckarr@uw.edu | |
| Nicole R. | Bush | PhD | Department of Psychiatry and Behavioral Sciences and Department of Pediatrics, School of Medicine | University of California, San Francisco | San Francisco, California, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023271 (Catherine Karr), UG3OD035519 (Qi Zhao) | nicole.bush@ucsf.edu | |
| Kaja Z. | LeWinn | ScD | Department of Psychiatry and Behavioral Sciences, School of Medicine | University of California, San Francisco | San Francisco, California, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023271 (Catherine Karr), UG3OD035519 (Qi Zhao) | kaja.lewinn@ucsf.edu | |
| Sheela | Sathyanarayana | MD, MPH | Department of Pediatrics, School of Medicine; Department of Environmental and Occupational Health Sciences, School of Public Health | University of Washington and Seattle Children's Research Institute | Seattle, Washington, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023271 (Catherine Karr), UG3OD035508 (Sheela Sathyanarayana) | sheela.sathyanarayana@seattlechildrens.org | |
| Qi | Zhao | MD, PhD | Department of Preventive Medicine | University of Tennessee Health Science Center | Memphis, Tennessee, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023271 (Catherine Karr), UG3OD035519 (Qi Zhao) | qzhao11@uthsc.edu | |
| Frances | Tylavsky | DrPH, MS | Department of Preventive Medicine | University of Tennessee Health Science Center | Memphis, Tennessee, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023271 (Catherine Karr) | ftylavsk@uthsc.edu | |
| Kecia N. | Carroll | MD, MPH | Department of Pediatrics, Department of Environmental Medicine & Public Health | Icahn School of Medicine at Mount Sinai | New York, New York, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023271 (Catherine Karr), UG3/UH3OD023337 (Rosalind Wright) | kecia.carroll@mssm.edu | |
| Christine T. | Loftus | MS MPH PhD | Department of Environmental and Occupational Health Sciences; School of Public Health | University of Washington | Seattle, Washington, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023271 (Catherine Karr) | cloftus@uw.edu | |
| Leslie D. | Leve | PhD | Department of Counseling Psychology and Human Services & Prevention Science Institute | University of Oregon | Eugene, Oregon, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023389 (Leslie Leve) | leve@uoregon.edu | |
| Jody M. | Ganiban | PhD | Department of Psychological and Behavioral Sciences | George Washington University | Washington, DC, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023389 (Leslie Leve) | ganiban@gwu.edu | |
| Jenae M. | Neiderhiser | PhD | Department of Psychology | Penn State University | University Park, Pennsylvania, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023389 (Leslie Leve) | jenaemn@psu.edu | |
| Scott T. | Weiss | MD | Channing Division of Network Medicine, Department of Medicine | Brigham and Women's Hospital and Harvard Medical School | Boston, Massachusetts, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023268 (Scott Weiss) | scott.weiss@channing.harvard.edu | |
| Augusto A. | Litonjua | MD | Pediatric Pulmonary Division, Department of Pediatrics | Golisano Children's Hospital, University of Rochester | Rochester, New York, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023268 (Scott Weiss) | augusto_litonjua@urmc.rochester.edu | |
| Cindy T. | McEvoy | MD, MCR | Division of Neonatology, Department of Pediatrics | Oregon Health & Science University | Portland, Oregon, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023288 (Cynthia McEvoy) | mcevoyc@ohsu.edu | |
| Eliot R. | Spindel | MD, PhD | Division of Neuroscience | Oregon National Primate Research Center | Beaverton, Oregon, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023288 (Cynthia McEvoy) | spindele@ohsu.edu | |
| Robert S. | Tepper | MD, PhD | Division of Pediatric Pulmonology, Department of Pediatrics | Indiana School of Medicine | Indianapolis, Indiana, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023288 (Cynthia McEvoy) | rtepper@iu.edu | |
| Craig J. | Newschaffer | PhD | College of Health and Human Development | Penn State | State College, Pennsylvania, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023342 (Kristen Lyall) | newschaffer@psu.edu | |
| Kristen | Lyall | ScD | AJ Drexel Autism Institute | Drexel University | Philadelphia, Pennsylvania, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023342 (Kristen Lyall) | kld98@drexel.edu | |
| Heather E. | Volk | PhD | Mental Health | Johns Hopkins University | Baltimore, Maryland, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023342 (Kristen Lyall) | hvolk1@jhu.edu | |
| Rebecca | Landa | PhD | Department of Psychiatry and Behavioral Sciences | Center for Autism and Related Disorders, Kennedy Krieger Institute, Johns Hopkins University | Baltimore, Maryland, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023342 (Kristen Lyall) | landa@kennedykrieger.org | |
| Sally | Ozonoff | PhD | MIND Institute, Department of Psychiatry | University of California Davis | Sacramento, California, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023342 (Kristen Lyall) | sozonoff@ucdavis.edu | |
| Joseph | Piven | MD | Department of Psychiatry | University of North Carolina | Chapel Hill, North Carolina, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023342 (Kristen Lyall) | jpiven@med.unc.edu | |
| Heather | Hazlett | PhD | Department of Psychiatry | University of North Carolina | Chapel Hill, North Carolina, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023342 (Kristen Lyall) | heather_cody@med.unc.edu | |
| Juhi | Pandey | PhD | Center for Autism Research | Children's Hospital of Philadelphia | Philadelphia, Pennsylvania, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023342 (Kristen Lyall) | pandeyj@chop.edu | |
| Robert | Schultz | PhD | Center for Autism Research | Children's Hospital of Philadelphia | Philadelphia, Pennsylvania, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023342 (Kristen Lyall) | schultzrt@chop.edu | |
| Steven | Dager | PhD | Department of Radiology | University of Washington | Seattle, Washington, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023342 (Kristen Lyall) | srd@uw.edu | |
| Kelly | Botteron | PhD | Department of Psychiatry | Washington University | St Louis, Missouri, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023342 (Kristen Lyall) | botteronk@wustl.edu | |
| Daniel | Messinger | PhD | Department of Psychology | University of Miami | Miami, Florida, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023342 (Kristen Lyall) | dmessinger@miami.edu | |
| Wendy | Stone | PhD | Department of Psychology | University of Washington | Seattle, Washington, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023342 (Kristen Lyall) | stonew@uw.edu | |
| Jennifer | Ames | PhD | Kaiser Permanente Division of Research | Kaiser Permanente | Oakland, California, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023342 (Kristen Lyall) | Jennifer.L.Ames@kp.org | |
