Lead Exposure, Micronutrients, Social Vulnerability, and Preterm Birth (ECHO)

Testing whether prenatal lead exposure is associated with preterm birth, and whether maternal micronutrient adequacy and community-level social vulnerability modify that association, using ECHO program cohort data.

Prenatal lead exposure has been studied extensively for its consequences for child neurodevelopment. Its relationship to the timing of birth has received less attention. This project, part of the NIH ECHO (Environmental influences on Child Health Outcomes) program, examines whether prenatal lead exposure from multiple pathways, including water, air, and housing age, is associated with preterm birth, and whether that association is modified by maternal micronutrient adequacy and community-level social vulnerability.

Using data from the ECHO Data Warehouse, we apply generalized estimating equations to account for clustering across ECHO cohorts, with multiple imputation for missing exposure and covariate data. A secondary aim extends the framework to test whether social vulnerability, as captured by the CDC SVI, conditions the lead-PTB association independently of micronutrient status. This is a collaborative project with Eaves (PI) at UNC Chapel Hill (June 2025 to May 2027).