Turning great ideas into healthier communities


Child Health and Development Studies

The Child Health and Development Studies (CHDS) investigates how health and disease are passed on between generations—not only genetically, but also through social, personal, and environmental surroundings. Studies spanning over 60 years enable CHDS scientists to study health across generations and seek ways to prevent disease early in life.

Program Director(s)

Barbara Cohn

Program Site



A Lifecourse Approach to Emerging Health Disparities in a U.S. Cohort

This study, sponsored by the National Institute of Child Health and Development, was a collaboration between CHDS investigators and Columbia University. The focus of this project is to understand how and when racial and socioeconomic disparities in health emerge over the life course. It will provide critical information for understanding why disparities exist and how they might be addressed.

Breast Cancer and Organochlorines

This project considered timing of exposure in a prospective epidemiological study of the relationship between DDT exposure and breast cancer.

Can Placenta Factors Explain Race Patterns of Breast Cancer?

Higher birth weights have been reported to increase breast cancer risk, and birth weights of mothers and daughters are highly correlated. However, race/ethnicity patterns for birth weight do not match patterns of breast cancer in California (lowest in Asians and Hispanics). A key to progress in breast cancer prevention will lie in reconciling critical paradoxes like this one. This grant examines whether race differences in placental characteristics shed light on this paradox.

Celiac Disease Within a Multi-Generational Cohort Study

The goal of this project is to provide information about the consequences of untreated celiac disease, increase awareness of the disease and potentially provide evidence of the importance of screening children and young adults, reducing the disease’s impact on multiple generations.

Chemical Safety During Breast Cancer Susceptibility Windows

Development of chemical testing that interrogates effects on high impact pathways in humans is likely to be most effective for identifying and controlling dangerous exposures. This project planned to discover some of these pathways for pregnancy and in utero windows of susceptibility by implementing metabolomics in the CHDS, including the first investigation of paternal contributions to daughter's breast cancer.

Early Determinants of Adult Health

This collaborative project between Child Health and Development Studies (CHDS) investigators and Columbia University, Harvard University, the University of California, Davis, and the Kaiser Permanente Division of Research examines how prenatal and childhood factors influence the risk for diabetes, heart disease, breast cancer and brain function in adulthood. This project launched a new era of research at the CHDS focused on adult health of CHDS "children."

Early Determinants of Mammographic Density

The purpose of this study by the Child Health and Development Studies, Kaiser Permanente and Columbia University is to learn more about the effects of the prenatal period and early childhood on women's adult health, particularly the health of their breasts. It examines whether mammographic density (which may be linked to later risk of breast cancer) is related to prenatal or early childhood factors.

Early Life Exposures and Risk of Young-Onset Colorectal Cancer

The incidence of colorectal cancer (CRC) has nearly doubled among younger adults (age <50 years) since the early 1990s. Factors contributing to rising incidence rates have puzzled researchers for years, and family history remains the only known risk factor. This project will evaluate the role of early life exposures in understanding increased risk of young-onset colorectal cancer and characterize family history and germline mutations in young-onset CRC.

Environmental Causes of Breast Cancer Across Generations

This study tests the idea that prenatal exposure to environmental chemicals increases the risk of breast cancer. Many of these compounds are known to affect fertility, birth outcomes, and immune function and are thus suspected causes of or contributors to breast cancer. However, no human study has been able to measure exposure in the womb, a time of vulnerability for the developing fetus.

Estriol, Blood Flow, and Breast Cancer Risk

This study proposed that estriol released from the placenta directly into the uterine vasculature likely explains the fifteen- to twenty-fold increase in uterine blood flow that occurs during human pregnancy. Lifelong residual vascular effects that enhance clearance of genotoxic and other noxious substances from the breasts may explain the protective effect of pregnancy against breast cancer.