| Thomas G. | O’Connor | PhD | Departments of Psychiatry, Neuroscience, Obstetrics and Gynecology | University of Rochester | Rochester, New York, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023349 (Thomas O’Connor) | tom_oconnor@urmc.Rochester.edu | |
| Richard K. | Miller | PhD | Departments of Obstetrics and Gynecology | University of Rochester | Rochester, New York, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023349 (Thomas O’Connor) | richardk_miller@urmc.rochester.edu | |
| Emily | Oken | MD, MPH | Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine | Harvard Pilgrim Health Care Institute and Harvard Medical School | Boston, Massachusetts, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023286 and UG3OD035533 (Emily Oken) | emily_oken@hms.harvard.edu | |
| Michele R. | Hacker | ScD | Department of Obstetrics and Gynecology | Beth Israel Deaconess Medical Center | Boston, Massachusetts, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035533 (Emily Oken) | mhacker@bidmc.harvard.edu | |
| Tamarra | James-Todd | PhD | Department of Environmental Health | Harvard Chan School of Public Health | Boston, Massachusetts, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035533 (Emily Oken) | tjtodd@hsph.harvard.edu | |
| T. Michael | O'Shea | Jr | MD, MPH | Division of Neonatology, Department of Pediatrics | University of North Carolina School of Medicine | Chapel Hill, North Carolina, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023348 (Mike O’Shea), UH3OD023347 (Barry Lester) | moshea52@email.unc.edu |
| Rebecca C. | Fry | PhD | Department of Environmental Sciences and Engineering | University of North Carolina Gillings School of Global Public Health | Chapel Hill, North Carolina, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023348 (Mike O’Shea) | rfry@unc.edu | |
| Jean A. | Frazier | MD | EK Shriver Center and Psychiatry | UMASS Chan Medical School | Worcster, Massachusetts, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | jean.frazier@umassmed.edu | |
| Rachana | Singh | MD, MS | Department of Pediatrics | Tufts University School of Medicine | Boston, Massachusetts, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | jean.frazier@umassmed.edu | |
| Caitlin | Rollins | MD, SM | Department of Neurology | Harvard Medical School | Boston, Massachusetts, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | Rachana.Singh1@tuftsmedicine.org | |
| Angela | Montgomery | MD | Division of Neonatology, Department of Pediatrics | Yale School of Medicine | New Haven, Connecticut, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | angela.montgomery@yale.edu | |
| Ruben | Vaidya | MD | Department of Pediatrics | University of Massachusetts Chan Medical School-Baystate | Springfield, Massachusetts, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | Ruben.VaidyaMD@baystatehealth.org | |
| Robert M. | Joseph | PhD | Department of Anatomy & Neurobiology | Boston University Chobanian & Avedisian School of Medicine | Boston, Massachusetts, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | rmjoseph@bu.edu | |
| Lisa K. | Washburn | MD | Pediatrics | Wake Forest School of Medicine | Winston-Salem, North Carolina, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | lwcadmus@gmail.com | |
| Semsa | Gogcu | MD, MPH | Section of Neonatology, Department of Pediatrics; Department of Pediatrics | Wake Forest School of Medicine; Wake Forest University School of Medicine/Atrium Health Wake Forest | Winston-Salem, North Carolina, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea), UG3OD035513 (Annemarie Stroustrup), UH3OD023320 (Judy Aschner) | sgogcu@wakehealth.edu | |
| Kelly | Bear | DO | Section of Neonatology, Department of Pediatrics | ECU Health | Greenville, North Carolina, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | BEARK17@ECU.EDU | |
| Julie V. | Rollins | MA | Division of Neonatology, Department of Pediatrics | University of North Carolina School of Medicine | Chapel Hill, North Carolina, USA | ECHO Cohort Study Site Award Project Director | UG3/UH3OD023348 (Mike O’Shea) | julie.rollins@unc.edu | |
| Stephen R. | Hooper | PhD | Department of Health Sciences | School of Medicine, University of North Carolina at Chapel Hill | Chapel Hill, North Carolina, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | stephen_hooper@med.unc.edu | |
| Genevieve | Taylor | MD | Pediatrics | School of Medicine, University of North Carolina at Chapel Hill | Chapel Hill, North Carolina, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | gtaylor@med.unc.edu | |
| Wesley | Jackson | MD, MPH | Division of Neonatology, Department of Pediatrics | University of North Carolina School of Medicine | Chapel Hill, North Carolina, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | wesley.jackson@unc.edu | |
| Amanda | Thompson | PhD | Department of Anthropology, Department of Nutrition | University of North Carolina at Chapel Hill; Gillings School of Global Public Health, University of North Carolina at Chapel Hill | Chapel Hill, North Carolina, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | althomps@email.unc.edu | |
| Julie | Daniels | PhD | Epidemiology and Maternal and Child Health | University of North Carolina at Chapel Hill; Gillings School of Global Public Health, University of North Carolina at Chapel Hill | Chapel Hill, North Carolina, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | julie_daniels@unc.edu | |
| Michelle | Hernandez | MD | Pediatrics | School of Medicine, University of North Carolina at Chapel Hill | Chapel Hill, North Carolina, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | michelle_hernandez@med.unc.edu | |
| Kun | Lu | PhD | Environmental Sciences and Engineering | Gillings School of Global Public Health, University of North Carolina at Chapel Hill | Chapel Hill, North Carolina, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | kunlu@unc.edu | |
| Michael | Msall | MD | Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities | University of Chicago Medicine: Comer Children's Hospital | Chicago Illinois, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | mmsall@peds.bsd.uchicago.edu | |
| Madeleine | Lenski | MSPH | Department of Epidemiology and Biostatistics | Michigan State University | East Lansing, Michigan, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | lenskim@msu.edu | |
| Rawad | Obeid | MD | Pediatrics | Beaumont Hospital | Royal Oak, Michigan, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | Rawad.Obeid@beaumont.org | |
| Steven L. | Pastyrnak | PhD | Pediatrics | Corewell Health, Helen DeVos Children's Hospital | Grand Rapids, Michigan, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea), UH3OD023347 (Barry Lester) | Steve.Pastyrnak@helendevoschildrens.org | |
| Elizabeth | Jensen | PhD | Epidemiology and Prevention | Wake Forest University School of Medicine | Winston-Salem, North Carolina, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | ejensen@wakehealth.edu | |
| Christina | Sakai | MD | Pediatrics | Mass General Hospital for Children | Boston, Massachusetts, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023348 (Mike O’Shea) | Christina.sakai@gmail.com | |
