New $27 Million NIH Grant to Support Research on Earliest Impacts on Child Health as Part of National ECHO Study

Dr. Judy Aschner of the Center for Discovery and Innovation investigates childhood development

A Hackensack Meridian Health physician-scientist has been awarded a major National Institutes of Health (NIH) grant to continue her research into how environmental factors affect children with a variety of disabilities, as part of a massive ongoing nationwide study.

The five-year, $27 million grant to Judy Aschner, M.D. and team is part of the Environmental Influences on Child Health Outcomes (ECHO) program, a massive national cohort started in 2016 and renewed in 2023.

The new funding for a pregnancy cohort of women recruited from HUMC and Northwestern University in Chicago, continues the long-standing ECHO research of Dr. Aschner, member of the Center for Discovery and Innovation (CDI). The grant, entitled “Enriching ECHO Cohorts with High-risk Pregnancies and Children with Health Challenges (Enriching ECHO)” will advance ECHO research by focusing on the impact of the environment on outcomes for children with a variety of sensory, motor and neurodevelopmental challenges.

“This work has lasting significance for science, and society,” said Ihor Sawczuk, M.D., FACS, president of Academics, Research, and Innovation at Hackensack Meridian Health, founding chair of the Hackensack Meridian Health Research Institute, and associate dean of Clinical Integration and professor and chair emeritus of Urology at the Hackensack Meridian School of Medicine. “Dr. Aschner’s contributions continue to push our understanding of this critical window of human development.”

The scientific premise of Aschner and her team is that prenatal and perinatal (the time immediately before and after birth) environmental exposures and modifiable personal factors impact the well-being of children with chronic health challenges. This results in definable outcomes of function, life satisfaction, and participation in community and family life. Their hypothesis: These studies will identify modifiable factors associated with better-than-expected positive health outcomes along the continuum of development to allow children with chronic health challenges - and by extension, all children - to thrive.

Among the aims of the study are: recruiting women with high-risk pregnancies, comparing the trajectories of the development of the children who are born with and without disabilities and exploring the environmental and psychosocial exposures of the children over time that predict their health outcomes.

“ECHO has done some remarkable work since it was started a decade ago,” said Aschner. “But we think we can do even more to understand the impact of environmental exposures during pregnancy and in early childhood, especially for children who are challenged with disabilities - and ultimately change lives.”

This new grant is an extension of a previously funded ECHO grant at HMH that launched this pregnancy cohort. Since January 2024, nearly 850 pregnant women were recruited before the 20th week of gestation from the high-risk obstetric practices at Hackensack University Medical Center, and Prentice Women's Hospital at Northwestern University. The study plans seven years of follow-up for the women and their children at the Joseph M. Sanzari Children’s Hospital at HUMC and Lurie Children’s Hospital in Chicago.

“Judy Aschner’s work is incredibly important and impactful for childhood development,” added David Perlin, Ph.D., executive vice president and chief scientific officer of the CDI.

The national ECHO program focuses on five key pediatric outcomes with a high public health impact: pre-, peri-, and post-natal outcomes; upper and lower airway health; obesity; neurodevelopment; and positive health. ECHO’s first phase was funded from September 2016 to August 2023 and included over 69 cohorts in 31 NIH awards with over 41,000 participants. Dr. Aschner has been a principal investigator of an ECHO cohort since 2016. She was the principal investigator for the ECHO-DINE (Developmental Impact of NICU Exposures) award in ECHO cycle 1 consisting of former preterm infants originally recruited from Neonatal Intensive Care Units (NICU) at eight hospitals in the US. This preterm cohort was also funded in cycle 2 of EHCO and will allow for continued follow-up of these children (now approaching middle childhood and adolescence) for another seven years.