Participation in TIDES began in 2011 when pregnant mothers were in their first trimester of pregnancy and ended shortly after birth for girl babies, and at one year old for boy babies. During the first five years of TIDES, we enrolled almost 800 mothers and their babies across four research study sites.

Our study suggested that prenatal exposure to common chemicals in our diet and homes – phthalates, which make plastics soft and flexible – may affect the reproductive tract development of boys while in utero but not that of girls. These results are also affected by the amount of stress the moms reported during pregnancy.


Due to the success of TIDES I and the importance of our findings related to phthalate exposures, the National Institutes of Health (NIH) funded a continuation study in 2015, TIDES II. This phase followed the TIDES children between the ages of four and six years old as well as their mothers. TIDES II was important because it gave us the opportunity to extend our knowledge beyond pregnancy and learn about the potential effects of prenatal and postnatal phthalates on the development of young children. We examined how the environment and events occurring between ages four and six, as well as during pregnancy, affect a child’s growth, well-being, and behavior.

In 2016, TIDES families began participating in the Environmental Influences on Child Health Outcomes (ECHO) Cycle 1 Program funded by NIH. The goal of ECHO is to understand the effects of a broad range of early environmental exposures on child health and development from birth through adolescence. ECHO’s five key health outcomes are pre-, peri-, and postnatal; upper and lower airways; obesity; neurodevelopment; and positive health. During ECHO Cycle 1 (2016-2022), more than 107,000 children and caregivers participated at various sites across the U.S. and provided over 100,000 biospecimen samples.


TIDES III is a newly funded phase of measurements that will be conducted when the TIDES children are 12 and 14 years old. TIDES III seeks to determine if common chemicals in our environment affect adolescent lung health, including lung function and inflammation. These chemicals can also affect hormones like testosterone and estrogen; therefore, we will seek to determine if they affect male and female lung health differently. Similar to TIDES II and TIDES ECHO, the TIDES III study visits will include surveys, body measurements (height and weight), biospecimen collection (urine and blood), and airway measurements (spirometry and FeNO, which is short for Forced exhaled Nitric Oxide).

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