Effects of Prenatal Opioid Exposure on Infant Autonomic Physiology

产前阿片类药物暴露对婴儿自主生理学的影响

基本信息

批准号：
10266050
负责人：
Alexandra Tabachnick
金额：
$ 2.03万
依托单位：
UNIVERSITY OF DELAWARE
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-06-01 至 2021-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10266050
关键词：
Accounting Address Affect Age-Months Applications Grants Area Attention Autonomic nervous system Buffers Cardiac Child Rearing Clinical Code Data Development Economic Burden Environment Exposure to Face Future Goals Helping to End Addiction Long-term Infant Infant autonomic nervous system Intervention Interview Investigation Life Measures Medicaid Medical Mental Health Methadone Methodology Mothers Nervous System Physiology Opiate Addiction Outcome Physiology Play Pregnancy Pregnant Women Prevalence Psychophysiology Public Health Randomized Controlled Trials Recovery Regulation Reporting Research Rest Risk Scientist Sinus Arrhythmia Standardization Time TimeLine Tobacco Training United States National Institutes of Health Woman Women&apos s Group caregiving community based research dosage fetal opioid exposure fetal substance exposure health care service utilization indexing infant outcome interest longitudinal design medication-assisted treatment neonatal period non-opioid analgesic opioid exposure opioid use opioid use disorder physical conditioning postnatal programs prospective resilience respiratory response social stressor sociodemographic variables standard of care substance use treatment planning

项目摘要

PROJECT SUMMARY/ABSTRACT The increasing prevalence of opioid dependence among pregnant women is a major public health concern, partially because prenatal opioid exposure is associated with a range of adverse neurodevelopmental and medical outcomes for infants. Prenatal opioid exposure has been associated with atypical autonomic nervous system (ANS) functioning in the first days of life, but there have been few investigations later in development. Further, although prenatal opioid exposure is frequently accompanied by exposure to other substances, few studies account for polysubstance exposure. Thus, the unique effects of prenatal opioid exposure on autonomic functioning are not well understood. [In addition, although the postnatal caregiving environment may moderate the effect of opioid exposure on infant functioning, parenting quality as a moderator of prenatal opioid exposure has received relatively little attention.] Autonomic dysregulation has important implications for physical and mental health, so determining the degree to which prenatal opioid exposure affects infant ANS functioning, and identifying modifiable moderators of this effect, are critical steps to inform treatment. Consistent with NIH’s programmatic interests (i.e., the HEAL Initiative), the proposed study will assess the effect of prenatal opioid exposure on infant ANS regulation at six months of age [and will examine parenting quality as a modifiable moderator of this effect.] As part of a larger randomized controlled trial, the proposed study will [examine the effect of opioid exposure within a group of women receiving medication-assisted treatment for opioid dependence (e.g., methadone).] Substance exposure information will be collected with a validated interview (the Timeline Followback) with mothers during pregnancy and when infants are six months old. [Parenting quality will be assessed via observational coding of a video-recorded free play activity when infants are six months old.] Two indicators of infant ANS functioning will also be collected at six months: respiratory sinus arrhythmia (RSA) and cardiac pre-ejection period (PEP). Infant RSA and PEP will be measured at rest and in response to a social stressor (the still-face paradigm). The proposed study will determine the degree to which prenatal opioid exposure is related to infant autonomic activity at six months of age, [and will examine parenting quality as a moderator of this effect.] Because receiving medication-assisted treatment (MAT) during pregnancy is the current standard of care for opioid-dependent pregnant women, understanding the impact of prenatal opioid exposure, and identifying malleable moderators of this effect, are critical steps to identify treatment targets and inform treatment planning for women and their infants. The proposed plan includes advanced training for the applicant in ANS, prenatal substance exposure, parenting, and community-based research.

项目摘要/摘要孕妇阿片类药物依赖的患病率日益增加，这是一个主要的公共卫生问题，部分是因为产前阿片类药物暴露与一系列不良神经发育和婴儿的医疗结果。产前阿片类药物暴露与非典型自主神经有关系统（ANS）在生命的头几天起作用，但是后来开发的调查很少。尽管产前阿片类药物的暴露经常伴有暴露于其他物质，但很少研究解释了多进化剂的暴露。那，产前阿片类药物的独特作用对自主功能尚不清楚。 [此外，尽管产后照顾环境可能缓解阿片类药物暴露对婴儿功能的影响，作为产前主持人的育儿质量阿片类药物的暴露受到相对较少的关注。]自主性失调对身心健康，因此确定产前阿片类药物影响婴儿ANS的程度功能和确定可修改的调节器的效果是为治疗提供信息的关键步骤。符合NIH的计划兴趣（即HEL HEAD计划），拟议的研究将评估产前阿片类药物暴露对六个月大的婴儿ANS调节的影响[并将检查育儿质量是这种效果的可修改主持人。]作为较大的随机对照试验的一部分，提议研究将[检查阿片类药物在接受药物辅助的妇女中的影响阿片类药物依赖性的治疗（例如，Metagadone）。]物质暴露信息将与A收集在怀孕期间和婴儿六个月时，经过验证的访谈（时间表后卫）老的。 [育儿质量将通过视频记录的自由游戏活动的观察编码进行评估婴儿六个月大。]婴儿ANS功能的两个指标也将在六个月内收集：呼吸窦性心律失常（RSA）和心脏前预测期（PEP）。婴儿RSA和PEP将会在休息时测量并响应社会压力源（仍然是面对面的范式）。拟议的研究将确定产前阿片类药物与婴儿在六个月时婴儿自主活动有关的程度年龄，[并将研究育儿质量作为这种效果的主持人。]因为接受药物辅助怀孕期间的治疗（MAT）是阿片类药物依赖性孕妇的当前护理标准，了解产前阿片类药物暴露的影响，并确定这种影响的可延展调节剂确定治疗目标并为妇女及其婴儿提供治疗计划的关键步骤。这拟议的计划包括针对ANS的申请人的高级培训和基于社区的研究。