ENRICH-2: Stress-Reactivity and Self-Regulation in Infants with Prenatal Alcohol Exposure

ENRICH-2：产前酒精暴露婴儿的应激反应和自我调节

• 批准号: 10430305
• 负责人: Ludmila Nicole Bakhireva
• 金额: $ 6.98万
• 依托单位: UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-15 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10430305
• 关键词: Address; Adrenal Glands; Affect; Age-Months; Alcohols; Area; Arousal; Autonomic nervous system; Behavioral; Biological; Biological Markers; Brain; Caregivers; Child; Child Health; Classification; Clinical; Clinical Data; Collection; Corticotropin-Releasing Hormone; Cortisone; DSM-V; Data; Development; Diagnostic; Disease; Early Intervention; Electrophysiology (science); Environment; Enzymes; Ethanol; Evaluation; Exposure to; Face; Fetal Alcohol Exposure; Fetal Alcohol Spectrum Disorder; Fetal alcohol effects; Funding; Glucocorticoid Receptor; Goals; Grant; Guidelines; Health; Human; Hydrocortisone; Hypothalamic structure; Impairment; Infant; Infant Health; Informal Social Control; Infrastructure; Interview; Knowledge; Life; Literature; Longevity; Measures; Mediating; Mediator of activation protein; NR3C1 gene; National Institute on Alcohol Abuse and Alcoholism; Nervous System Physiology; Neurodevelopmental Disorder; Neurosecretory Systems; New Mexico; Newborn Infant; Outcome; Paper; Peer Review; Physiological; Pituitary Gland; Procedures; Prospective cohort; Prospective cohort study; Public Health; Publishing; Recovery; Regulation; Reporting; Research; Secondary to; Services; Severities; Specimen; Stress; Techniques; Testing; Time; Umbilical Cord Blood; Umbilical cord structure; Update; behavior measurement; clinical care; cognitive function; cohort; convict; disability; fetal; fetal diagnosis; fetal programming; heart rate variability; hypothalamic-pituitary-adrenal axis; indexing; infancy; infant outcome; innovation; interest; negative affect; neurodevelopment; neuroimaging; novel; novel strategies; overexpression; postnatal; pre-clinical; prenatal stress; prospective; recruit; response; stress reactivity; stressor

SUMMARY/ABSTRACT The new clinical guidelines for diagnosing Fetal Alcohol Spectrum Disorders (FASD) list self-regulation as one of the key behavioral deficits in children affected by prenatal alcohol exposure (PAE). There is a fundamental gap in knowledge about the underlying mechanisms, spectrum, and severity of such deficits early in life and the best analytical approaches to identify them. In addition, the effect of prenatal stress and postnatal environment on PAE-induced alterations is poorly understood. The primary focus of the parent Ethanol, Neurodevelopment, Infant, and Child Health 2 (ENRICH-2) study is on identification of neurobehavioral deficits associated with PAE early in life. This administrative supplement will allow us to examine the comorbid effect of COVID-19 pandemic and alcohol use on adverse maternal and infant outcomes in this cohort. The long-term goal of this supplement is to characterize the psycho-social effect of COVID-19 pandemic on adverse outcomes, including alcohol use, in a longitudinal birth cohort study, thus providing the foundation for future intervention studies. The objective of this supplement is to comprehensively evaluate the effect of COVID-19 related stress in pregnant and postpartum women enrolled in the ENRICH-2 cohort. We will evaluate this by adding state-of-the-art self- reported measures integrated with real-time physiological data that are not currently part of the funded parent study. The rationale for this supplement is driven by the gap in knowledge about the effect of the COVID-19 pandemic on psychosocial outcomes, alcohol use, and stress-related physical outcomes in pregnant and postpartum women, a vulnerable population disproportionately affected. We will address this gap in knowledge by pursuing two specific aims which evaluate the effect of COVID-19 on adverse maternal and infant outcomes in the ENRICH-2 cohort: 1) psychosocial outcomes and alcohol use, assessed as COVID-19 stress related to exposures and symptoms, COVID-19 pandemic adjustment, emotion regulation, mother-infant attachment, and alcohol consumption and 2) physiologic outcomes assessed as heart rate variability and sleep patterns, evaluated by wearable electronics – an approach particularly novel in the current social distancing environment. This approach is highly innovative, and will allow for the objective, real-time data collection in the climate of prolonged social distancing and challenges associated with face-to-face research visits in vulnerable populations. A detailed characterization of COVID-19 related outcomes in pregnant and postpartum women, effect of COVID-related social isolation and other hardships on mental health and alcohol use, as well as the cumulative effect on pediatric neurodevelopmental outcomes are highly significant in order to lay out the foundation for early effective interventions to mitigate the effects in these vulnerable populations.

摘要/摘要 诊断性胎儿酒精谱系疾病（FASD）的新临床指南列出了自我调节 在受到产前酒精暴露（PAE）影响的儿童中的关键行为定义。有一个基本 了解这种不足的生命早期的基本机制，频谱和严重程度的差距 识别它们的最佳分析方法。另外，产后应力和产后环境的影响 在PAE引起的变化方面，人们的理解很少。父乙醇的主要重点，神经发育， 婴儿和儿童健康2（富集2）研究是关于神经行为的鉴定定义与PAE相关的 生命的早期。这种行政补充剂将使我们能够检查COVID-19的合并效应 在该队列中，对不良母乳和婴儿结局的酒精使用。这种补充的长期目标 是为了表征COVID-19的大流行对不良后果的心理社会影响，包括饮酒， 在一项纵向出生队列研究中，为将来的干预研究奠定了基础。目的 这种补充是为了全面评估COVID-19相关压力在怀孕和 产后妇女参加了富集-2队列。我们将通过添加最先进的自我来评估这一点 报告的措施与当前不属于资助父母一部分的实时物理数据集成了 学习。这种补充的基本原理是由关于COVID-19的影响的知识的差距所驱动的 心理社会结局，饮酒和与压力相关的身​​体结局的大流行 产后妇女，脆弱的人口受到不成比例的影响。我们将在知识上解决这个差距 通过追求两个特定的目标，这些目标评估了Covid-19对不良母校和婴儿结果的影响 在富集2中：1）心理社会结果和饮酒，被评估为与19的压力有关 暴露和症状，共同调节，情绪调节，母亲依恋和 饮酒和2）评估为心率变异性和睡眠方式的生理结局， 通过可穿戴电子设备评估 - 一种在当前社会距离环境中尤其是新颖的方法。 这种方法具有很高的创新性，并将允许在气候下进行客观的实时数据收集 长期的社会疏远和与弱势群体面对面研究访问相关的挑战 人群。 COVID-19中孕妇和产后妇女相关结果的详细表征， 与共同相关的社会隔离和其他困难对心理健康和饮酒的影响以及 对小儿神经发育结果的累积影响非常重要，以便布置 基础早期有效干预措施减轻这些脆弱人群的影响。