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: 10092992
• 负责人: ARPANA AGRAWAL
• 金额: $ 62.37万
• 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/10092992
• 关键词: Accounting; Address; African American; Age; Age-Months; 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; multiple drug use; 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; substance use; 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，关岛和波多黎各的领土以及哥伦比亚特区已合法化 医疗和/或休闲大麻的使用。同时，Delta-9四氢大麻酚（THC）的效力 在与经常使用相关的危害的看法上有所增加，变得更加允许， 强调了重点努力评估大麻使用对健康和行为的影响的重要性。 特别是，人们对产前升级的潜在不利后果越来越关注 大麻使用（PCU）。近4％的美国孕妇报告了上个月的大麻使用，代表1.6-- 在过去的十年中，折叠增加。 PCU对新生儿结局的潜在影响，包括新生儿 事实证明，大脑和幼儿发展里程碑很难研究，部分原因是PCU共同 发生在其他药物中，最著名的是烟草，因此很难描述PCU的特定作用。 此外，PCU还与其他孕产妇精神病（犯罪，外部化行为）合并 作为对问题使用物质使用的家庭脆弱性，可能会混淆PCU因果关系的解释 关于后代的大脑和行为。该提案通过招募来解决文献中当前的挑战 来自城市医院门诊诊所的孕妇，病历显示约80％的妇女 使用大麻的人不使用其他药物，其他约有20％的女性使用大麻报告 烟草，但几乎没有酒精或其他药物。近期大麻使用史的孕妇将 被选中；报告仅使用产前大麻的女性（PCU，n = 200）将与女性进行比较 不报告产前药物使用（NPCU，n = 200），以评估PCU在（AIM 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）； （AIM 2）新生儿皮皮质下 150个PCU和100个社会人口统计学匹配的形态，结构和功能连接性 NPCU婴儿； （AIM 3）在6、12和18个月大的婴儿社会情感行为和气质 以及母亲的互动； （目标4）大脑结构和连通性与 婴儿在早期的行为。分析将控制其他产科特征的索引以及 孕产妇心理健康，家族史和家庭环境的综合指数。潜在的 设计，将遵循1个三个月内招募的妇女，其后代直到18个月 产后，对PCU伴随的风险和保护性影响提供了详细的表征。 PCU， 烟草和其他药物使用将在生化上得到验证。报告PCU的女性更有可能是社会化的 在经济上处于不利地位，因此，儿童早期社会情感困难的经济负担可能 在这个小组中特别明显。这项研究的结果将直接影响这一点的福祉 研究人口及其婴儿；它还将告知制定理性的公共卫生政策 在美国使用大麻。