| Hudson | Santos | RN, PhD | Dean's Office Graduate School, School of Nursing and Health Studies | University of Miami | Coral Gables, Florida, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023348 (Mike O’Shea), UG3OD035542 (Hudson Santos) | hsantos@miami.edu | |
| Jean M. | Kerver | PhD, MSc, RD | Departments of Epidemiology & Biostatistics, and Pediatrics & Human Development | Michigan State University, College of Human Medicine | East Lansing, Michigan, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023285 (Jean Kerver) | kerverje@msu.edu | |
| Nigel | Paneth | MD, MPH | Departments of Epidemiology & Biostatistics, and Pediatrics & Human Development | Michigan State University, College of Human Medicine | East Lansing, Michigan, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023285 (Jean Kerver) | paneth@msu.edu | |
| Charles J. | Barone | II | MD, FAAP | Department of Pediatrics | Henry Ford Health | Detroit, Michigan, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023285 (Jean Kerver), UG3/UH3OD023282 (James Gern) | cbarone1@hfhs.org |
| Michael R. | Elliott | PhD | Department of Biostatistics | University of Michigan | Ann Arbor, Michigan, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023285 (Jean Kerver) | mrelliot@umich.edu | |
| Douglas M. | Ruden | PhD | Department of Obstetrics and Gynecology, Institute of Environmental Health Sciences (IEHS), C.S. Mott Center for Human Health and Development | Wayne State University | Detroit, Michigan, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023285 (Jean Kerver) | douglasr@wayne.edu | |
| Chris | Fussman | MS | Lifecourse Epidemiology and Genomics Division | Michigan Department of Health and Human Services (MDHHS) | Lansing, Michigan, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023285 (Jean Kerver) | fussmanc@michigan.gov | |
| Julie B. | Herbstman | PhD | Department of Environmental Health Sciences | Columbia University Mailman School of Public Health | New York, New York, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023290 (Julie Herbstman) | jh2678@cumc.columbia.edu | |
| Amy | Margolis | PhD | Department of Psychiatry | Columbia University Irving Medical Center | New York, New York, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023290 (Julie Herbstman) | amy.margolis@nyspi.columbia.edu | |
| Susan L. | Schantz | PhD | Beckman Institute for Advanced Science and Technology; Department of Comparative Biosciences | University of Illinois Urbana-Champaign | Urbana, Illinois, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023272 (Susan Schantz) | schantz@illinois.edu | |
| Sarah Dee | Geiger | PhD | Beckman Institute for Advanced Science and Technology; Department of Kinesiology and Community Health | University of Illinois Urbana-Champaign | Urbana, Illinois, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023272 (Susan Schantz) | smurphy7@illinois.edu | |
| Andrea | Aguiar | PhD | Beckman Institute for Advanced Science and Technology; Department of Comparative Biosciences | University of Illinois Urbana-Champaign | Urbana, Illinois, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023272 (Susan Schantz) | aaguiar@illinois.edu | |
| Karen | Tabb | PhD, MSW | Beckman Institute for Advanced Science and Technology; Department of Social Work | University of Illinois Urbana-Champaign | Urbana, Illinois, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023272 (Susan Schantz) | ktabb@illinois.edu | |
| Rita | Strakovsky | PhD | Department of Food Science and Human Nutrition | Michigan State University | East Lansing, Michigan, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023272 (Susan Schantz) | strakovs@msu.edu | |
| Tracey | Woodruff | PhD, MPH | Program on Reproductive Health and the Environment | University of California, San Francisco | San Francisco, California, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023272 (Susan Schantz) | tracey.woodruff@ucsf.edu | |
| Rachel | Morello-Frosch | PhD, MPH | Department of Environmental Science, Policy and Management and School of Public Health | University of California, Berkeley | Berkeley, California, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023272 (Susan Schantz) | rmf@berkeley.edu | |
| Amy | Padula | PhD | Program on Reproductive Health and the Environment | University of California, San Francisco | San Francisco, California, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023272 (Susan Schantz) | amy.padula@ucsf.edu | |
| Joseph B. | Stanford | MD, MSPH | Department of Family and Preventive Medicine | Spencer Fox Eccles School of Medicine, University of Utah | Salt Lake City, Utah, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023249 (Joseph Stanford) | joseph.stanford@utah.edu | |
| Christina A. | Porucznik | PhD, MSPH | Department of Family and Preventive Medicine | Spencer Fox Eccles School of Medicine, University of Utah | Salt Lake City, Utah, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023249 (Joseph Stanford) | christy.porucznik@utah.edu | |
| Angelo P. | Giardino | MD, PhD | Department of Pediatrics | Spencer Fox Eccles School of Medicine, University of Utah | Salt Lake City, Utah, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023249 (Joseph Stanford) | giardino@hsc.utah.edu | |
| Rosalind J. | Wright | MD, MPH | Department of Environmental Medicine & Public Health | Icahn School of Medicine at Mount Sinai | New York, New York, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023337 (Rosalind Wright) | rosalind.wright@mssm.edu | |
| Robert O. | Wright | MD, MPH | Department of Environmental Medicine & Public Health | Icahn School of Medicine at Mount Sinai | New York, New York, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023337 (Rosalind Wright) | robert.wright@mssm.edu | |
| Brent | Collett | PhD | Department of Psychiatry and Behavioral Medicine | University of Washington, Seattle Children's Research Institute | Seattle, Washington, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035508 (Sheela Sathyanarayana) | brent.collett@seattlechildrens.org | |
| Nicole | Baumann-Blackmore | MD | Department of Pediatrics | University of Wisconsin School of Medicine and Public Health | Madison, Wisconsin, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035509 (Anne Marie Singh) | nlbaumann@wisc.edu | |
| Ronald | Gangnon | PhD | Department of Population Health Sciences | University of Wisconsin | Madison, Wisconsin, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035509 (Anne Marie Singh) | ronald@biostat.wisc.edu | |
| Daniel J. | Jackson | MD | Department of Pediatrics | University of Wisconsin School of Medicine and Public Health | Madison, Wisconsin, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035509 (Anne Marie Singh) | djj@medicine.wisc.edu | |
| Chris G. | McKennan | PhD | Department of Statistics | University of Pittsburgh | Pittsburgh, Pennsylvania, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035509 (Anne Marie Singh) | CHM195@pitt.edu | |
| Jo | Wilson | MD | Department of Pediatrics | University of Wisconsin School of Medicine and Public Health | Madison, Wisconsin, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035509 (Anne Marie Singh) | wilson54@wisc.edu | |
