Sathyanarayana Lab

Current Research

The Sathyanarayana Lab’s research includes:

Environmental influences on Child Health Outcomes (ECHO) PATHWAYS

The NIH ECHO program is a federal initiative to investigate how exposure to a range of environmental factors in early development – from conception through early childhood – influences the health of children and adolescents. The studies will target four key pediatric outcomes that have a high public health impact: airway health, obesity, neurodevelopment and birth outcomes.

The ECHO Study plans to use the information we learn from families to investigate: 

  • How the environment may affect our children’s health. • How genes and the environment interact to affect growth, development, and health.
  • How conditions that appear later in childhood and adulthood begin in early childhood. 

PATHWAYS is a new research center at the Seattle Children’s Research Institute aimed at understanding how children’s health may be affected by conditions faced by their mothers during pregnancy – specifically, chemicals in the environment (including phthalates and air pollutants) and stressful conditions or experiences, such as poverty, hardship, or tragic events. PATHWAYS is a center grant under the NIH ECHO initiative, and Dr. Sheela Sathyanarayana is a Principal Investigator for this study. We are investigating whether these pregnancy exposures are linked to problems in child development by following over a thousand mother-child pairs over several years, from pregnancy through childhood. We will focus on two aspects of child health: lung function (including asthma and similar airway conditions) and neurodevelopment, which includes the child behaviors, emotional, and social well being.

Our overall objective is to determine whether exposure to stress or environmental chemicals, alone or in combination, during a mother’s pregnancy is associated with more respiratory or neurodevelopment problems in her child across childhood. A major part of this project is to investigate how the placenta plays a role in the development of these conditions.

We are conducting these studies using three ongoing cohorts of children: TIDES (The Infant Development and Environment Study), GAPPS (Global Alliance to Prevent Prematurity and Stillbirth), and CANDLE (Conditions Affecting Neurocognitive Development and Learning in Early childhood). The GAPPS cohort started as a biorepository to advance innovative research of both normal and abnormal pregnancies, including how pregnancy affects maternal and child health after delivery. We are now recruiting kids back at ages 4-6 years. CANDLE is based in Memphis, Tennessee and focused on how maternal stress related to child health outcomes. TIDES is an ongoing study that Dr. Sathyanarayana has participated in since 2009 (described below).

The Infant Development and Environment Study (TIDES)

Dr. Sheela Sathyanarayana is the clinical director and site principal investigator for TIDES, which looks at whether a pregnant woman’s exposure to common chemicals influences her baby’s development. The study has four sites in Seattle, Minneapolis, San Francisco, and Rochester. The study zeroes in on the impact of phthalates – chemicals that make plastics soft, and are present in food and everyday products. Phthalates alter hormone concentration and affect reproductive development in animal studies. We are trying to see if the same happens in humans too.

In the study’s first phase, we showed that prenatal exposure to phthalates in our diet and homes may affect the reproductive tract development in boys but not in girls. These results were affected by the amount of stress that the mother reported during pregnancy. We also found that women’s attitudes about phthalates and other environmental chemicals vary widely and can influence their consumer choices and the amount of these chemicals to which they are exposed.

In 2015, the National Institutes of Health provided funding to continue TIDES. This enables us to follow study participants to see how chemical exposures affect their development in the preschool years.

Currently, we are doing age 6 study visits to examine how phthalate exposures in pregnancy affect childhood behaviors. We are also collaborating with partners at New York University to study effects of these chemicals on heart function and obesity.

The study is led and coordinated by Dr. Shanna Swan’s team at Mount Sinai Medical Center. The four clinical centers are Seattle Children’s Research Institute; the University of Minnesota; the University of Rochester; and the University of California, San Francisco.

Prenatal Environmental Reproductive Hormone Concentrations (PERCH)

The TIDES study found that phthalate exposure can cause babies to be born with an unusually long – or short – distance between their genitals and anus. This may indicate that phthalate exposure affects how reproductive organs develop.

PERCH takes a closer look at this phenomenon, with hopes of pinpointing how phthalates alter reproductive development. The study uses data and specimens from TIDES participants to investigate the role of prenatal sex steroid hormones as a link between first trimester phthalate exposure and newborn anogenital distance (AGD).

Preventing Environmental Exposures in Pregnancy (PEEPS)


The PEEPS study’s purpose was to determine how to reduce exposures to phthalates and bisphenol A (BPA), which are environmental chemicals commonly found in food. We developed two strategies, and compared how they affected the environmental chemical concentrations in the bodies of study participants.

The first intervention provided families with educational materials on how to decrease exposures, and with food storage containers made of stainless steel and glass, instead of plastic. The families were asked to follow these educational guidelines and use these alternative containers to the best of their abilities for a five-day period.

The second intervention provided families with a fresh food diet and alternative food storage containers for a five-day period.

We expected to see no significant change in environmental chemical concentrations in the first group, and a decrease in environmental chemical concentrations in the second group.

While we saw no significant change in concentrations in the first group, we saw a significant increase in BPA and phthalate concentrations for the group that was given fresh food and alternative storage containers.

This was unexpected, so we tested the foods that participants were given and found high concentrations of the chemicals in spices and high-fat dairy. Our results show that, without regulations to reduce phthalate and BPA concentrations in food production, it may be difficult to develop effective interventions.

Our results were published in a paper in the Journal of Exposure Science and Environmental Epidemiology.

Learn more

To learn more about these studies and our overall research, please email Suzanne Peck, the Sathyanarayana Lab’s research associate.