PRENATAL COCAINE USE--10 YEAR FOLLOW UP

产前可卡因使用——10 年随访

基本信息

批准号：
6634257
负责人：
GALE A. RICHARDSON
金额：
$ 26.34万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
1999
资助国家：
美国
起止时间：
1999-06-20 至 2004-05-31
项目状态：
已结题

项目摘要

The long-term effects of cocaine exposure during pregnancy and the effects of cocaine use on the child's environment are major public health concerns, but very little information exists regarding these effects. This proposal represents an opportunity to define the long-term effects of prenatal cocaine exposure with a large, well-established cohort of substance-using women and their offspring. This is a unique study of prenatal cocaine use in which trimester-specific information has been collected and the children have been assessed through age 7. The strengths of the study include exceptional follow-up rates, a detailed assessment of all substances, measurement of potential confounding variables, particularly environmental variables, and a comprehensive child assessment battery. We have found direct effects of prenatal cocaine exposure on the development of the central nervous system and on growth. At birth, we detected neurological and neurobehavioral effects on the EEG-sleep studies and the Brazelton NBAS, respectively. We found that prenatal cocaine exposure predicted delayed motor development at 1 year. At both 1 and 3 years of age, exposed children were reported by their mothers to be fussier and more difficult, a finding that was confirmed by independent observation in our testing situation. At 3 years, prenatal cocaine use significantly predicted decreased IQ scores, an increased number of behavior problems, and decreased head circumference. At age 7, the same domains were affected: Prenatal cocaine use predicted smaller head circumference, lower IQ and achievement test scores, and increased attention and behavior problems. A longitudinal analysis demonstrated a significant time by exposure interaction, revealing a significant decline in IQ scores between 3 and 7 years among the cocaine-exposed children. This is a proposal to assess the cohort at 10 years of age, when we can assess new and more complex dimensions of functioning. As the child matures, CNS development continues, and more cognitive demands are made. We will assess the child's cognitive, neuropsychological, behavioral, and physical characteristics using age-appropriate instruments that will allow us to explore the more subtle neuropsychological consequences of prenatal exposure. We will also carefully assess the mother's current substance use, sociodemographic, psychological, and environmental characteristics. The longitudinal design and careful attention to factors in the current environment allow a more detailed identification of the long-term effects of prenatal cocaine use. Our hypotheses are: (1 ) the effects of cocaine exposure on our moderately exposed sample will continue to be manifested as neurobehavioral and growth deficits (this follows from the teratologic model); and (2) deficits will be seen in the following domains: cognitive (learning and memory), behavior and attention problems, and mood.

怀孕期间接触可卡因的长期影响以及使用可卡因对儿童环境的影响是主要的公共卫生问题，但有关这些影响的信息很少。该提案提供了一个机会，可以通过大量确定的药物使用妇女及其后代来确定产前接触可卡因的长期影响。这是一项关于产前可卡因使用的独特研究，其中收集了妊娠期特定信息，并对 7 岁以下的儿童进行了评估。该研究的优点包括出色的随访率、对所有物质的详细评估、潜力测量混淆变量，特别是环境变量，以及全面的儿童评估电池。我们发现产前接触可卡因对中枢神经系统的发育和生长有直接影响。出生时，我们分别通过脑电图睡眠研究和 Brazelton NBAS 检测到神经系统和神经行为的影响。我们发现，产前接触可卡因可导致 1 岁时运动发育迟缓。据母亲报告，在 1 岁和 3 岁时，暴露的儿童变得更加烦躁和困难，这一发现在我们的测试情况中得到了独立观察的证实。 3岁时，产前使用可卡因可显着预测智商得分下降、行为问题数量增加以及头围减小。 7 岁时，同样的领域受到影响：产前使用可卡因会导致头围变小、智商和成绩测试分数降低，以及注意力和行为问题增加。纵向分析表明，接触可卡因的儿童在 3 至 7 岁之间的智商分数显着下降。这是一项评估 10 岁群体的提议，届时我们可以评估新的、更复杂的功能维度。随着孩子的成熟，中枢神经系统不断发育，对认知能力提出了更多要求。我们将使用适合年龄的仪器评估孩子的认知、神经心理学、行为和身体特征，这将使我们能够探索产前暴露的更微妙的神经心理学后果。我们还将仔细评估母亲目前的药物使用、社会人口、心理和环境特征。纵向设计和对当前环境因素的仔细关注可以更详细地确定产前使用可卡因的长期影响。我们的假设是：（1）可卡因暴露对我们的中度暴露样本的影响将继续表现为神经行为和生长缺陷（这来自畸胎学模型）； (2) 缺陷会出现在以下领域：认知（学习和记忆）、行为和注意力问题以及情绪。