| Matt | Altman | MD | Department of Medicine | University of Washington | Seattle, Washington, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035509 (Anne Marie Singh) | maltman@benaroyaresearch.org | |
| Judy L. | Aschner | MD | Department of Pediatrics | Albert Einstein College of Medicine; Hackensack Meridian School of Medicine; Center for Discovery and Innovation | Bronx, New York, USA; Nutley, New Jersey, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023320 and UG3OD035546 (Judy Aschner), UG3OD035513 (Annemarie Stroustrup) | judy.aschner@einsteinmed.edu; judy.aschner@hmhn.org | |
| Annemarie | Stroustrup | MD, MPH | Department of Pediatrics | Northwell Health, Cohen Children's Medical Center, and the Zucker School of Medicine at Hofstra / Northwell | New Hyde Park, New York, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023320 (Judy Aschner), UG3OD035513 (Annemarie Stroustrup) | astroustrup@northwell.edu | |
| Stephanie L. | Merhar | MD, MS | Department of Pediatrics | Cincinnati Children's | Cincinnati, Ohio, USA | ECHO Cohort Study Site Co-Investigator | UH3OD023320 (Judy Aschner), UG3OD035513 (Annemarie Stroustrup) | stephanie.merhar@cchmc.org | |
| Paul E. | Moore | MD | Department of Pediatrics | Vanderbilt University Medical Center | Nashville, Tennessee, USA | ECHO Cohort Study Site Co-Investigator | UH3OD023320 (Judy Aschner), UG3OD035513 (Annemarie Stroustrup) | paul.moore@vumc.org | |
| Gloria S. | Pryhuber | MD | Department of Pediatrics | University of Rochester Medical Center | Rochester, New York, USA | ECHO Cohort Study Site Co-Investigator | UH3OD023320 (Judy Aschner) | gloria_pryhuber@urmc.rochester.edu | |
| Mark | Hudak | MD | Department of Pediatrics | University of Florida College of Medicine | Jacksonville, Florida, USA | ECHO Cohort Study Site Co-Investigator | UH3OD023320 (Judy Aschner) | mark.hudak@jax.ufl.edu | |
| Ann Marie | Reynolds Lyndaker | MD, MPH | Department of Pediatrics | University of Buffalo Jacobs School of Medicine and Biomedical Sciences | Buffalo, New York, USA | ECHO Cohort Study Site Co-Investigator | UH3OD023320 (Judy Aschner) | amr1@buffalo.edu | |
| Andrea L. | Lampland | MD | Department of Pediatrics | Children's Minnesota | Minneapolis, Minnesota, USA | ECHO Cohort Study Site Co-Investigator | UH3OD023320 (Judy Aschner) | andrea.lampland@childrensms.org | |
| Burton | Rochelson | MD | Department of Obstetrics and Gynecology | Northwell Health and the Zucker School of Medicine at Hofstra / Northwell | New Hyde Park, New York, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035532 (Annemarie Stroustrup) | brochels@northwell.edu | |
| Sophia | Jan | MD, MSHP | Department of Pediatrics | Northwell Health, Cohen Children's Medical Center, and the Zucker School of Medicine at Hofstra / Northwell | New Hyde Park, New York, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035532 (Annemarie Stroustrup) | sjan1@northwell.edu | |
| Matthew J. | Blitz | MD, MBA | Department of Obstetrics and Gynecology | Northwell Health and the Zucker School of Medicine at Hofstra / Northwell | New Hyde Park, New York, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035532 (Annemarie Stroustrup) | mblitz@northwell.edu | |
| Michelle W. | Katzow | MD, MS | Department of Pediatrics | Northwell Health, Cohen Children's Medical Center, and the Zucker School of Medicine at Hofstra / Northwell | New Hyde Park, New York, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035532 (Annemarie Stroustrup) | mkatzow@northwell.edu | |
| Zenobia | Brown | MD, MPH | Department of Science Education | Northwell Health and the Zucker School of Medicine at Hofstra / Northwell | New Hyde Park, New York, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035532 (Annemarie Stroustrup) | zbrown2@northwell.edu | |
| Codruta | Chiuzan | PhD | Institute of Health System Science | Northwell Health, Feinstein Institutes for Medical Research | Manhasset, New York, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035532 (Annemarie Stroustrup) | cchiuzan@northwell.edu | |
| Timothy | Rafael | MD | Department of Obstetrics and Gynecology | Northwell Health and the Zucker School of Medicine at Hofstra / Northwell | New Hyde Park, New York, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035532 (Annemarie Stroustrup) | trafael@northwell.edu | |
| Dawnette | Lewis | MD, MPH | Department of Obstetrics and Gynecology | Northwell Health and the Zucker School of Medicine at Hofstra / Northwell | New Hyde Park, New York, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035532 (Annemarie Stroustrup) | dlewis@northwell.edu | |
| Natalie | Meirowitz | MD | Department of Obstetrics and Gynecology | Northwell Health and the Zucker School of Medicine at Hofstra / Northwell | New Hyde Park, New York, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035532 (Annemarie Stroustrup) | nmeirowi@northwell.edu | |
| Brenda | Poindexter | MD | Department of Pediatrics | Children's Healthcare of Atlanta Emory University | Atlanta, Georgia, USA | ECHO Cohort Study Site Co-Investigator | UH3OD023320 (Judy Aschner) | breda.pointdexter@emory.edu | |
| Tebeb | Gebretsadik | MPH | Department of Biostatistics | Vanderbilt University Medical Center | Nashville, Tennessee, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035516 and UG3OD035517 (Tina Hartert) | tebeb.gebretsadik@vumc.org | |
| Sarah | Osmundson | MD, MSC | Department of Obstetrics and Gynecology | Vanderbilt University Medical Center | Nashville, Tennessee, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035517 (Tina Hartert) | sarah.osmundson@vumc.org | |
| Jennifer K. | Straughen | PhD | Department of Public Health Sciences | Henry Ford Health | Detroit, Michigan, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035518 (Jennifer Straughen) | jstraug1@hfhs.org | |
| Amy | Eapen | MD | Division of Allergy and Clinical Immunology | Henry Ford Health | Detroit, Michigan, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035518 (Jennifer Straughen) | aeapen1@hfhs.org | |
| Andrea | Cassidy-Bushrow | PhD | Department of Public Health Sciences | Henry Ford Health | Detroit, Michigan, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023282 (James Gern) | acassid1@hfhs.org | |
| Ganesa | Wegienka | PhD | Department of Public Health Sciences | Henry Ford Health | Detroit, Michigan, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023282 (James Gern) | gwegien1@hfhs.org | |
| Alex | Sitarik | MPH | Department of Public Health Sciences | Henry Ford Health | Detroit, Michigan, USA | ECHO Cohort Study Site Biostatistician | UG3/UH3OD023282 (James Gern) | asitari1@hfhs.org | |
| Kim | Woodcroft | PhD | Department of Public Health Sciences | Henry Ford Health | Detroit, Michigan, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035518 (Jennifer Straughen), UG3/UH3OD023282 (James Gern) | kwoodcr1@hfhs.org | |
| Audrey | Urquhart | MPH | Department of Public Health Sciences | Henry Ford Health | Detroit, Michigan, USA | ECHO Cohort Study Site Epidemiologist | UG3OD035518 (Jennifer Straughen), UG3/UH3OD023282 (James Gern) | aurquha1@hfhs.org | |
