Prenatal tobacco exposure: effects on neuropsychological outcomes and ADHD

产前烟草暴露：对神经心理学结果和多动症的影响

• 批准号: 7528650
• 负责人: Valerie S Knopik
• 金额: $ 61.78万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-30 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7528650
• 关键词: Accounting; Affect; Age; Alcohol or Other Drugs use; Attention; Attention deficit hyperactivity disorder; Basic Science; Behavior; Birth Records; Blood specimen; Brain region; Characteristics; Child; Childhood; Cognition; Cognitive; Cognitive deficits; Complement; Condition; Confidential Information; DNA; Databases; Depth; Diagnostic; Disease; Enrollment; Environmental Tobacco Smoke; Event; Exposure to; Failure; Family; Fathers; Funding; Future; Genetic; Goals; Health; Health Personnel; Impaired cognition; Incentives; Infant; Interview; Language; Learning; Life; Literature; Low Birth Weight Infant; Masks; Measures; Memory; Missouri; Molecular Genetics; Mothers; Neurocognitive; Newborn Infant; Outcome; Parents; Perinatal; Pregnancy; Pregnant Women; Probability; Psychopathology; Public Health; Rate; Reading; Reporting; Research; Research Personnel; Risk; Risk Factors; Sampling; Scheme; School-Age Population; Shipping; Ships; Siblings; Smoke; Smoking; Standards of Weights and Measures; Symptoms; TNFRSF5 gene; Testing; Text; Thinking; Time; Tobacco Dependence; Woman; Work; adolescent drug use; adolescent substance use; aged; base; clinically significant; cohort; design; executive function; externalizing behavior; fetal tobacco exposure; genetic analysis; interest; maternal cigarette smoking; neuropsychological; postnatal; prenatal; prenatal exposure; size; transmission process

DESCRIPTION (provided by applicant): This re-revised new investigator R01 seeks funding to investigate the effects of prenatal tobacco exposure on offspring attention problems and associated learning and cognitive deficits. Maternal smoking during pregnancy (MSDP) is a major health concern associated with higher rates of a variety of poor child outcomes, including attention deficit hyperactivity disorder (ADHD); conduct disorder, impaired learning and memory, lowered IQ, and cognitive dysfunction. ADHD and many of these childhood outcomes are clinically significant conditions with clear public health implications and also are, in turn, substantial predictors of adolescent drug use problems. However, the evidence suggesting causal effects of MSDP for these childhood outcomes is muddied in the existing literature due to the frequent inability to separate these prenatal tobacco exposure effects from other confounding environmental and genetic factors. Specifically, the vast majority of prior studies provide only limited control for the fact that prenatal exposures may be correlated with parental behaviors that could also act as important risk factors that are in turn transmitted to their offspring. Failure to control for such (possibly heritable) confounding factors may account for a large part of the suggested associations between MSDP and offspring outcomes, resulting in biased effect sizes. Therefore, this application proposes to collect interview and comprehensive neuropsychological lab-based data from 400 families with at least 2 Missouri-born children (aged 8-15 at the time of testing), where the mother smoked during one pregnancy but not during another pregnancy by the same father (thus, with offspring who are full sibling pairs discordant for prenatal tobacco exposure). This within-mother, between-pregnancy contrast provides the best possible methodologic control for confounding factors, such as heritable and sociodemographic characteristics of the mother that predict increased probability of MSDP, as well as other differences between mothers who do and do not smoke during pregnancy (and their partners). Such confounding factors, if not controlled for, might otherwise artifactually create, or alternatively mask, an association between MSDP and child outcomes (of particular interest for this proposal: memory, executive function, language/reading, and ADHD). Such a design will therefore provide opportunities to accurately determine effect sizes while also allowing us to develop a cohort which, in the future, could be followed longitudinally through periods of increased externalizing symptoms and substance use initiation. PUBLIC HEALTH RELEVANCE: In two or three sentences, describe the relevance of this research to public health. If the application is funded, this description, as is, will become public information. Therefore, do not include proprietary/confidential information. Maternal smoking during pregnancy (MSDP) is a major public health concern with nearly half of all women who smoke continuing to do so throughout their pregnancies. As a result, more than half a million infants per year are prenatally exposed to maternal smoking. This genetically informed study on effects of prenatal exposure considers the potential confounding effects of differences between women who smoke and don't smoke during pregnancy. Findings could provide yet one more incentive for pregnant women to overcome tobacco dependence and quit, but findings can also guide treatment providers to think more comprehensively about smoking during pregnancy and the potential correlates of said behavior.

描述（由申请人提供）：此重新定义的新研究者R01寻求资金来研究产前烟草暴露对后代注意力问题以及相关学习和认知缺陷的影响。怀孕期间的孕产妇吸烟（MSDP）是与各种贫困儿童结局率更高的较高率有关的主要健康问题，包括注意力缺陷多动障碍（ADHD）；进行障碍，学习和记忆力受损，降低智商和认知功能障碍。多动症和许多这些童年结果在临床上是重要的疾病，具有明显的公共卫生影响，反过来也是青少年吸毒问题的实质性预测指标。但是，由于经常无法将这些产前烟草暴露的影响与其他混杂的环境和遗传因素分开，因此现有文献中表明MSDP对这些童年结局的因果影响的证据被混乱。具体而言，绝大多数先前的研究仅提供了有限的控制，即产前暴露可能与父母行为相关，这些行为也可以作为重要的风险因素，而这些风险因素反过来又可以传播给其后代。无法控制这种（可能是可遗传的）混杂因素可能是MSDP与后代结果之间建议的关联的很大一部分，从而导致效应大小。因此，本申请建议收集来自至少2个密苏里州儿童的400个家庭的访谈和全面的神经心理实验室数据（在测试时8-15岁），在那儿，母亲在一次怀孕期间在同一父亲的另一次怀孕期间吸烟（因此，后代，他们是全同性恋的婚外情企业的eblosbling tobacco exposertant for Pairst tobacco tobacco tobacco tobacco tobaporpose）。这是母亲的怀孕对比，为混杂因素提供了最佳的方法论控制，例如母亲的遗传和社会人口统计学特征，这些特征预测了MSDP的可能性增加，以及在怀孕期间（及其伴侣）中没有吸烟的母亲之间的其他差异。这样的混杂因素（如果不控制）可能会人为地创建MSDP与儿童结果之间的关联（此提案特别感兴趣：记忆，执行功能，语言/阅读和ADHD）。因此，这样的设计将提供准确确定效应大小的机会，同时还可以使我们开发一个队列，将来可以通过增加外在症状和吸毒启动的时期进行纵向遵循。公共卫生相关性：用两三个句子描述这项研究与公共卫生的相关性。如果申请是资助的，那么此描述将成为公共信息。因此，请勿包含专有/机密信息。怀孕期间的孕产妇吸烟（MSDP）是一个主要的公共卫生问题，在整个怀孕期间，几乎所有吸烟的妇女中，几乎一半的妇女。结果，每年超过50万婴儿在产前暴露于孕产妇吸烟。这项对产前暴露影响的遗传知情研究认为，在怀孕期间吸烟和不吸烟的女性之间的差异差异的潜在混杂作用。调查结果可能还可以为孕妇克服烟草依赖和戒烟提供另一种激励，但是发现还可以指导治疗提供者对怀孕期间的吸烟以及所述行为的潜在相关性更全面地思考。