Prenatal exposure to organophosphate ester flame retardants and behavioral outcomes in early childhood in the Environmental influences on Child Health Outcomes (ECHO) cohort.

Background: Prenatal exposure to organophosphate esters (OPEs) has been linked to neurotoxic effects in children; however, epidemiological evidence remains inconclusive. We investigated associations of prenatal OPE exposure with child behaviors.

Methods: We analyzed data of 2948 mother-child dyads from 12 prospective cohorts of the Environmental influences on Child Health Outcomes (ECHO) Cohort.

Association of Preconception and Prenatal Cannabis Use with Breastfeeding.

Introduction: Breastfeeding is recommended. It is unknown whether preconception or prenatal cannabis use are related to breastfeeding behaviors.

Methods: This population-based retrospective cohort study included 200,207 pregnancies in Northern California (2016-2022) with live births screened in early pregnancy for cannabis use.

Exposure to organophosphate ester flame retardants and plasticizers during pregnancy and autism-related outcomes in the ECHO Cohort.

Background: Organophosphate ester flame retardants and plasticizers (OPEs) have myriad uses in industry and consumer products. Increasing human exposure to OPEs has raised concerns about their potential effects on child neurodevelopment during pregnancy.

Objective: We investigated whether OPE urinary concentrations during pregnancy were associated with child autism-related outcomes.

Maternal Prenatal Cannabis Use and Major Structural Birth Defects.

Objective: We evaluated associations between prenatal cannabis use and major structural birth defects of the child.

Methods: This population-based retrospective cohort study comprised singleton births (January 2011-July 2020) universally screened for substance use at entrance to prenatal care. Prenatal cannabis use was defined as self-reported use or a positive toxicology test during pregnancy.

Effect of a Tailored eHealth Physical Activity Intervention on Physical Activity and Depression During Postpartum: Randomized Controlled Trial (The Postpartum Wellness Study).

Background: Strong evidence suggests physical activity (PA) can ameliorate postpartum depression (PPD) symptoms; however, many postpartum individuals do not meet PA guidelines. Electronic health (eHealth) interventions are a promising approach to address common barriers to PA during postpartum.

Objective: To test the effectiveness of a tailored eHealth PA intervention for increasing PA and decreasing depressive symptoms in individuals at high risk for PPD.

Alcohol, Cannabis, and nicotine use during early pregnancy and infant hearing loss.

Objective: To examine whether maternal prenatal alcohol, cannabis, or nicotine use was associated with offspring diagnoses of hearing loss during the first six months of life.

Methods: We conducted a population-based retrospective birth cohort study of infants (N = 297,147) born between 2011 and 2023 to pregnant individuals (N = 233,902) in Kaiser Permanente Northern California universally screened for any prenatal alcohol, cannabis, or nicotine use since pregnancy at entrance to prenatal care (at ∼8-10 weeks gestation). Offspring hearing loss was defined as ≥1 hearing loss diagnosis in the infant's electronic health record based on ICD codes.

Demographic Correlates of Autism: How Do Associations Compare Between Diagnosis and a Quantitative Trait Measure?

Prevalence of autism diagnosis has historically differed by demographic factors. Using data from 8224 participants drawn from the Environmental influences on Child Health Outcomes (ECHO) Program, we examined relationships between demographic factors and parent-reported autism-related traits as captured by the Social Responsiveness Scale (SRS; T score > 65) and compared these to relations with parent-reported clinician diagnosis of ASD, in generalized linear mixed effects regression analyses. Results suggested lower odds of autism diagnosis, but not of SRS T > 65, for non-Hispanic Black children (adjusted odds ratio [OR] = 0.

Cannabis Use During Early Pregnancy Following Recreational Cannabis Legalization.

Importance: It is unknown whether state recreational cannabis legalization (RCL) is related to increased rates of prenatal cannabis use or whether RCL-related changes vary with cannabis screening methods or the local policy environment.

Objective: To test whether RCL in California was associated with changes in prenatal cannabis use rates, whether changes were evident in both self-report and urine toxicology testing, and whether rates varied by local policies banning vs allowing adult-use retailers post-RCL.

Design, Setting, And Participants: This population-based time-series study used data from pregnancies in Kaiser Permanente Northern California universally screened for cannabis use during early pregnancy by self-report and toxicology testing from January 1, 2012, to December 31, 2019.

A Tailored Postpartum eHealth Physical Activity Intervention for Individuals at High Risk of Postpartum Depression-the POstpartum Wellness Study (POW): Protocol and Data Overview for a Randomized Controlled Trial.

Background: Postpartum depression (PPD) is associated with significant health consequences for the parent and child. Current recommendations for PPD prevention require intense health care system resources. Evidence-based interventions for PPD prevention that do not further burden the health care system are needed.

Racial Residential Segregation and Mental Health During Pregnancy.

Importance: Research suggests the social, physical, and socioeconomic contexts of residing in segregated neighborhoods may negatively affect mental health.

Objective: To assess the association between racial residential segregation and prenatal mental health among Asian, Black, Hispanic, and White individuals.

Design, Setting, And Participants: This population-based cross-sectional study was conducted in Kaiser Permanente Northern California (KPNC), an integrated health care delivery system.

Gestational exposure to organophosphate ester flame retardants and risk of childhood obesity in the environmental influences on child health outcomes consortium.