| Albert | Levin | PhD | Department of Public Health Sciences | Henry Ford Health | Detroit, Michigan, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035518 (Jennifer Straughen) | alevin1@hfhs.org | |
| Tisa | Johnson-Hooper | MD | Department of Pediatrics | Henry Ford Health | Detroit, Michigan, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035518 (Jennifer Straughen) | tjohnso2@hfhs.org | |
| Brent | Davidson | MD | Department of Women's Health | Henry Ford Health | Detroit, Michigan, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023282 (James Gern) | bdavids1@hfhs.org | |
| Tengfei | Ma | PhD | Department of Public Health Sciences | Henry Ford Health | Detroit, Michigan, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035518 (Jennifer Straughen) | tengfei.ma@hfhs.org | |
| Emily S. | Barrett | PhD | Department of Biostatistics and Epidemiology | Environmental and Occupational Health Sciences Institute, Rutgers University | Piscataway, New Jersey, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035527 (Emily S Barrett) | emily.barrett@eoshi.rutgers.edu | |
| Martin J. | Blaser | MD | Center for Advanced Biotechnology & Medicine | Rutgers University | Piscataway, New Jersey, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035527 (Emily S Barrett) | blaser@cabm.rutgers.edu | |
| Maria Gloria | Dominguez-Bello | PhD | Departments of Biochemistry and Microbiology & Anthropology | Rutgers University | New Brunswick, New Jersey, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035527 (Emily S Barrett) | mg.dominguez-bello@rutgers.edu | |
| Daniel B. | Horton | MD | Department of Pediatrics | Robert Wood Johnson Medical School, Rutgers University | New Brunswick, New Jersey, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035527 (Emily S Barrett) | daniel.horton@rutgers.edu | |
| Manuel | Jimenez | MD | Departments of Pediatrics, Family Medicine, and Community Health | Robert Wood Johnson Medical School, Rutgers University | New Brunswick, New Jersey, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035527 (Emily S Barrett) | jimenema@rwjms.rutgers.edu | |
| Todd | Rosen | MD | Department of Obstetrics, Gynecology, and Reproductive Sciences | Robert Wood Johnson Medical School, Rutgers University | New Brunswick, New Jersey, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035527 (Emily S Barrett) | rosentj@rwjms.rutgers.edu | |
| Kristy | Palomares | MD, PhD | Department of Obstetrics and Gynecology | Saint Peter's University Hospital | New Brunswick, New Jersey, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035527 (Emily S Barrett) | kpalomares@saintpetersuh.com | |
| Lyndsay A. | Avalos | PhD, MPH | Division of Research | Kaiser Permanente Northern California | Oakland, California, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035540 (Monique Marie Hedderson) | Lyndsay.A.Avalos@kp.org | |
| Yeyi | Zhu | PhD, MS | Division of Research | Kaiser Permanente Northern California | Oakland, California, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035540 (Monique Marie Hedderson) | Yeyi.Zhu@kp.org | |
| Kelly J . | Hunt | PhD | Department of Public Health Sciences | Medical University of South Carolina | Charleston, South Carolina, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035543 (Kelly J Hunt) | huntke@musc.edu | |
| Roger B. | Newman | MD | Department of Obstetrics and Gynecology | Medical University of South Carolina | Charleston, South Carolina, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035543 (Kelly J Hunt) | newmanr@musc.edu | |
| Michael S. | Bloom | PhD | Department of Global and Community Health | George Mason University | Fairfax, Virginia, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035543 (Kelly J Hunt) | mbloom22@gmu.edu | |
| Mallory H. | Alkis | MD | Department of Obstetrics and Gynecology | Medical University of South Carolina | Charleston, South Carolina, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035543 (Kelly J Hunt) | hudsonm@musc.edu | |
| James R. | Roberts | MD, MPH | Department of Pediatrics | Medical University of South Carolina | Charleston, South Carolina, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035543 (Kelly J Hunt) | robertsj@musc.edu | |
| Sunni L. | Mumford | PhD | Department of Biostatistics, Epidemiology and Informatics; Department of Obstetrics and Gynecology | University of Pennsylvania Perelman School of Medicine | Philadelphia, Pennsylvania, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035537 (Sunni L Mumford) | sunni.mumford@pennmedicine.upenn.edu | |
| Heather H. | Burris | MD, MPH | Division of Neonatology, Department of Pediatrics | Children's Hospital of Philadelphia; University of Pennsylvania Perelman School of Medicine | Philadelphia, Pennsylvania, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035537 (Sunni L Mumford) | BURRISH@chop.edu | |
| Sara B. | DeMauro | MD, MSCE | Division of Neonatology, Department of Pediatrics | Children's Hospital of Philadelphia; University of Pennsylvania Perelman School of Medicine | Philadelphia, Pennsylvania, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035537 (Sunni L Mumford) | DEMAURO@chop.edu | |
| Lynn M. | Yee | MD, MPH | Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology | Feinberg School of Medicine, Northwestern University | Chicago, Illinois, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035546 (Judy Aschner) | lynn.yee@northwestern.edu | |
| Aaron | Hamvas | MD | Division of Neonatology, Department of Pediatrics | Ann & Robert H. Lurie Children's Hospital, Feinberg School of Medicine, Northwestern University | Chicago, Illinois, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035546 (Judy Aschner) | ahamvas@luriechildrens.org | |
| Antonia F. | Olidipo | MD, MSCI | Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology | Hackensack University Medical Center, Hackensack Meridian School of Medicine | Nutley, New Jersey, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035546 (Judy Aschner) | antonia.olidipo@hmhn.org | |
| Andrew S. | Haddad | MD | Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology | Hackensack University Medical Center, Hackensack Meridian School of Medicine | Nutley, New Jersey, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035546 (Judy Aschner) | andrews.haddad@hmhn.org | |
| Lisa R. | Eiland | MD | Division of Neonatology, Department of Pediatrics | Hackensack University Medical Center, Hackensack Meridian School of Medicine | Nutley, New Jersey, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035546 (Judy Aschner) | lisa.eiland@hmhn.org | |
| Nicole T. | Spillane | MD | Division of Neonatology, Department of Pediatrics | Hackensack University Medical Center, Hackensack Meridian School of Medicine | Nutley, New Jersey, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035546 (Judy Aschner) | nicole.spillane@hmhn.org | |
| Kirin N. | Suri | MD | Division of Developmental and Behavioral Pediatrics, Department of Pediatrics | Hackensack University Medical Center, Hackensack Meridian School of Medicine | Nutley, New Jersey, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035546 (Judy Aschner) | kirin.suri@hmhn.org | |
