Prenatal & Environmental Tobacco Smoke (ETS) Exposure: Effects on Child Regulati

产前

• 批准号: 8370116
• 负责人: Rina D Eiden
• 金额: $ 64.86万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-01 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8370116
• 关键词: Accounting; Address; Affect; Age; Age-Years; Alcohol or Other Drugs use; Anger; Appointment; Arousal; Behavior; Behavior Control; Behavioral; Biological; Biological Assay; Buffers; Characteristics; Child; Child Behavior; Child Development; Cigarette; Competence; Data; Data Analyses; Decision Making; Development; Developmental Process; Distress; Environmental Exposure; Environmental Risk Factor; Environmental Tobacco Smoke; Event; Exhibits; Exposure to; Family; First Pregnancy Trimester; Frequencies; Frustration; Gestational Age; Goals; Heterogeneity; Hostility; Household; Hydrocortisone; Infant; Informal Social Control; Institutes; Intervention; Interview; Joints; Laboratories; Lead; Life Stress; Liquid substance; Literature; Longitudinal Studies; Low income; Maternal Behavior; Measures; Meconium; Mediating; Mediator of activation protein; Mental Depression; Methods; Modeling; Mothers; Nursery Schools; Oral; Outcome; Parenting behavior; Pathway interactions; Patient Self-Report; Perinatal; Physiological; Physiology; Preventive Intervention; Problem behavior; Procedures; Process; Protocols documentation; Psychopathology; Public Health; Recruitment Activity; Regulation; Reporting; Research Design; Risk; Risk Factors; Role; Sampling; School-Age Population; Schools; Sleep; Smoking; Staging; Stress; Time; Toddler; Woman; boys; caregiving; cigarette smoking; cohort; demographics; design; early childhood; follow-up; high risk; indexing; infancy; infant outcome; kindergarten; maternal cigarette smoking; non-smoking; peer; prenatal; prenatal environmental exposure; prenatal exposure; psychobiologic; resilience; social skills

DESCRIPTION (provided by applicant): This is a competing renewal of a multi-method longitudinal study of developmental trajectories of reactivity and regulation using behavioral and biological indices and predictors of social competence among cigarette exposed and non-exposed children. The rates of cigarette smoking continue to be quite high, particularly among younger, lower-income women, and our understanding of developmental pathways to regulatory disturbances reported among cigarette exposed children is limited. The original application focused on reactivity and regulation of infants and toddlers at 2, 9, 16, and 24 months. In order to maintain the sample and obtain maternal reports of children's self-regulation, we initiated a brief assessment at 36 months in Year 4 of the project. In the current renewal, we aim to complete the 36 month assessments, and initiate and complete assessments upon entry into kindergarten. The specific aims of this application are to 1) examine direct effects of cigarette exposure on adrenocortical, autonomic, and behavioral reactivity and regulation, self-regulation, and social competence in the preschool/school age period; 2) to examine if the relationship between cigarette exposure and these child outcomes are mediated by reactivity/regulation in infancy; and 3) to examine if these associations may be moderated by infant perinatal risks, maternal risks (psychopathology, parenting), or cumulative environmental risk. The final sample consists of 251 mother-infant dyads (168 in the smoking group and 83 in the non-smoking group) recruited in the first trimester of pregnancy. Prenatal exposure was ascertained by a combination of self-report (from 3 prenatal interviews), maternal oral fluid (at 3 prenatal interviews), and meconium assays (at delivery). Analyses of infant outcome data indicate significant effects of prenatal exposure on infant autonomic regulation during sleep at 2 months, and during affect arousing tasks at 9 months of infant age. Cigarette exposed infants had lower baseline cortisol, and a profile of high behavioral reactivity and low frequency regulatory behavior at 9 months. Prenatal exposure was associated with lower behavioral competence at 16 and 24 months and environmental exposure was associated with higher behavior problems. Data analyses for the current proposal will build on these infant/toddler outcomes by focusing on developmental trajectories of self-regulation from 24 month to kindergarten, on reactivity and regulation in infancy as mediators of salient outcomes at kindergarten, and reasons for heterogeneity in outcomes among cigarette exposed children. This study addresses several gaps in the literature including examination of multiple levels of self-regulation, long-term developmental pathways associated with cigarette exposure, and consideration of key mediators and moderators of these pathways. Understanding developmental trajectories will inform the timing of prevention/intervention efforts. Understanding mediating processes that predict outcomes, or may act to increase risk or promote resilience will inform the content of interventions. PUBLIC HEALTH RELEVANCE: The impact of maternal smoking is a significant public health concern because of the likely negative consequences on child development that involve a cascade of negative developmental events that compromise children's self-regulatory capacity, setting the stage for problem behavior and poor social competence. We know surprisingly little about the psychobiological mechanisms that account for this cascade of negative outcomes and the risk and protective factors that might exacerbate or buffer them. Understanding these developmental processes is crucial for the development of effective preventive interventions targeting children of cigarette smoking mothers.

