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

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.

关于使用可卡因的长期影响的信息很少 怀孕期间以及产后使用可卡因对孩子的影响 环境。 该提案将前瞻性地评估一个大型的、良好的 建立了使用药物的妇女及其后代的队列来定义 产前接触可卡因的长期影响。的优势 研究包括出色的随访率、对所有患者的详细评估 物质、潜在混杂变量的测量以及 针对特定假设的评估组。 女性被录取 怀孕期间以及出生时、1 岁和 3 岁时进行随访。可卡因 对怀孕的每个三个月和每个 随访期。 还收集了所有其他药物使用的数据， 社会人口因素、母亲心理特征、 当前环境和儿童特征。这使我们能够：（1） 评估产前使用可卡因/快克与儿童之间的关系 在控制这些混杂因素的同时得出结果； (2)探索 当前环境对儿童发展的影响 可能因产前接触物质而变得脆弱。 对我们数据的持续分析得出了重要的发现。在 每个后续阶段，我们都发现产前可卡因的直接影响 接触中枢神经系统的发育。 出生时，我们 检测到脑电图睡眠研究中的神经和神经行为影响 分别是 Brazelton NBAS。 这些早期指标现在已 已得到证实，因为我们发现产前接触可卡因会导致 1岁时运动发育减慢。在 1 年和 3 年，暴露 据母亲报告，孩子们变得更挑剔、更难相处。 3 年时，产前接触可卡因与减少 10 分数、行为问题数量增加以及头脑下降 圆周。 一般来说，这些影响与暴露有关 在头三个月期间。可卡因的使用也会影响 孩子成长的环境。使用可卡因/快克的女性 怀孕期间也使用了更多的酒精、烟草和大麻， 怀孕期间和产后几年。目前的可卡因使用者还 与非用户相比，他们提供的家庭环境刺激性和组织性较差。 因此，儿童直接受到可卡因的影响 产前和间接接触可卡因的影响 环境。 这是一项针对 7 岁儿童进行评估的提案。这个年纪 提供了评估新功能维度的机会。随着更多 对孩子提出了复杂的认知需求，微妙的功能障碍 早期无法测量的中枢神经系统将变得明显。 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、心理和环境特征 母亲。 纵向设计和对协变量的仔细关注将 允许对长期的更完整的描述和理解 产前使用可卡因的影响。