| Stephanie A. | Fisher | MD, MPH | Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology | Feinberg School of Medicine, Northwestern University | Chicago, Illinois, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035546 (Judy Aschner) | stephanie.fisher@northwestern.edu | |
| Jeffrey A. | Goldstein | MD, PhD | Department of Pathology | Feinberg School of Medicine, Northwestern University | Chicago, Illinois, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035546 (Judy Aschner) | ja.goldstein@northwestern.edu | |
| Leena B. | Mithal | MD | Division of Infectious Diseases, Department of Pediatrics | Ann & Robert H. Lurie Children's Hospital, Feinberg School of Medicine, Northwestern University | Chicago, Illinois, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035546 (Judy Aschner) | lmithal@luriechildrens.org | |
| Raye-Ann O. | DeRegnier | MD | Division of Neonatology, Department of Pediatrics | Ann & Robert H. Lurie Children's Hospital, Feinberg School of Medicine, Northwestern University | Chicago, Illinois, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035546 (Judy Aschner) | r-deregnier@northwestern.edu | |
| Nathalie L. | Maitre | MD, PhD | Division of Neonatology, Department of Pediatrics | Emory University School of Medicine and Cerebral Palsy Foundation | Atlanta, Georgia, USA and New York, New York, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035546 (Judy Aschner) | nathalie.linda.maitre@emory.edu | |
| Ruby H.N. | Nguyen | PhD, MHS | Division of Epidemiology & Community Health | School of Public Health, University of Minnesota | Minneapolis, Minnesota, USA | ECHO award Principal Investigator | UG3OD035529 (Hong-Ngoc Nguyen) | Nguyen@umn.edu | |
| Meghan M. | JaKa | PhD, MS | Division of Research & Evaluation | HealthPartners Institute | Minneapolis, Minnesota, USA | ECHO site Principal Investigator | UG3OD035529 (Hong-Ngoc Nguyen) | meghan.m.jaka@healthpartners.com | |
| Abbey C. | Sidebottom | PhD, MPH | Care Delivery Research | Allina Health | Minneapolis, Minnesota, USA | ECHO site Principal Investigator | UG3OD035529 (Hong-Ngoc Nguyen) | abbey.sidebottom@allina.com | |
| Michael J. | Paidas | MD | Department of Obstetrics and Gynecology | University of Miami Miller School of Medicine | Miami, Florida, USA | ECHO site Principal Investigator | UG3OD035542 (Hudson Santos) | mxp1440@med.miami.edu | |
| JoNell E. | Potter | APRN, PhD | Department of Obstetrics, Gynecology and Reproductive Sciences | University of Miami Miller School of Medicine | Miami, Florida, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035542 (Hudson Santos) | jpotter2@med.miami.edu | |
| Natale | Ruby | PhD, PsyD | Mailman Center for Child Development | University of Miami Miller School of Medicine | Miami, Florida, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035542 (Hudson Santos) | rnatale@med.miami.edu | |
| Lunthita | Duthely | EdD | Department of Obstetrics, Gynecology and Reproductive Sciences and Department of Public Health Sciences | University of Miami School of Medicine | Miami, Florida, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035542 (Hudson Santos) | LDuthely@med.miami.edu | |
| Arumugam | Jayakumar | PhD | Department of Obstetrics, Gynecology and Reproductive Sciences | University of Miami Miller School of Medicine | Miami, Florida, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035542 (Hudson Santos) | ajayakumar@med.miami.edu | |
| Karen | Young | MD | Department of Pediatrics | University of Miami Miller School of Medicine | Miami, Florida, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035542 (Hudson Santos) | kyoung3@miami.edu | |
| Isabel | Maldonado | MPH, BS | School of Nursing and Health Studies | University of Miami | Miami, Florida, USA | ECHO Cohort Study Site Program Director | UG3OD035542 (Hudson Santos) | icm16@miami.edu | |
| Meghan | Miller | PhD | Psychiatry and Behavioral Sciences; MIND Institute | University of California Davis | Sacramento, California, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035550 (Rebecca Schmidt) | mrhmiller@ucdavis.edu | |
| Jonathan L. | Slaughter | MD, MPH | Center for Perinatal Research, Abigail Wexner Research Institute and Division of Neonatology, Nationwide Children's Hospital and Department of Pediatrics, College of Medicine and Division of Epidemiology, College of Public Health, The Ohio State University | Nationwide Children's Hospital and The Ohio State University | Columbus, Ohio, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035536 (Jonathan Slaughter) | jonathan.slaughter@nationwidechildrens.org | |
| Sarah A. | Keim | PhD, MS, MA | Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital and Department of Pediatrics, College of Medicine and Division of Epidemiology, College of Public Health, The Ohio State University | Nationwide Children's Hospital and The Ohio State University | Columbus, Ohio, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035536 (Jonathan Slaughter) | Sarah.Keim@nationwidechildrens.org | |
| Courtney D. | Lynch | PhD, MPH | Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, College of Medicine and Division of Epidemiology, College of Public Health, The Ohio State University | The Ohio State University | Columbus, Ohio, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035536 (Jonathan Slaughter) | Courtney.Lynch@osumc.edu | |
| Kartik K. | Venkatesh | MD, PhD | Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, College of Medicine and Division of Epidemiology, College of Public Health, The Ohio State University | The Ohio State University | Columbus, Ohio, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035536 (Jonathan Slaughter) | kartik.venkatesh@osumc.edu | |
| Kristina W. | Whitworth | PhD | Center for Precision Environmental Health and Department of Medicine | Baylor College of Medicine | Houston, Texas, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035544 (Kristina Whitworth) | kristina.whitworth@bcm.edu | |
| Elaine | Symanski | PhD | Center for Precision Environmental Health and Department of Medicine | Baylor College of Medicine | Houston, Texas, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035544 (Kristina Whitworth) | elaine.symanski@bcm.edu | |
| Thomas F. | Northrup | PhD | Department of Family and Community Medicine | University of Texas Health Science Center at Houston (UTHealth Houston) McGovern Medical School | Houston, Texas, USA | ECHO Cohort Study Site Principal Investigator | UG3OD035544 (Kristina Whitworth) | thomas.f.northrup@uth.tmc.edu | |
| Hector | Mendez-Figueroa | MD | Department of Obstetrics, Gynecology and Reproductive Sciences | University of Texas Health Science Center at Houston (UTHealth Houston) McGovern Medical School | Houston, Texas, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035544 (Kristina Whitworth) | hector.mendezfigueroa@uth.tmc.edu | |
| Ricardo A. | Mosquera | MD | Department of Pediatrics | University of Texas Health Science Center at Houston (UTHealth Houston) McGovern Medical School | Houston, Texas, USA | ECHO Cohort Study Site Co-Investigator | UG3OD035544 (Kristina Whitworth) | ricardo.a.mosquera@uth.tmc.edu | |
