COCAINE EXPOSURE IN UTERO--ELEMENTARY SHCOOL FOLLOWUP

子宫内可卡因暴露水平与小学生神经心理、情绪和行为状态之间是否存在剂量反应关系尚不清楚。我们建议在8.5岁、9.5岁和10.5岁时，对160-170名照顾者/儿童双体的非裔美国人队列继续进行纵向蒙面评估，从出生开始进行前瞻性随访。该队列在该领域是独一无二的，因为可卡因暴露水平的特点是母亲访谈和婴儿胎便分析。该研究将评估，在潜在的混杂生物和社会变量被统计控制后，子宫内可卡因暴露水平与多个领域的结果之间是否存在独立关系，包括记忆、注意力和冲动控制、复杂运动技能、语言、执行功能、认知能力和学习障碍。儿童的照顾者将每年接受访谈，以测量潜在的混淆或中介环境变量，如照顾者物质使用、心理健康、社会支持和主要和次要的生活压力。我们将监测子宫内可卡因暴露水平是否与DICA-IV和儿童、家长和教师报告所评估的儿童精神诊断相关（包括抑郁、行为问题、暴力暴露和儿童物质暴露）。混合线性回归模型是一个丰富的纵向数据集，它将允许识别历史和并发的生物和社会因素，这些因素与可卡因暴露水平相互作用，区分小学阶段有和没有表现出不良后果的儿童。这些数据可以为照顾全国可卡因暴露小学生的公共政策选择提供信息。

Whether there is a dose response relationship between levels of in- utero cocaine exposure and the neuropsychological, emotional, and behavioral status of elementary school children is unresolved. We propose to continue a longitudinal masked evaluation at 8.5, 9.5, and 10.5 years of age, of a predominantly African-American cohort of 160-170 caregiver/child dyads, followed prospectively since birth. The cohort is unique in the field in that level of cocaine exposure is characterized by both maternal interview and infant meconium assays. The study will evaluate whether, after potentially confounding biologic and social variables are controlled for statistically, there are independent relationships between level of in utero cocaine exposure and outcomes in multiple domains, including memory, attention and impulse control, complex motor skills, language, executive functions, cognitive abilities, and learning disabilities. Children's caregivers will be interviewed annually to measure potentially confounding or mediating environmental variables such as caregiver substance use, mental health, social support, and major and minor life stresses. We will monitor whether level of in utero cocaine exposure correlates with children's psychiatric diagnoses as assessed by the DICA-IV and child, parent, and teacher report symptom report measures (covering depression, behavioral problems, exposure to violence, and child substance exposure). Mixed linear regression models of this is a rich longitudinal data set, which will permit the identification of historical and concurrent biologic and social factors, which, in interaction with level of cocaine exposure, differentiate children who do and do not show adverse outcomes in elementary school years. This data can inform public policy choices for care of cocaine exposed elementary school children nationwide.