Exposure to DDT, DDE and PCBs Before Birth and Human Testicular Cancer: A Prospective Study Based on Archived Pregnancy Samples

Testicular cancer incidence arose dramatically worldwide among men born after 1945. The widespread introduction of DDT may have contributed to this increase. This study investigates whether in utero exposure to DDT, DDE, or congener-specific PCBs increase the risk of testicular cancer.

Fetal Exposure to Maternal Stress and Inflammation: Effects on Neurodevelopment

In partnership with Temple University, this project aims to investigate how maternal stress and maternal inflammation during pregnancy, and fetal hypoxia in the CHDS mothers influence the risk of symptoms of depression during adolescence in offspring (CHDS children).

Finding Metabolic Signatures in Pregnancy that Predict Breast Cancer: 60-Year Prospective Study in the CHDS Pregnancy Cohort

In partnership with Emory University, this project studies second and third trimester archival samples of women who subsequently developed breast cancer, compared to second and third trimester archival samples from women who did not develop breast cancer, to identify predictive gestational biomarkers which could lead to new approaches to prevent breast cancer.

Germline EDC Exposure and Breast Cancer Risk in the 3Gs Study

Pregnancy exposures impact three generations simultaneously: 1) the mother, 2) the fetus, and 3) the reproductive cells (germline) that will form the grandchild. These are windows of susceptibility of the breast to endocrine disrupting chemicals, EDCs. We are investigating the impact of germline exposure to EDCs on breast cancer risk factors and the effect of race and socioeconomic status (SES) on that relationship. We will develop a health communication campaign aimed at reducing EDC exposures.

Grandparental Exposures and Risk of Autism in the Third Generation

This proposal looks for environmental risk factors for autism during the critical period of susceptibility, in the womb. In this study we ask whether specific exposures during the 1960s to grandfathers and grandmothers during conception and pregnancy are linked to autism in their grandchildren. No study has been able to ask this question before now.

Identification of Spectrum Neurodevelopmental Sequelae in CHDS Cohort

In this pilot study, CHDS will identify cases of spectrum of neurodevelopmental sequelae including ADD, ADHD, learning disabilities, sensory processing disorders, mental illness, emotional disturbance, social cognitive deficits, and autism spectrum disorder in the CHDS cohort grandchildren. This study prepares for the first three generation study of autism in relation to CHDS mothers exposures.

Immune Markers in Pregnancy and Breast Cancer

This project examined clinically observed indicators of placental function as prospective predictors of maternal breast cancer.

In Utero Organochlorine Exposure and Breast Density

This project tests the hypothesis that in-utero exposure to organochlorine compounds alters breast density in women measured at 40-44 years of age. High breast density is associated with increased risk of breast cancer.

Linking Neighborhood and Individual ACEs to Breast Cancer

We will examine adverse experiences in childhood (ACEs) measured at the neighborhood and individual level over the course of childhood and construct pathways to risk of breast cancer (age at menarche, breast density) from infancy through adolescence, correlated with characteristics of place of residence. Focusing on neighborhood level ACEs will allow us to apply what we have learned to create a California map to identify current childhood populations at risk.

Maintenance of Child Health and Development Studies Name and Address Files

The project's general aims are: 1) to maintain the accuracy of the Child Health and Development Studies (CHDS) files for name and addresses, mortality and occurrences of malignancies; 2) to manage the CHDS serum collection; and 3) to facilitate the biomedical and psychosocial studies through dissemination of data to qualified researchers without violating participant confidentiality.

Maternal Inflammation During Pregnancy: Clincial and Neurocognitive Outcomes in Adult Offspring

This study is a partnership with the University of California, Berkeley (UCB) and Temple University. The purpose of the study is to look at what influences brain health throughout development, including early life and prenatal development, and will help us understand how early experiences influence brain development in adulthood. The unique and valuable information this study provides will be used for research that will help us understand brain health, including depression and anxiety.

New Bone-Age Assessment Technique for Cancer Epidemiology

This project developed computer-assisted bone age scoring of wrist radiographs in collaboration with Harvard Medical School to facilitate studies of the relation of early life factors to cancer.