| Margaret R. | Karagas | PhD | Department of Epidemiology | Geisel School of Medicine at Dartmouth | Hanover, New Hampshire, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023275 (Margaret Karagas) | margaret.karagas@dartmouth.edu | |
| Juliette C. | Madan | MD, MS | Departments of Psychiatry, Pediatrics & Epidemiology | Geisel School of Medicine at Dartmouth, Dartmouth Hitchcock Medical Center | Hanover, New Hampshire, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023275 (Margaret Karagas) | juliette.madan@dartmouth.edu | |
| Debra M. | MacKenzie | PhD | Community Environmental Health Program, Department of Pharmaceutical Sciences | College of Pharmacy, University of New Mexico Health Sciences Center | Albuquerque, New Mexico, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023344 (Debra MacKenzie) | dmackenzie@salud.unm.edu | |
| Johnnye L. | Lewis | PhD | Community Environmental Health Program, Department of Pharmaceutical Sciences | College of Pharmacy, University of New Mexico Health Sciences Center | Albuquerque, New Mexico, USA | ECHO Cohort Study Site Principal Investigator | UG3/UH3OD023344 (Debra MacKenzie) | jlewis@cybermesa.com; jlewis@salud.unm.edu | |
| Brandon J. | Rennie | PhD | Center for Development and Disability | University of New Mexico | Albuquerque, New Mexico, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023344 (Debra MacKenzie) | Brennie@salud.unm.edu | |
| Bennett L. | Leventhal | MD | Community Environmental Health Program, Department of Pharmaceutical Sciences UNM | College of Pharmacy, University of New Mexico Health Sciences Center; University of Chicago | Albuquerque, New Mexico, USA; Chicago, Illinois, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023344 (Debra MacKenzie) | Bennett.leventhal@outlook.com | |
| Young Shin | Kim | MD, MS, MPH, PhD | Department of Psychiatry and Behavioral Sciences | University of California, San Francisco | San Francisco, California, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023344 (Debra MacKenzie) | Youngshin.Kim@ucsf.edu | |
| Somer | Bishop | PhD | Department of Psychiatry and Behavioral Sciences | University of California, San Francisco | San Francisco, California, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023344 (Debra MacKenzie) | Somer.Bishop@ucsf.com | |
| Sara S. | Nozadi | PhD | Community Environmental Health Program, Department of Pharmaceutical Sciences | College of Pharmacy, University of New Mexico Health Sciences Center | Albuquerque, New Mexico, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023344 (Debra MacKenzie) | snozadi@unm.edu | |
| Li | Luo | PhD | Department of Internal Medicine | Comprehensive Cancer Center, University of New Mexico Health Sciences Center | Albuquerque, New Mexico, USA | ECHO Cohort Study Site Co-Investigator | UG3/UH3OD023344 (Debra MacKenzie) | lluo@salud.unm.edu | |
| Barry M. | Lester | PhD | Department of Pediatrics, Department of Psychiatry and Human Behavior | Warren Alpert Medical School of Brown University | Providence, Rhode Island, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023347 (Barry Lester) | barry_lester@brown.edu | |
| Carmen J. | Marsit | PhD | Department of Environmental Health | Rollins School of Public Health, Emory University | Atlanta, Georgia, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023347 (Barry Lester) | carmen.j.marsit@emory.edu | |
| Todd | Everson | PhD | Department of Environmental Health | Rollins School of Public Health, Emory University | Atlanta, Georgia, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023347 (Barry Lester) | todd.m.everson@emory.edu | |
| Cynthia M. | Loncar | PhD | Department of Psychiatry and Human Behavior | Warren Alpert Medical School of Brown University | Providence, Rhode Island, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023347 (Barry Lester) | cloncar@kentri.org | |
| Elisabeth C. | McGowan | MD | Department of Pediatrics | Warren Alpert Medical School of Brown University | Providence, Rhode Island, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023347 (Barry Lester) | emcgowan@wihri.org | |
| Stephen J. | Sheinkopf | PhD | Department of Pediatrics | Thompson Center for Autism & Neurodevelopment, University of Missouri | Columbia, Missouri, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023347 (Barry Lester) | ssheinkopf@health.missouri.edu | |
| Brian S. | Carter | MD | Department of Pediatrics | Children's Mercy-Kansas City | Kansas City, Missouri, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023347 (Barry Lester) | bscarter@cmh.edu | |
| Jennifer | Check | MD | Department of Pediatrics | Wake Forest School of Medicine | Winston, Salem North Carolina, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023347 (Barry Lester) | jcheck@wakehealth.edu | |
| Jennifer B. | Helderman | MD | Department of Pediatrics | Wake Forest School of Medicine | Winston, Salem North Carolina, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023347 (Barry Lester) | jhelderm@wakehealth.edu | |
| Charles R. | Neal | MD | Department of Pediatrics | University of Hawaii John A Burns School of Medicine | Honolulu, Hawaii, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023347 (Barry Lester) | cneal@hphmg.org | |
| Lynne M. | Smith | MD | Department of Pediatrics | UCLA Clinical and Translational Science Institute at The Lundquist Institute, Harbor-UCLA Medical Center | Los Angeles, California, USA | ECHO Cohort Study Site Principal Investigator | UH3OD023347 (Barry Lester) | smith@lundquist.org-test |
Contributor Information
Krystin Jones, Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, United States.
Bianca P Acevedo, Cohen Children’s Medical Center, Northwell Health, New Hyde Park, NY 11040, United States.
Lyndsay A Avalos, Kaiser Permanente Northern California, Division of Research, Pleasanton, CA 94588, United States.
Brennan H Baker, Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA 98105, United States; Seattle Children’s Research Institute, Seattle, WA 98101, United States.
Nicole R Bush, Department of Psychiatry and Behavioral Sciences, Department of Pediatrics, Weill Institute for Neurosciences, University of California, San Francisco, CA 94143,United States.
Claudia Buss, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Psychology, Berlin 10117, Germany; Development, Health, and Disease Research Program and Department of Pediatrics, University of California Irvine, School of Medicine, Irvine, CA 92697, United States; German Center for Mental Health (DZPG), Partner Site Berlin, Charité—Universitätsmedizin, Berlin 10117, Germany; German Center for Child and Adolescent Health (DZKJ), Partner Site Berlin, Charité—Universitätsmedizin Berlin, Berlin 10117, Germany.
Luke P Grosvenor, Kaiser Permanente Northern California, Division of Research, Pleasanton, CA 94588, United States.
Alison E Hipwell, Department of Psychiatry, Psychology and Clinical & Translational Science, University of Pittsburgh, Pittsburgh, PA 15213, United States.
Kristine Marceau, Department of Human Development and Family Science, Purdue University, West Lafayette, IN 47906, United States.
