Prenatal Cannabis Use (PCU) and Development of Offspring Brain and Behavior During Early Life (0-18 Months)

产前大麻使用 (PCU) 与后代大脑和生命早期（0-18 个月）行为的发育

• 批准号: 9903265
• 负责人: ARPANA AGRAWAL
• 金额: $ 64.03万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9903265
• 关键词: Accounting; Address; African American; Age; Age-Months; Alcohol or Other Drugs use; Alcohols; Ambulatory Care Facilities; American; Amygdaloid structure; Anisotropy; Attention; Behavior; Behavioral; Biochemical; Birth; Blood Circulation; Brain; Breast Feeding; CNR1 gene; Cannabinoids; Cannabis; Cell Differentiation process; Cerebellum; Characteristics; Child; Child Rearing; Childhood; Cognition; Cognitive; Congresses; Data; Development; Diffusion; Discipline of obstetrics; District of Columbia; Drug usage; Economic Burden; Emotional; Exclusion; Family; Family Characteristics; First Pregnancy Trimester; Future; Guam; Gynecologist; Head circumference; Health; Health Policy; Health behavior; Height; Hippocampus (Brain); Home environment; Impaired cognition; Impairment; Impulsivity; Individual; Infant; Infant Behavior; Investigation; Language; Legal; Life; Link; Literature; Low Birth Weight Infant; Measures; Medial; Mediating; Medical; Medical Records; Mental disorders; Morphology; Mothers; Motor; Neonatal; Neurons; Outcome; Perception; Personal Satisfaction; Pharmaceutical Preparations; Placenta; Population; Postpartum Period; Predisposition; Prefrontal Cortex; Pregnancy; Pregnant Women; Premature Birth; Public Health; Puerto Rico; Recording of previous events; Reporting; Research; Risk; Role; Sampling; Severities; Structure; Symptoms; Temperament; Testing; Tetrahydrocannabinol; Tobacco; Tobacco use; Toddler; Underserved Population; United States; Urban Hospitals; Urine; Weight; Woman; adverse outcome; brain behavior; cognitive control; comorbidity; design; disadvantaged population; early childhood; emotional behavior; endocannabinoid signaling; executive function; experience; externalizing behavior; fetal; fetal marijuana exposure; in utero; inattention; indexing; low socioeconomic status; marijuana use; marijuana use in pregnancy; neonatal brain; neonatal brain development; neonatal outcome; neonate; neurobehavior; neurobehavioral; neurogenesis; offspring; permissiveness; pregnant; prenatal; prenatal exposure; prepregnancy; prospective; psychosocial; receptor; recruit; skills; social; societal costs; sociodemographics; socioeconomic disadvantage; tobacco exposure; white matter