Pregnancy Hormones, Environment, Genes, and Offspring Health

This planning grant tested the feasibility of creating a genetic library for the CHDS that can be used to understand how genes interact with environment to influence health of parents and offspring. It included intensive examination of the ethics of genetic studies in long-term studies.

Prenatal Determinants of Schizophrenia, II

This study investigates the role of prenatal determinants of schizophrenia and schizophrenia spectrum disorder.The study builds on and extends two prior investigations: the original Child Health and Development Study and the Prenatal Determinants of Schizophrenia Study, This project is a collaboration with Kaiser Foundation Research Institute.

Prenatal Environmental Determinants of Intergenerational Risk (PEDIGREE)

This is a unique study of human exposure to endocrine active environmental chemicals during two critical windows of exposure for the breast: 1) pregnancy which places the breast at risk for carcinogenesis in the mother and 2) the prenatal period when breast differentiation places the breast at risk for carcinogenesis in the daughter. We are investigating how history of maternal breast cancer modifies F0 environmental exposure effects on mammographic density and Line-1 DNA methylation in the F1.

Prenatal Exposure to Environmental DDT and Risk of Metabolic Syndrome

In partnership with the University of California, Davis, we will investigate, for the first time, maternal exposures to endocrine-active compounds in relation to biomarkers of metabolic disruption, including hemoglobin A1-C a marker of diabetes.

Prenatal Exposure to Organochlorines and Fecundability

A prospective study to investigate the relation between prenatal exposure to environmental chemicals and fecundability (time to pregnancy) in adult CHDS daughters.

Prenatal Factors and Risk of Bipolar Disorder

This study examines the relationship between early developmental insults and risk of adult bipolar affective disorder. Investigators aim to better understand early developmental risk factors for bipolar disorder, and assess whether these factors are specific to schizophrenia. This project is a collaboration with the Research Foundation for Mental Hygiene.

Prenatal Organochlorine Exposure and Human Reproduction

This pilot study collected semen samples from CHDS sons as preparation for a proposal to fund an examination of the relationship between prenatal exposure to organochlorines and semen quality.

Prenatal Organochlorine Exposure and Male Reproduction (Study of the Environment and Reproduction)

The Study of the Environment and Reproduction is a joint project between the Child Health and Development Studies,Kaiser Permanente and Columbia University. It examines the effects of prenatal exposure to pesticides and men's fertility. Prenatal exposure to pesticides could occur if a man's mother was exposed to pesticides before or during her pregnancy. Some pesticides are stored for long periods in body tissues and might affect the developing reproductive system of a fetus.

Prenatal Organochlorines, Thyroid, and Development

This project assessed whether exposure to endocrine disrupting compounds during pregnancy is associated with a) adverse development (cognitive function, height, weight, weight for height, and for females, age at menarche) in the offspring at birth, early childhood, middle childhood, and adolescence, b) mild deficiencies in maternal thyroid function, and c) whether adverse developmental findings, if any, are attributed in part to deficiencies in exposure to maternal thyroid hormone in utero.

Prostate Cancer: Prospective Serum Markers in Blacks and Whites

The project examined the possible relationship of genetics and serum levels of androgens and growth factors to the risk of prostate cancer in African-American and Caucasian men.

Reporting Personal Levels of Environmental Chemicals: Impact

The first study of its kind, this project will test the hypothesis that personal report-back will increase participant's commitment to research, knowledge about environmental chemicals, and motivate personal and community-level action to reduce exposures; and that personal report-back will motivate women who are often asked for health advice to discuss environmental chemical exposures with their broad networks, spreading the message.

Rethink Plastic

The goal of this pilot study is to design a social network intervention to reduce plastic use in families with children and adolescents. Plastics were chosen because they are common sources of environmental estrogens, a possible risk factor for breast cancer. As a Community Research Collaboration pilot study CHDS researchers will be joined two community partners: the Participant Advisory Council of the CHDS and the Plastics Pollution Coalition.

