Fetal and Infant Neurobehavioral Effects of maternal Buprenorphine Treatment

母体丁丙诺啡治疗对胎儿和婴儿神经行为的影响

• 批准号: 8610598
• 负责人: LAUREN M JANSSON
• 金额: $ 9.3万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-01 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8610598
• 关键词: Affect; Age-Months; Birth; Buprenorphine; Clinical; Clinical Research; Complex; Cross-Sectional Studies; Data; Data Collection; Dependency; Development; Digestive Signs and Symptoms; Dose; Exhibits; Fetus; Functional disorder; Gestational Age; Goals; Guidelines; Incidence; Infant; Infant autonomic nervous system; Knowledge; Maintenance; Mediating; Methadone; Mothers; Neonatal; Neonatal Abstinence Syndrome; Nervous system structure; Neurobiology; Newborn Infant; Opiates; Opioid; Outcome; Patients; Perinatal; Pharmaceutical Preparations; Physiological; Population; Pregnancy; Pregnant Women; Problem behavior; Provider; Recruitment Activity; Research; Research Personnel; Research Project Grants; Respiratory System; Safety; Schedule; Second Pregnancy Trimester; Severities; Study Subject; Symptoms; Techniques; Third Pregnancy Trimester; Time; Withdrawal; Woman; Work; cohort; experience; fetal; improved; in utero; interest; neonate; neurobehavior; neurobehavioral; pregnant; research facility

DESCRIPTION (provided by applicant): The population of opioid dependent pregnant women and their fetuses and infants are a highly vulnerable and complex group that are currently poorly understood. Infants display a range of physiologic and behavioral problems that are widely variable, have unknown pathophysiology, and are characterized by significant deficits in neuroregulatory functioning. Research by this team has shown that methadone negatively affects fetal neurobehaviors in late gestation, and that severity of newborn neuroregulatory dysfunction is related to maternal and infant autonomic nervous system activity. New research has shown the optimality of buprenorphine maintenance during pregnancy as compared to methadone, principally due to improved neonatal outcomes, which is likely to result in increased numbers of providers and patients seeking this medication for treatment of opioid dependency during pregnancy. However, little information regarding the effects of buprenorphine on the developing fetus and infant exists. Pilot data from this group of investigators has suggested that buprenorphine, as compared to methadone-exposed fetuses, exhibit more optimal fetal functioning in the second and third trimesters of gestation. With this proposed research project, we intend to track the longitudinal neurobehavioral development of the buprenorphine-exposed fetus across gestation through 1 month of age in an effort to determine the safety of this medication for use during gestation, the relationship between maternal physiologic changes due to buprenorphine administration and newborn functioning, and to determine potential fetal neurobehavioral markers that may predict NAS expression and infant neurobehavioral outcome. Comparisons to results from a similar project in methadone-exposed pregnancies will be made. This proposal seeks to advance the way we inform the treatment of the opioid dependent woman during pregnancy and her infant after birth.

描述（由申请人提供）：阿片类药物依赖的孕妇及其胎儿和婴儿的种群是一个高度脆弱且复杂的群体，目前知之甚少。婴儿表现出一系列可变的生理和行为问题，具有未知的病理生理学，并以神经调节功能的严重缺陷为特征。该团队的研究表明，美沙酮在妊娠晚期会对胎儿神经行为产生负面影响，而新生儿神经调节功能障碍的严重程度与母亲和婴儿自主神经系统活动有关。与美沙酮相比，新的研究表明，与美沙酮相比，怀孕期间丁丙诺啡维持的最佳性，这主要是由于新生儿结局的改善，这可能导致提供者和寻求这种药物治疗阿片类药物依赖性治疗阿片类药物依赖性的患者数量增加。但是，关于丁丙诺啡对发育中的胎儿和婴儿的影响的信息很少。这组研究人员的试验数据表明，与美沙酮暴露的胎儿相比，丁丙诺啡在妊娠的第二和第三个三体情况下表现出最佳的胎儿功能。通过该提出的研究项目，我们打算跟踪截短妊娠的纵向神经行为的纵向神经性胎儿的纵向发展，直到1个月，以确定这种药物在妊娠期间使用的安全性丁丙诺啡给药和新生儿功能，并确定可能预测NAS表达和婴儿神经行为预后的潜在胎儿神经行为标记。将进行与美沙酮暴露妊娠的类似项目的结果进行比较。该提议旨在推进我们在怀孕期间和出生后怀孕期间对阿片类药物依赖性妇女的待遇的方式。