Introduction: Organophosphate esters (OPEs) are increasing in use as flame retardants and plasticizers and concerns have been raised given their endocrine-disrupting activities and possible obesogenic consequences. However, longitudinal studies on gestational OPE exposure and childhood obesity are scarce. This study examined whether OPE levels in maternal urine during pregnancy were associated with the risk of childhood obesity.

Early Maternal Prenatal Cannabis Use and Child Developmental Delays.

Importance: Maternal prenatal cannabis use is associated with adverse neonatal health effects, yet little is known about its association with child developmental outcomes.

Objective: To evaluate associations between maternal prenatal cannabis use in early pregnancy and child early developmental delays.

Design, Setting, And Participants: This cohort study included 119 976 children born to 106 240 unique individuals between January 2015 and December 2019 and followed up to aged 5.

Prenatal Cannabis Use and Offspring Attention Deficit Hyperactivity Disorder and Disruptive Behavior Disorders: A Retrospective Cohort Study.

Objective: To examine whether maternal cannabis use during early pregnancy is associated with offspring attention deficit hyperactivity disorder (ADHD) and disruptive behavior disorders (DBD).

Methods: We conducted a population-based retrospective birth cohort study of children (N = 141,570) born between 2011 and 2018 to pregnant individuals (N = 117,130) in Kaiser Permanente Northern California universally screened for any prenatal cannabis use at the entrance to prenatal care (at ∼8-10 wk gestation). Prenatal cannabis use was defined as (1) self-reported use and/or a positive toxicology test, (2) self-reported use, (3) a positive toxicology test, and (4) self-reported use frequency.

Theoretical Behavior Substitutions during the 24-h Day in Pregnancy and Infant Growth Outcomes.

Purpose: The purpose of this study is to assess associations of theoretically reallocating time from sleep, sedentary behavior, or light-intensity physical activity (LPA) to moderate/vigorous-intensity physical activity (MVPA) during pregnancy with infant growth outcomes.

Methods: We used data from a cohort of pregnant individuals with overweight or obesity ( n = 116). At 9 to 15 and 30 to 36 wk of gestation, waking movement was measured using wrist-worn accelerometers and sleep duration was self-reported.

Prenatal Cannabis Use and Maternal Pregnancy Outcomes.

Importance: Many studies have evaluated whether in utero cannabis exposure is associated with fetal and neonatal outcomes, yet little is known about whether prenatal cannabis use is associated with maternal health outcomes during pregnancy.

Objective: To evaluate whether prenatal cannabis use is associated with maternal health outcomes during pregnancy.

Design, Setting, And Participants: This population-based retrospective cohort study included pregnancies in Northern California from January 2011 to December 2019 that lasted 20 weeks or longer and were screened for prenatal cannabis use.

Group Multimodal Prenatal Care and Postpartum Outcomes.

Importance: An increasing body of evidence suggests equivalent if not improved postpartum outcomes of in-person group prenatal care compared with individual prenatal care. However, research is needed to evaluate outcomes of group multimodal prenatal care (GMPC), with groups delivered virtually in combination with individual in-person office appointments to collect vital signs and conduct other tests compared with individual multimodal prenatal care (IMPC) delivered through a combination of remotely delivered and in-person visits.

Objective: To compare postpartum outcomes between GMPC and IMPC.

Association of Adverse Childhood Experiences and Resilience With Depression and Anxiety During Pregnancy.

This was a retrospective cohort study of pregnant individuals in the Kaiser Permanente Northern California system who were screened for adverse childhood experiences and resilience as part of standard prenatal care at about 16 weeks of gestation. Overall, 14,625 pregnancies were included; 17.0% had newly identified depression; 9.

Behavior reallocations within 24-h movement profiles and change in cardiometabolic biomarkers during pregnancy.

Objective: The goal of this study was to investigate associations of reallocations within 24-h movement profiles and changes in cardiometabolic biomarkers from early to late pregnancy.

Methods: In 137 individuals with prepregnancy overweight/obesity, waking movement was measured using wrist-worn accelerometers, sleep was self-reported, and biomarkers were measured in fasting serum samples at 12 and 32 weeks' gestation. We used compositional isotemporal substitution models.

Association of maternal education, neighborhood deprivation, and racial segregation with gestational age at birth by maternal race/ethnicity and United States Census region in the ECHO cohorts.

Background: In the United States, disparities in gestational age at birth by maternal race, ethnicity, and geography are theorized to be related, in part, to differences in individual- and neighborhood-level socioeconomic status (SES). Yet, few studies have examined their combined effects or whether associations vary by maternal race and ethnicity and United States Census region.

Methods: We assembled data from 34 cohorts in the Environmental influences on Child Health Outcomes (ECHO) program representing 10,304 participants who delivered a liveborn, singleton infant from 2000 through 2019.

Neonatal outcomes associated with in utero cannabis exposure: a population-based retrospective cohort study.

Background: The full spectrum of associations between in utero cannabis exposure and adverse neonatal outcomes is still unclear.

Objective: This study aimed to evaluate the associations between in utero cannabis exposure and neonatal outcomes.

Study Design: This population-based retrospective cohort study of singleton births among Kaiser Permanente Northern California members (January 1, 2011-July 31, 2020) included parent-infant dyads in which the pregnant parent was screened for cannabis use as part of standard prenatal care, generally upon entrance into care.