ECHO-PROTECT Cohort Study Site in Puerto Rico

The effect of early environmental exposures on child health and development is an important area of public health that no single cohort, or even a few, can answer alone. Determining this effect becomes more challenging when considering that these exposures influence multiple interrelated health outcomes such as obesity, neurodevelopment and reproductive development. The ECHO Cohort Site in Puerto Rico (PR) will focus on these health outcomes, taking advantage of the rich and large sample size and longitudinal nature of the national ECHO Cohort and expertise across the ECHO consortium. The project will contribute innovative research to (Aim 1) examine the influence of environmental factors on maternal diet and obesity during pregnancy, child diet and obesity during early to middle childhood, and the relationship between maternal-child diet and onset of puberty and (Aim 2) determine the relationship between in utero and early childhood exposure to environmental chemicals, individually and as mixtures, and neurodevelopment and reproductive development, across early childhood, middle childhood, and adolescence. Most importantly, the project will build upon the ongoing ECHO cohort in PR (Aim 3) to follow up and collect data and biospecimens from the 800 children that are participating in the ECHO UG3 cohort, as well as recruit an additional 1,200 pregnant participants, yielding 1,000 more children, for a total of 1800 children contributing data and biospecimens to the ECHO Cohort. The proposed 1,200 new pregnancies will include at least 80 completed pregnancies with preconception data (Aim 4), tracked from a cohort of 470 potential preconception participants and, if available, their conceiving partner. This research will contribute meaningfully to ECHO’s mission, offering (a) an important cohort that will enrich consortium wide data, (b) significant, innovative science on the influence of the environment and exposure to multiple chemicals on multiple interrelated health outcomes such as obesity, neurodevelopment, and reproductive development, and (c) expertise to lead and participate in additional new scientific directions involving biomarkers of exposure or biologic response, child brain or reproductive development, and statistical methods in collaboration with the ECHO consortium, to answer impactful and cutting-edge research questions. Results from our study will inform future clinical intervention, risk assessment and policy-setting efforts, with direct relevance to the U.S. population.