Twenty-nine states, the territories of Guam and Puerto Rico, and the District of Columbia have legalized medical and/or recreational cannabis use. Concurrently, the potency of delta-9 tetrahydrocannabinol (THC) has increased while perceptions regarding harms associated with regular use have become more permissive, underscoring the importance of focused effort to evaluate the impact of cannabis use on health and behavior. In particular, there is growing concern about potential adverse consequences of escalations in prenatal cannabis use (PCU). Nearly 4% of pregnant U.S. women report past month cannabis use, representing a 1.6- fold increase in the past decade. The potential impact of PCU on neonatal outcomes, including the neonatal brain, and early childhood developmental milestones has proven difficult to study in part because PCU co- occurs with other drug use, most notably tobacco, making it difficult to delineate the specific effects of PCU. Further, PCU is comorbid with other maternal psychiatric illness (delinquency, externalizing behavior) as well as familial vulnerability to problem substance use that can confound the interpretation of causal effects of PCU on offspring brain and behavior. This proposal addresses current challenges in the literature by recruiting pregnant women from an urban hospital outpatient clinic, where medical records show that ~80% of women who use cannabis do not use other drugs, with the other ~20% of women who use cannabis reporting using tobacco but very little to no alcohol or other drugs. Pregnant women with a recent history of cannabis use will be selected; women reporting prenatal cannabis use only (PCU, n=200) will be compared with women reporting no prenatal substance use (NPCU, n=200), to evaluate the role of PCU in (Aim 1) birth characteristics (e.g., birthweight) and neonatal neurobehavior (e.g., excitability); (Aim 2) neonatal subcortical morphology and structural and functional connectivity in 150 PCU and 100 sociodemographically matched NPCU infants; (Aim 3) infant social-emotional behavior and temperament at 6, 12 and 18 months of age, as well as mother-infant interactions; and (Aim 4) the extent to which brain structure and connectivity is related to infant behavior during early life. Analyses will control for an index of other obstetric characteristics as well as composite indices of maternal psychosocial health, family history and home environment. Prospective in design, women recruited within the 1st trimester will be followed, with their offspring until 18 months postpartum, affording detailed characterization of risk and protective influences that accompany PCU. PCU, tobacco and other drug use will be biochemically validated. Women reporting PCU are more likely to be socio- economically disadvantaged and thus, the economic burden of early childhood social-emotional difficulties may be particularly pronounced in this group. Results from this study will directly impact the well-being of this understudied population and their infants; it will also inform the development of a rational public health policy on cannabis use in the United States.

二十九个州、关岛和波多黎各领土以及哥伦比亚特区已将其合法化 医疗和/或娱乐性大麻的使用。同时，Delta-9 四氢大麻酚 (THC) 的功效 随着人们对经常使用带来的危害的看法变得更加宽容， 强调集中努力评估大麻使用对健康和行为影响的重要性。 特别是，人们越来越担心产前检查升级的潜在不利后果。 大麻使用（PCU）。近 4% 的美国孕妇报告过去一个月吸食过大麻，相当于 1.6- 过去十年成倍增长。 PCU 对新生儿结局的潜在影响，包括新生儿 大脑和儿童早期发育里程碑已被证明很难研究，部分原因是 PCU 共同 这种情况与其他药物使用（尤其是烟草）一起发生，因此很难描述 PCU 的具体影响。 此外，PCU 还与其他孕产妇精神疾病（犯罪、外化行为）共存。 作为家庭对问题物质使用的脆弱性，可能会混淆对 PCU 因果效应的解释 对后代大脑和行为的影响。该提案通过招募 某城市医院门诊的孕妇，病历显示~80%的女性 使用大麻的女性不使用其他药物，另外约 20% 的使用大麻的女性报告使用 烟草，但很少或没有酒精或其他药物。最近有吸食大麻史的孕妇会 被选中；仅报告产前吸食大麻的女性（PCU，n=200）将与女性进行比较 报告没有产前物质使用（NCU，n=200），以评估 PCU 在（目标 1）出生中的作用 特征（例如出生体重）和新生儿神经行为（例如兴奋性）； （目标 2）新生儿皮质下 150 个 PCU 和 100 个社会人口统计学匹配的形态、结构和功能连接 NCU 婴儿； （目标 3）6、12 和 18 个月大的婴儿社交情感行为和气质，如 以及母婴互动； （目标 4）大脑结构和连接性与以下因素相关的程度： 婴儿在生命早期的行为。分析将控制其他产科特征的指数以及 孕产妇心理社会健康、家族史和家庭环境的综合指数。前景在 设计中，将跟踪妊娠第一个月内招募的女性及其后代直至 18 个月 产后，提供伴随 PCU 的风险和保护性影响的详细特征。电脑控制单元， 烟草和其他药物的使用将经过生化验证。报告 PCU 的女性更有可能受到社会影响 经济上处于不利地位，因此，幼儿社会情感困难的经济负担可能 在这个群体中尤为明显。这项研究的结果将直接影响该群体的福祉 未充分研究的人群及其婴儿；它还将为制定合理的公共卫生政策提供信息 关于美国大麻的使用。