The Atlanta ECHO Pedriatric Cohort investigates how prenatal stress leads to perturbations in the metabolome, epigenome, and microbiome, and how these biological perturbations predict child neurodevelopment. Enrolled children are followed with annual visits, with a focus on child neurodevelopment as a specialised outcome area. The sample includes hard-to-reach racial and ethnic minority families, as the cohort is wholly composed of Black American families, 75% of whom are of lower socioeconomic status. The study is based in Atlanta, in the Southeast of the United States of America.