Stress, Epigentics, and Aging

This study examines the role of childhood and adult socioeconomic status (SES) and psychosocial stressors on telomere length and methylation age in adulthood; behavioral and psychological responses to stress as potential mediators of these associations, and positive and negative coping factors as potential modifiers.

The Epidemiology of Growth Factors and Immune Function in Pregnancy: Relation to Maternal Breast Cancer

The project investigated the relation between prospectively obtained measures of serum markers of placental function in pregnancy and breast cancer.

Tobacco Smoke Exposure and Atrial Fibrilation

The purpose of this study is to simultaneously combat two of the most important threats to health and wellness today: atrial fibrillation (AF) and tobacco smoke exposure. We will leverage the multi-generational nature of the Childhood Health and Development Study to test the hypothesis that exposure to tobacco smoke during early development leads to AF in adulthood and to evaluate whether individual-level adult tobacco smoke exposure is correlated with discrete episodes of atrial arrhythmias.

Here's How We're Making a Difference

Developing Best Practices in Sharing Study Findings with Participants

PHI’s Child Health and Development Studies is not only advancing groundbreaking research on how environment influences health, but they’re also developing and testing best practices for reporting this information back to study participants. CHDS is testing the blood levels of 150 African-American and 150 non-African-American women for chemicals like pesticides and flame retardants. The findings—for individuals and for the group as a whole—will be shared with participants, allowing researchers to assess best practices and impact of personal report-back. The project is a novel collaboration between researchers and cohort members who function as the community partner via their membership in a Participant Advisory Council. Its findings will be used to help shape other biomonitoring report-back approaches across the country.

Linking Pregnancy History to Cardiovascular Risk

Research from the Child Health and Development Studies showed some combinations of pregnancy complications were associated with as much as a 7-fold increase in risk of cardiovascular disease death overall. Other combinations were associated with a 4- to 5-fold higher risk of dying of cardiovascular disease early, before the age of 60. It’s the most extensive study of its kind, following 15,000 women over fifty years, and means that many doctors could be screening—and intervening early—for cardiovascular risk simply by looking at a woman’s pregnancy history.

Making New Connections Between Chemical Exposure and Disease Across Generations

Research from PHI's Child Health and Development Studies found that women who were exposed to higher levels of the pesticide DDT in utero—particularly a more estrogenic form, o,p’-DDT, found in commercial DDT—were nearly four times more likely to be diagnosed with breast cancer as adults than women who were exposed to lower in utero levels. The study was published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).

“This 54-year study is the first to provide direct evidence that chemical exposures for pregnant women may have lifelong consequences for their daughters’ breast cancer risk,” said one of the study’s authors, PHI's Barbara A. Cohn, PhD. “Environmental chemicals have long been suspected causes of breast cancer, but until now, there have been few human studies to support this idea.”

Learn more about the study, which was covered in media outlets such as NBC News, The Washington Post, Forbes, TIME Magazine, National Geographic, and more. See the coverage.

Producing Lifesaving Research: Women with Irregular Menstrual Cycles at Increased Risk of Ovarian Cancer Death

PHI’s Child Health and Development Studies (CHDS) found that women with irregular menstrual cycles had up to a threefold increased risk of ovarian cancer. Ovarian cancer is the fifth leading cause of cancer death for women in the US, claiming over 14,000 lives in 2015. The lack of specific early symptoms and disease aggressiveness command the need for new tools to identify early warning signs for a type of cancer that in the past has gone unnoticed until it’s too late.

More than 60 years ago, CHDS enrolled over 15,000 mothers early on in their pregnancy. Identifying early risk factors for ovarian cancer, which is usually not diagnosed until after it has spread, allows clinicians to develop strategies to potentially save lives. The findings from this study published in 2016 in the International Journal of Cancer give clinicians a new high-risk target—women with irregular menstrual cycles—for more intensive ovarian cancer screening and the opportunity for earlier intervention and life-saving treatment. Learn more about the study.