描述（由申请人提供）：这是对使用行为和生物学指数以及暴露于卷烟和非暴露儿童中社会能力的反应性和调节发展轨迹的多方法纵向研究的竞争更新。吸烟率仍然很高，尤其是在年轻的低收入妇女中，我们对卷烟暴露儿童报告的调节性障碍的发育途径的理解受到限制。最初的应用集中在2、9、16和24个月时婴儿和幼儿的反应性和调节。为了维护样本并获得有关儿童自我调节的母亲报告，我们在项目第4年的36个月中进行了简短的评估。在当前的续约中，我们旨在完成36个月的评估，并在进入幼儿园时开始并完成评估。本应用的具体目的是1）检查卷烟暴露对学龄前/学龄前年龄期间肾上腺皮质，自主和行为反应性，自我调节以及社会能力的直接影响； 2）检查香烟暴露与这些儿童结局之间的关系是否是由婴儿期的反应性/调节介导的； 3）检查这些关联是否可能由婴儿围产期风险，孕产妇风险（心理病理学，育儿）或累积环境风险来调节。最终样本包括251个母亲二元组（在吸烟组中为168个，在非吸烟组中有83个）在怀孕的第一学期招募。通过自我报告（来自3次产前访谈），孕产妇液体（在3次产前访谈）和胎粪测定（分娩时）的结合（在交货时）来确定产前暴露。对婴儿结果数据的分析表明，在2个月的睡眠期间以及在婴儿年龄9个月的时间内影响唤醒任务时，产前暴露对婴儿自主神经调节的显着影响。卷烟暴露的婴儿的基线皮质醇以及9个月时高行为反应性和低频调节行为的特征。产前暴露与16个月和24个月的行为能力降低有关，环境暴露与较高的行为问题有关。当前提案的数据分析将通过关注从24个月到幼儿园的自我调节的发展轨迹，在婴儿期的反应性和调节中，作为幼儿园显着结果的反应性和调节，以及在香烟暴露的儿童中异质性的原因。这项研究解决了文献中的几个差距，包括检查多个自我调节，与卷烟暴露相关的长期发育途径以及对这些途径的关键介体和主持人的考虑。了解发展轨迹将为预防/干预工作的时间提供信息。了解预测结果的中介过程，或者可能采取行动增加风险或促进弹性将为干预措施提供信息。 公共卫生相关性：孕产妇的影响是一个重大的公共卫生问题，因为可能对儿童发育产生负面影响，涉及一系列负面发展事件，损害儿童的自我调节能力，为问题行为和社会能力造成了不良的舞台。我们对这些级联的负面结果以及可能加剧或缓冲它们的风险和保护因素的心理生物学机制知之甚少。了解这些发展过程对于针对吸烟母亲的儿童的有效预防干预措施的发展至关重要。