Psychosocial stressors as modifiers of the associations between well-studied and understudied chemicals and birth outcomes in the ECHO Cohort
Open accessAbstract
Psychosocial stressors may exacerbate observed associations between environmental toxicants and adverse birth outcomes. However, studies have primarily focused on well-known compounds rather than a broader range of chemicals of concern. Pregnant women in this analysis had a prenatal urine sample analyzed for 113 well-studied and understudied chemical analytes, and at least one measure of psychosocial stress (N=1,566). We measured analytes from 10 chemical classes, including fungicides/herbicides, insecticides, halogenated phenols, organophosphorus flame retardants, benzophenones, bisphenols, parabens, antimicrobials, phthalates/alternative plasticizers, and polycyclic aromatic hydrocarbons. Principal component analysis was used to identify clusters of exposure patterns. Generalized Estimating Equation models assessed associations between principal components (PCs) and molar sums of each chemical class with birthweight z-scores and gestational age at birth, stratified by individual stressors (i.e., categorical adverse childhood experiences [ACEs; 0, 1-2, and 3-5]; binary prenatal perceived stress, depression, and anxiety). The PC reflecting higher exposure to all analytes (PC1) was negatively associated with birthweight z-scores only among those who experienced 3-5 ACEs compared with those with no ACEs (β PC1 =-0.08, 95% confidence interval [CI]=-0.11, -0.05 for 3-5 ACEs; β PC1 =-0.01, 95% CI=-0.05, 0.04 for 0 ACEs). Most phthalate molar sums were inversely associated with gestational age only among those with anxiety during pregnancy (e.g., β DINP =-0.29, 95% CI=-0.41, -0.18 for anxiety-yes; β DINP = 0.23, 95% CI=0.01, 0.46 for anxiety-no). Findings suggest that certain psychosocial stressors modify associations between understudied chemicals and birth outcomes. • We studied the effect of psychosocial stressors and chemicals on birth outcomes. • We analyzed 1,556 mother-child pairs in the ECHO Cohort. • Stressors included adverse childhood experiences, depression, anxiety, and stress. • We observed some evidence of joint effects, particularly for phthalate exposures. • Future studies may consider co-exposure to multiple psychosocial stressors.
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Pregnancy-period environmental and dietary exposures are shaped by geography, occupation, housing, and socioeconomic position, and often co-occur with psychosocial stress and constrained access to health-promoting resources.
“Pregnancy-period environmental and dietary exposures are shaped by geography, occupation, housing, and socioeconomic position, and they often co-occur with psychosocial stress and constrained access to health-promoting resources [71,72,73,74].”
From Placental Pathophysiology and Developmental Programming of Adult Cardiometabolic Risk: A Narrative Review of Pregnancy Exposures (2026) · cites this paper as [73]
The Introduction (page not supplied) says chemical exposures vary by sociodemographic group and describes evidence that environmental toxicants co-occur with psychosocial stress. The Methods > Covariates section mentions differences in diets and chemical exposure sources. Neither passage establishes the claimed roles of geography, occupation, or housing, or co-occurrence with constrained access to health-promoting resources. (LLM, conf=0.86)
Experimental — accuracy not yet measuredCurrent studies support measurable biological embedding during fetal life, but they do not yet provide validated causal or prognostic markers for adult disease.
“Current studies support measurable biological embedding during fetal life [73,80,115], but they do not yet provide validated causal or prognostic markers for adult disease.”
From Placental Pathophysiology and Developmental Programming of Adult Cardiometabolic Risk: A Narrative Review of Pregnancy Exposures (2026) · cites this paper as [73]
The Results report measurable associations between prenatal chemical exposures, psychosocial stressors, and birth outcomes, including birthweight. That supports a narrower claim about fetal growth, but the paper does not establish biological embedding during fetal life or evaluate validated markers for adult disease. No page number was supplied for the indexed Results passage. (LLM, conf=0.78)
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- Authors
- Eick, S. M., Brennan, P. A., Buckley, J. P., Liang, D., Li, X., Karvonen, K. L., Cowell, W., Zhu, Y., Barrett, E. S., Peterson, A. K., Baker, B. H., Aung, M., Morello-Frosch, R., Woodruff, T. J., Chu, M. T., Varshavsky, J., Hockett, C. W., Carignan, C. C., Oh, J., & Dunlop, A. L.
