1/5 The Cumulative Risk of Substance Exposure and Early Life Adversity on Child Health Development and Outcomes

项目摘要/说明 孕妇在孕期感染SARS-CoV-2病毒是否会损害发育中的胎儿大脑或增加胎儿的大脑发育 对后来的发展和环境侮辱的敏感性？新型冠状病毒(新冠肺炎)暴发 从根本上改变了儿童健康的格局，带来了社会和经济领域的全面变化 儿童成长所用的织物。这些环境的快速变化，加上相对新奇的 SARS-CoV-2病毒的多样性和感染的广泛性提出了多个紧迫的问题。 在直接影响新生儿和儿童健康的未知因素中有：1.新冠肺炎感染是如何在 怀孕对发育中的胎儿或随后的婴儿神经发育有影响吗？和2.美国将如何 前所未有的规模和范围的同时环境变化影响儿童健康和 神经发育？不幸的是，在疫情爆发过程中，对儿童的影响一直缓慢。 公认的新冠肺炎感染或对婴幼儿的影响的研究很少或根本不存在。 此外，虽然每个人都感受到了新冠肺炎疫情对健康和经济的影响，但 少数族裔和低收入家庭感受到了最严重的影响。因此，最多的 已经面临神经发育结果恶化风险的敏感家庭和儿童是 受到不成比例和更强烈的影响。因此，对新生儿和婴儿的研究对 制定有效的孕妇护理指南，优化对母亲的早期护理和支持 他们的新生儿，并优先考虑产前和产后干预。这份补充提案旨在为 通过表征出生婴儿的神经发育特征，为这些结果提供重要和及时的证据 对产前感染和不感染新冠肺炎的母亲，并检查社会、 经济因素和物质使用因素。建立在两项现有和正在进行的婴儿神经发育研究的基础上 (R34DA050284和UH3OD023313)，具有深刻的纵向神经成像、神经认知、 社会经济、人口统计、心理社会和生物医学数据，我们将首先研究大脑的差异 从出生到1岁的母亲所生婴儿的结构、功能和连接性发展 怀孕期间感染SARS-CoV-2病毒，出生于5月1日至9月1日。1,2020年，与 婴儿在同一时间招募，但给未感染的母亲。我们还将检查感染的影响 怀孕期间的时间和脑部测量的症状严重程度。接下来，我们将比较这些大脑 2020年1月1日之前满1岁的儿童的数据的发展趋势，使我们能够检查 特定环境因素的影响，包括母婴压力、营养、睡眠健康和父母- 由于与疫情有关的封锁和社会疏远政策，儿童互动发生了变化。我们会 进一步通过种族和社会经济的视角来看待这些环境因素，检查差异 跨越种族和收入维度。

PROJECT SUMMARY / DESCRIPTION Does maternal infection by the SARS-CoV-2 virus during pregnancy harm the developing fetal brain or increase the sensitivity to later developmental and environmental insults? he novel coronavirus (Covid-19) outbreak has fundamentally altered the child health landscape, ushering in sweeping changes in the social and economic fabric within which children grow. The rapidity of these environment changes, coupled with the relatively novelty of the SARS-CoV-2 virus and the widespread nature of infections, have presented multiple pressing questions. Among the unknowns that directly affect newborn and child health are: 1. How does Covid-19 infection during pregnancy effect the developing fetus or subsequent infant neurodevelopment? And 2. How will the unprecedented scale and scope of concurrent environmental changes impact child health and neurodevelopment? Unfortunately, over the course of the outbreak, the impact on children has been slow to be recognized with studies of Covid-19 infection or effects in infants and young children sparse to nonexistent. Moreover, while the health and economic impacts of the Covid-19 outbreak have been felt by everyone, the most severe effects have be felt by racial and ethnic minorities and lower income families. Thus, the most sensitive families and children already at risk for worsened neurodevelopmental outcomes are disproportionately and more intensely affected. Studies of newborns and infants are, therefore, critical to designing effective guidelines of care for expectant mothers, optimizing early care and support for mothers and their newborns, and prioritizing pre- and postnatal interventions. This supplement proposal aims to contribute important and timely evidence for these outcomes by characterizing neurodevelopmental profiles in infants born to mothers with and without antenatal Covid-19 infection, and examining the concurrent impact of social, economic, and substance use factors. Building on two existing and on-going studies of infant neurodevelopment (R34DA050284 and UH3OD023313), with deeply characterised longitudinal neuroimaging, neurocognitive, socioeconomic, demographic, psychosocial and biospecimen data, we will first investigate differences in brain structure, function, and connectivity development from birth to 1yr of age in infants born to mothers who were infected by the SARS-CoV-2 virus during pregnancy and born between May 1, and Sept. 1, 2020, compared to infants recruited at the same time but to non-infected mothers. We will also examine the impact of infection timing during pregnancy and symptom severity on brain measures. Next, we will compare these brain development trends to data from children who turned 1year old prior to Jan. 1, 2020, allowing us to examine the impact of specific environmental factors, including maternal and infant stress, nutrition, sleep health, and parent- child interaction that have changed due to outbreak-related lock-down and social distancing polices. We will further look at these environmental factors through a racial and socioeconomic lens, examining differences across race and income dimensions.