Prenatal Cannabis Use (PCU) and Development of Offspring Brain and Behavior During Early Life (0-18 Months)

29个州、关岛和波多黎各领土以及哥伦比亚特区已经合法化 医用和/或娱乐用大麻。同时，Delta9四氢大麻酚(THC)的效力 在人们对与经常使用相关的伤害的看法变得更加宽容的同时， 强调集中努力评估大麻使用对健康和行为的影响的重要性。 特别是，人们越来越关注产前升级的潜在不良后果。 大麻使用(PCU)。近4%的美国孕妇报告说在过去的一个月里使用了大麻，相当于1.6%- 在过去的十年里翻了一番。PCU对新生儿结局的潜在影响，包括新生儿 大脑和儿童早期发展里程碑被证明很难研究，部分原因是PCU共同 与其他药物的使用，尤其是烟草的使用一起发生，使得很难描述多氯联苯的具体影响。 此外，PCU还与其他母体精神疾病(犯罪、外化行为)并存 作为对问题物质使用的家族易感性，可能会混淆对PCU因果关系的解释 对后代的大脑和行为的影响。这项提案通过招募 来自城市医院门诊部的孕妇，那里的医疗记录显示，~80%的女性 使用大麻的妇女不使用其他药物，其他约20%的使用大麻的妇女报告使用 烟草，但很少到没有酒精或其他药物。有近期吸食大麻史的孕妇会 将被选中；报告仅在产前使用大麻的妇女(PCU，n=200)将与妇女进行比较 报告未使用产前药物(NPCU，n=200)，以评估PCU在(目标1)分娩中的作用 特征(如出生体重)和新生儿神经行为(如兴奋性)；(目标2)新生儿皮质下 150个PCU和100个社会人口学匹配的形态以及结构和功能的连通性 NPCU婴儿；(目标3)6、12和18个月大的婴儿的社会情绪行为和气质，如 以及母婴互动；(目标4)大脑结构和连通性在多大程度上与 婴幼儿早期的行为。分析将控制其他产科特征的指标以及 母亲心理社会健康、家族史和家庭环境的综合指数。潜在客户 设计，在怀孕第一个三个月内招募的妇女将被跟踪，她们的后代直到18个月 产后，提供了伴随PCU的风险和保护性影响的详细特征。PCU， 烟草和其他药物的使用将得到生化验证。报告PCU的女性更有可能是社会性- 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 在这个群体中尤其明显。这项研究的结果将直接影响到 研究不足的人口及其婴儿；它还将为制定合理的公共卫生政策提供信息 关于美国的大麻使用情况。

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.