PRENATAL COCAINE USE--7 YEAR FOLLOW UP

产前可卡因使用——7 年随访

• 批准号: 2770095
• 负责人: GALE A. RICHARDSON
• 金额: $ 20.84万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 1995
• 资助国家: 美国
• 起止时间: 1995-09-30 至 2000-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2770095
• 关键词: African American; caucasian American; child mental disorders; child physical development; clinical research; crack cocaine; embryo /fetus toxicology; human subject; interview; longitudinal human study; middle childhood (6-11); neuropsychological tests; neuropsychology; questionnaires; African American; caucasian American; child mental disorders; child physical development; clinical research; crack cocaine; embryo /fetus toxicology; human subject; interview; longitudinal human study; middle childhood (6-11); neuropsychological tests; neuropsychology; questionnaires

Little information exists regarding the long-term effects of cocaine use during pregnancy and the effects of postpartum cocaine use on the child's environment. This proposal will evaluate prospectively a large, well- established cohort of substance-using women and their offspring to define the long-term effects of prenatal cocaine exposure. The strengths of the study include exceptional follow-up rates, detailed assessment of all substances, measurement of potential confounding variables, and an assessment battery targeted to specific hypotheses. Women were enrolled during pregnancy and follow-ups occurred at birth, 1, and 3 years. Cocaine and crack use were assessed for each trimester of pregnancy and for each follow-up period. Data were also collected on all other drug use, sociodemographic factors, maternal psychological characteristics, the current environment, and child characteristics. This allows us to: (1) evaluate the relationship between prenatal cocaine/crack use and child outcome while controlling for these confounding factors; and (2) explore the effect of the current environment on the development of children who potentially have been made vulnerable by prenatal substance exposure. Important findings have emerged from the ongoing analyses of our data. At each follow-up phase, we have found direct effects of prenatal cocaine exposure on the development of the central nervous system. At birth, we detected neurological and neurobehavioral effects on the EEG-sleep studies and the Brazelton NBAS, respectively. These early indicators have now been confirmed as we have found that prenatal cocaine exposure leads to slowed motor development at 1 year. At both 1 and 3 years, exposed children were reported by their mothers to be fussier and more difficult. At 3 years, prenatal cocaine exposure was associated with decreased 10 scores, increased number of behavior problems, and decreased head circumference. In general, these effects were associated with exposure during the first trimester. Cocaine use also has effects on the environment in which the child is raised. Women who used cocaine/crack during pregnancy also used more alcohol, tobacco, and marijuana, during pregnancy and through the postpartum years. Current cocaine users also provided less stimulating and organized home environments than non-users. Thus, the children are directly exposed to the effects of cocaine prenatally and indirectly exposed to the effects of cocaine through their environment. This is a proposal to assess the children at 7 years of age. This age provides an opportunity to evaluate new dimensions of functioning. As more complex cognitive demands are made upon the child, subtle dysfunctions of the CNS that could not be measured earlier will become apparent. We will assess the physical, developmental, behavioral, and neuropsychological characteristics of the child, as well as the current substance use and sociodemographic, psychological, and environmental characteristics of the mother. The longitudinal design and careful attention to covariates will allow a more complete description and understanding of the long-term effects of prenatal cocaine use.

关于可卡因使用的长期影响的信息很少 怀孕期间以及产后可卡因对孩子的影响 环境。 该建议将评估前瞻性的大型，良好的 建立的使用物质的妇女及其后代定义的队列 产前可卡因暴露的长期影响。优势 研究包括出色的随访率，对所有的详细评估 物质，潜在混杂变量的测量以及 评估电池针对特定假设。 妇女被录取 在怀孕期间和随访期间发生在出生时，1和3年。可卡因 评估了怀孕的每个三个月的裂缝使用 后续期。 还收集了所有其他药物使用的数据， 社会人口统计学因素，母性心理特征， 当前的环境和儿童特征。这使我们可以：（1） 评估产前可卡因/裂纹使用与孩子之间的关系 在控制这些混杂因素的同时； （2）探索 当前环境对儿童发展的影响 可能因产前物质暴露而变得脆弱。 重要的发现来自我们数据正在进行的分析。在 每个随访阶段，我们都发现了产前可卡因的直接影响 中枢神经系统发展的暴露。 出生时，我们 检测到的神经系统和神经行为对脑电图研究的影响 和Brazelton NBA。 这些早期指标现在有 由于我们发现产前可卡因的暴露导致 1年的运动发育减慢了。在1至3年中，暴露 据报道，母亲的孩子更加挑剔，更困难。 在3年时，产前可卡因暴露与降低10 得分，行为问题数量增加，头部减少 圆周。 通常，这些影响与暴露有关 在头三个月。可卡因的使用也对 养育孩子的环境。使用可卡因/裂缝的女性 怀孕期间还使用了更多的酒精，烟草和大麻 怀孕和产后期间。当前的可卡因用户 与非用户相比，提供的刺激性和有组织的家庭环境更少。 因此，孩子直接暴露于可卡因的影响 产前和间接暴露于可卡因的影响 环境。 这是一项评估7岁儿童的建议。这个年龄 提供了评估新功能维度的机会。更多 对孩子提出了复杂的认知要求，微妙的功能障碍 无法及早测量的中枢神经系统将变得显而易见。 我们将 评估身体，发育，行为和神经心理学 儿童的特征以及当前的物质使用和 社会人口统计学，心理和环境特征 母亲。 纵向设计和对协变量的谨慎关注将 允许对长期的更完整的描述和理解 产前可卡因的影响。