4/5 The Cumulative Risk of Substance Exposure and Early Life Adversity on Child Health Development and Outcomes

4/5 物质暴露和早年不幸对儿童健康发展和结果的累积风险

• 批准号: 10170530
• 负责人: CHARLES Alexander NELSON
• 金额: $ 19.64万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10170530
• 关键词: Adolescent; Affect; Age-Months; Amygdaloid structure; Animal Model; Animal Testing; Antibodies; Bacterial Infections; Birth; Boston; Brain; COVID-19; COVID-19 pandemic; Child; Child Development; Child Health; Childhood; Clinical; Cognition; Cognitive; Consent; Consequentialism; Contracts; DNA Methylation; DSM-V; Development; Diagnosis; Diffusion Magnetic Resonance Imaging; Distress; Electroencephalography; Enrollment; Environment; Epigenetic Process; Event; Exposure to; Fetal Development; Frequencies; Funding; Goals; Grant; Head; Health; Hippocampus (Brain); Hospitals; Human; Ice; Individual; Infant; Infant Development; Infection; Inflammation; Influenza A Virus, H1N1 Subtype; Intervention; Interview; Language; Learning; Life; Linguistics; Longitudinal Studies; Magnetic Resonance Imaging; Maternal Health; Measures; Mediating; Medicine; Mental Depression; Mental Health; Metabolic; MicroRNAs; Mind; Modification; Mothers; Motor; Natural Disasters; Near-Infrared Spectroscopy; Neonatal; Newborn Infant; Opioid; Outcome; Outcome Measure; Patient Self-Report; Pattern; Pediatric Hospitals; Pediatrics; Perinatal; Physiological; Play; Population; Positioning Attribute; Predisposition; Pregnancy; Pregnant Women; Prevalence; Psychopathology; Quebec; Questionnaires; Radiology Specialty; Reporting; Resolution; Rest; Risk; Role; Safety; Sampling; Scanning; Science; Social isolation; Standardization; Stress; Structure; Symptoms; System; Testing; Thick; Third Pregnancy Trimester; Trauma; Uncertainty; United States; Vertical Disease Transmission; Virus; Virus Diseases; Visit; Visual; Visual evoked cortical potential; Vulnerable Populations; Woman; Work; Zika Virus; autism spectrum disorder; base; behavior measurement; cognitive ability; cognitive function; early childhood; early life adversity; experience; fetal; follow-up; high risk; immune function; infancy; infant outcome; language outcome; loved ones; magnetic resonance imaging/electroencephalography; maternal depression; maternal stress; medical schools; morphometry; neonatal period; neural network; neurodevelopment; neuroimaging; neuropsychiatric disorder; offspring; pandemic disease; parent grant; parent project; perceived stress; postnatal; pregnant; prenatal; prenatal exposure; prenatal stress; primary outcome; professor; psychologic; psychological distress; psychological stressor; psychosocial; relating to nervous system; response; socioeconomics; stress related disorder; stressor; tool; vision development; visual tracking; white matter

Project Summary/Abstract Beyond the grave health threats posed by COVID-19, this world-wide pandemic has also dramatically increased psychological distress among much of the population. For those particularly vulnerable to stress-related disorders, COVID-19 represents an unprecedented challenge. Individuals both directly and indirectly affected by the virus are forced to navigate through a range of hardships, including social isolation, financial insecurity, and uncertainty about the health and safety of self and loved ones. High on the list of psychologically vulnerable groups are pregnant women. Psychological distress may be compounded both by the uncertainty surrounding COVID-19's vertical transmission and by the potential effects of maternal distress on fetal brain development. Numerous studies have reported strong associations between maternal stress during pregnancy and disruptions in child development. The effects of maternal psychological stressors on fetal and infant development have been demonstrated across multiple levels, including disrupted fetal brain maturation, alterations in miRNA expression and DNA methylation, and increased risks for altered developmental outcomes and neuropsychiatric disorders (Babenko, 2015; Bick & Nelson, 2016; Hackman et al., 2010; Nelson, 2020; Lupien et al., 2019; McEwen, 2012, 2017; Vanderberg et al., 2017; Laplante et al., 2015; Wu et al., 2020). Previous work supports that mothers who experienced either a bacterial or viral infection and elevated stress during pregnancy were more likely to have an adolescent child diagnosed with depression (Murphy et al., 2017). Similarly, children exposed to a prenatal infection of the 2001 H1N1 virus displayed slightly delayed development (Borren et al, 2018).With these findings in mind, it is critical to determine the extent to which a COVID-19 exposure and related prenatal stress affects infant development in order to provide appropriate treatment and interventions. At Boston Children's Hospital, we are in the unique position to build on our current funding (R34 DA050289) to study infants born to COVID-19-positive women. Among our Boston-based collaborative group, we estimate that over the next 6 months we should be able to enroll 75 pregnant women, limiting ourselves to just one Harvard-affiliated hospital, Brigham and Women's Hospital (BWH). Our plan is to administer a number of questionnaires to these women prior to giving birth. At birth, we will work with the OB team to decide which mothers to approach about seeking consent to perform an MRI on their newborns, as well as 2 follow up visits to the PI's lab at Boston Children's Hospital.

项目总结/摘要 除了COVID-19造成的严重健康威胁外，这场全球性的大流行还极大地 许多人的心理压力增加。对于那些特别容易受到 与压力相关的疾病相比，COVID-19是一个前所未有的挑战。个人直接 和间接受病毒影响的人被迫经历一系列困难，包括社会 孤独，经济不安全，以及对自己和亲人的健康和安全的不确定性。高 在心理脆弱群体名单上的是孕妇。心理压力可能是 围绕COVID-19垂直传播的不确定性以及潜在的 母亲窘迫对胎儿脑发育的影响。 许多研究都报告了母亲在怀孕期间的压力和 阻碍儿童发展。产妇心理应激源对胎儿及婴儿的影响 已经在多个层面上证明了发育，包括破坏胎儿大脑成熟， miRNA表达和DNA甲基化的改变，以及发育异常的风险增加。 结果和神经精神障碍（Babenko，2015; Bick &纳尔逊，2016; Hackman et al.，二○一○年; 纳尔逊，2020; Lupien等人，2019; McEwen，2012，2017; Vanderberg等人，2017; Laplante等人，二〇一五年; Wu等人，2020年）。以前的研究支持，经历过细菌或病毒感染的母亲 感染和怀孕期间的压力增加更有可能诊断出青春期儿童 患有抑郁症（Murphy等人，2017年）。同样，2001年产前感染的儿童 H1N1病毒表现出轻微的发育延迟（Borren et al，2018）。 这对于确定COVID-19暴露和相关产前压力对婴儿的影响程度至关重要 发展，以提供适当的治疗和干预措施。 在波士顿儿童医院，我们处于独特的地位，可以在现有资金的基础上（R34 DA050289）研究COVID-19阳性女性所生婴儿。在我们位于波士顿的合作组织中， 我们估计，在接下来的6个月里，我们应该能够招募75名孕妇， 我们自己只有一个哈佛附属医院，布里格姆妇女医院（BWH）。我们的计划是 在分娩前向这些妇女发放一些调查问卷。出生时，我们将与 产科团队决定与哪些母亲接触，寻求同意对她们的孩子进行MRI检查。 新生儿，以及波士顿儿童医院PI实验室的2次随访。