Cindy T McEvoy, Department of Pediatrics, Papé Pediatric Research Institute, Oregon Health & Science University, Portland, OR 97239, United States.
Wei Perng, Department of Epidemiology, Colorado School of Public Health; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States.
Alexandra D W Sullivan, Department of Psychiatry and Behavioral Sciences, Department of Pediatrics, Weill Institute for Neurosciences, University of California, San Francisco, CA 94143,United States.
Irene Tung, Department of Psychology, California State University, Dominguez Hills, Carson, CA 90747, United States.
Yeyi Zhu, Kaiser Permanente Northern California, Division of Research, Pleasanton, CA 94588, United States.
Christine Ladd-Acosta, Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, United States; Wendy Klag Center for Autism and Developmental Disabilities, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, United States.
Author contributions
Krystin Jones (Conceptualization [equal], Formal Analysis [equal], Visualization [lead], Writing – original draft [lead], Writing – review & editing [lead]), Bianca P. Acevedo (Writing – review & editing [supporting]), Lyndsay A. Avalos (Writing – review & editing [supporting]), Brennan H. Baker (Writing – review & editing [supporting]), Nicole R. Bush (Methodology [supporting], Writing – review & editing [supporting]), Claudia Buss (Writing – review & editing [equal]), Luke P. Grosvenor (Writing – review & editing [supporting]), Alison E. Hipwell (Writing – review & editing [supporting]), Kristine Marceau (Writing – review & editing [supporting]), Cindy T. McEvoy (Writing – review & editing [supporting]), Wei Perng (Writing – review & editing [supporting]), Alexandra D. W. Sullivan (Writing – review & editing [supporting]), Irene Tung (Writing – review & editing [supporting]), Yeyi Zhu (Writing – review & editing [supporting]), Christine Ladd-Acosta (Conceptualization [equal], Supervision [lead], Writing – original draft [supporting], Writing – review & editing [supporting])
Conflict of interest
Dr. Ladd-Acosta reports consulting fees from the University of Iowa for providing expertise on autism epigenetics, outside the scope of this work. All other co-authors declare no conflicts of interest.
Funding
Research reported in this publication was supported by the Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health, under Award Numbers U2COD023375 (Coordinating Center), U24OD023382 (Data Analysis Center), U24OD023319 with co-funding from the Office of Behavioural and Social Science Research (Measurement Core), U24OD035523 (Lab Core), ES0266542 (HHEAR), U24ES026539 (HHEAR Barbara O'Brien), U2CES026533 (HHEAR Lisa Peterson), U2CES026542 (HHEAR Patrick Parsons, Kannan Kurunthacalam), U2CES030859 (HHEAR Manish Arora), U2CES030857 (HHEAR Timothy R. Fennell, Susan J. Sumner, Xiuxia Du), U2CES026555 (HHEAR Susan L. Teitelbaum), U2CES026561 (HHEAR Robert O. Wright), U2CES030851 (HHEAR Heather M. Stapleton, P. Lee Ferguson), UG3/UH3OD023251 (Akram Alshawabkeh), UH3OD023320 and UG3OD035546 (Judy Aschner), UH3OD023332 (Clancy Blair, Leonardo Trasande), UG3/UH3OD023253 (Carlos Camargo), UG3/UH3OD023248 and UG3OD035526 (Dana Dabelea), UG3/UH3OD023313 (Daphne Koinis Mitchell), UH3OD023328 (Cristiane Duarte), UH3OD023318 (Anne Dunlop), UG3/UH3OD023279 (Amy Elliott), UG3/UH3OD023289 (Assiamira Ferrara), UG3/UH3OD023282 (James Gern), UH3OD023287 (Carrie Breton), UG3/UH3OD023365 (Irva Hertz-Picciotto), UG3/UH3OD023244 (Alison Hipwell), UG3/UH3OD023275 (Margaret Karagas), UH3OD023271 and UG3OD035528 (Catherine Karr), UH3OD023347 (Barry Lester), UG3/UH3OD023389 (Leslie Leve), UG3/UH3OD023344 (Debra MacKenzie), UH3OD023268 (Scott Weiss), UG3/UH3OD023288 (Cynthia McEvoy), UG3/UH3OD023342 (Kristen Lyall), UG3/UH3OD023349 (Thomas O'Connor), UH3OD023286 and UG3OD035533 (Emily Oken), UG3/UH3OD023348 (Mike O'Shea), UG3/UH3OD023285 (Jean Kerver), UG3/UH3OD023290 (Julie Herbstman), UG3/UH3OD023272 (Susan Schantz), UG3/UH3OD023249 (Joseph Stanford), UG3/UH3OD023305 (Leonardo Trasande), UG3/UH3OD023337 (Rosalind Wright), UG3OD035508 (Sheela Sathyanarayana), UG3OD035509 (Anne Marie Singh), UG3OD035513 and UG3OD035532 (Annemarie Stroustrup), UG3OD035516 and UG3OD035517 (Tina Hartert), UG3OD035518 (Jennifer Straughen), UG3OD035519 (Qi Zhao), UG3OD035521 (Katherine Rivera-Spoljaric), UG3OD035527 (Emily S Barrett), UG3OD035540 (Monique Marie Hedderson), UG3OD035543 (Kelly J. Hunt), UG3OD035537 (Sunni L. Mumford), UG3OD035529 (Hong-Ngoc Nguyen), UG3OD035542 (Hudson Santos), UG3OD035550 (Rebecca Schmidt), UG3OD035536 (Jonathan Slaughter), and UG3OD035544 (Kristina Whitworth). The sponsor, NIH, participated in the overall design and implementation of the ECHO Program, which was funded as a cooperative agreement between NIH and grant awardees. The sponsor approved the Steering Committee-developed ECHO protocol and its amendments, including COVID-19 measures. The sponsor had no access to the central database, which was housed at the ECHO Data Analysis Center. Data management and site monitoring were performed by the ECHO Data Analysis Center and Coordinating Center. All analyses for scientific publication were performed by the study statistician, independently of the sponsor. The lead author wrote all drafts of the manuscript and made revisions based on co-authors and the ECHO Publication Committee (a subcommittee of the ECHO Operations Committee) feedback without input from the sponsor. The study sponsor did not review or approve the manuscript for submission to the journal.
Data availability
Select de-identified data from the ECHO Program are available through NICHD’s Data and Specimen Hub (DASH). Information on study data not available on DASH, such as some Indigenous datasets, can be found on the ECHO study DASH webpage.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Data Availability Statement
Select de-identified data from the ECHO Program are available through NICHD’s Data and Specimen Hub (DASH). Information on study data not available on DASH, such as some Indigenous datasets, can be found on the ECHO study DASH webpage.