- Affiliations
- Emory University (US)
- University of North Carolina at Chapel Hill (US)
- Johns Hopkins University (US)
- University of California, San Francisco (US)
- New York University (US)
- Kaiser Permanente Northern California (US)
- Rutgers, The State University of New Jersey (US)
- University of Washington (US)
- University of Southern California (US)
- University of California, Berkeley (US)
- Tufts Medical Center (US)
- Northeastern University (US)
- University of South Dakota (US)
- Michigan State University (US)
- University of California, Davis (US)
- Corresponding author
- Eick, Stephanie M.
- Morello-Frosch, Rachel
- ORCID
- Eick, Stephanie M.
- Brennan, Patricia A.
- Buckley, Jessie P.
- Liang, Donghai
- Li, Xiuhong
- Karvonen, Kayla L.
- Cowell, Whitney
- Zhu, Yeyi
- Barrett, Emily S.
- Peterson, Alicia K.
- Baker, Brennan H.
- Aung, Max
- Morello-Frosch, Rachel
- Woodruff, Tracey J.
- Chu, MyDzung T.
- Varshavsky, Julia
- Hockett, Christine W.
- Carignan, Courtney C.
- Oh, Jiwon
- Dunlop, Anne L.
- Venue
- Environmental Pollution
- Publisher
- Elsevier BV
- Published
- 2026-01
- Volume
- 389
- Pages
- 127441
- ISSN
- 0269-7491 (ISSN-L)
- PMC
- PMC12810359
- OpenAlex
- W4416768311
- Semantic Scholar
- cb3d09fcf1bd3cc9c40a2269d0f69041ae76c492
- Cited by
- 2
- References
- 45
- Citations by year
- 2026: 2
- FWCI
- 0.84
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Environmental Pollution (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion, cc-by-nc)
- UNC Libraries
- Funders
- National Institutes of Health Office of the Director (UG3/UH3OD023251, U2CES026542, UG3/UH3OD023349, UG3/UH3OD023253, UG3/UH3OD023249, U24ES026539, UH3OD023271, UH3OD023268, U2CES030859, UG3/UH3OD023348, UG3/UH3OD023248, UH3OD023347, UG3/UH3OD023285, UG3/UH3OD023290, UG3/UH3OD023313, UG3/UH3OD023289, UG3/UH3OD023365, UG3/UH3OD023344, UH3OD023286, U24OD035523, UG3/UH3OD023279, UH3OD023287, UH3OD023318, UG3/UH3OD023275, U2CES030857, U2CES026555, UH3OD023332, UG3OD035528, UG3/UH3OD023288, UG3/UH3OD023244, U2CES030851, ES0266542, UG3/UH3OD023272, U2CES026561, UG3OD035546, UG3OD035533, U2CES026533, UG3/UH3OD023389, UG3/UH3OD023342, UG3/UH3OD023282, UG3OD035526, UH3OD023320, UH3OD023328, U24OD023319, U2COD023375, U24OD023382)
- National Institute of Environmental Health Sciences (K01ES035082)
- National Institutes of Health
- Office of Behavioral and Social Sciences Research (U24OD023319, U24OD035523, ES0266542)
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Toxic Organic Pollutants Impact
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Health, Environment, Cognitive Aging
- Keywords
- psychosocial stressors, prenatal chemical exposure, birth outcomes, birth weight, gestational age, adverse childhood experiences, antenatal depression, prenatal anxiety, phthalates, bisphenols, organophosphate flame retardants, halogenated phenols, benzophenone, polycyclic aromatic hydrocarbons, parabens, antimicrobial agents, ECHO cohort
- MeSH terms
- Adult, Birth Weight, Environmental Exposure, Environmental Pollutants, Female, Humans, Infant, Newborn, Pregnancy, Pregnancy Outcome, Stress, Psychological, Cohort Studies, Maternal Exposure, Young Adult
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