METHADONE, BUPRENORPHINE AND FETAL DEVELOPMENT

医学博士劳伦·M·詹森目前是马里兰州巴尔的摩约翰·霍普金斯大学成瘾与怀孕中心(CAP)的儿科主任。CAP是一项针对怀孕的鸦片和/或可卡因依赖妇女及其家人的城市多学科治疗计划。临床科学家发展奖旨在促进申请者对暴露于胎儿神经行为的物质的理解，并伴随着对新生儿的临床应用。此外，日耳曼对美沙酮维持和哺乳的临床问题将进行研究。具体地说，当前的提案将允许詹森博士在JHU人口与家庭健康科学学院接受胎儿神经行为发育方面的一般培训。她还将通过罗得岛州普罗维登斯的同事获得NICU网络神经行为量表(NNNS)管理方面的认证。研究设计、方法开发、数据库管理和数据分析方面的基础研究培训将通过JHU医学院精神病学和医学系的几个教员的指导提供。此外，还将完成妇幼保健课程以及临床试验和基于实验室的研究，并将提供写作课程和研讨会。在整个5年的资助期内，将通过开发和开展几项小规模研究来应用所获得的技能和知识。具体地说，建议进行四项研究以检验：(1)美沙酮维持妊娠高峰与低谷水平的胎儿神经行为；(2)高剂量(大于60毫克)与低剂量(低于40毫克)美沙酮维持妊娠的胎儿神经行为。(3)美沙酮与丁丙诺啡维持妊娠的胎儿神经行为；(4)美沙酮维持和母乳喂养。在研究1-3中，暴露于物质的胎儿神经行为状态将与婴儿分娩后的神经行为状态进行比较。将阐明临床相关性，以努力更好地了解和改善对阿片类药物暴露的新生儿的医疗护理。詹森博士尤其希望阐明一些变量，这些变量可以识别出神经行为问题风险最高的婴儿。在完成5年的资助期后，Jansson博士计划编写一份RO1资助金申请，以寻求在KO8资助期确定的研究想法。

Lauren M. Jansson, M.D. is currently the Director of Pediatrics at the Center for Addiction and Pregnancy (CAP) at Johns Hopkins in Baltimore, Md. CAP is an urban, multidisciplinary treatment program for pregnant opiate and/or cocaine dependent women and their families. A clinical Scientist Development Award is sought to further the applicant's understanding of substance exposed fetal neurobehavior with attendant clinical application to the newborn. In addition, clinical issues germaine to methadone maintenance and lactation will be studied. Specifically, the current proposal will allow Dr. Jansson to obtain general training in fetal neurobehavioral development at JHU School of Population and Family Health Science. She will also gain certification in NICU Network Neurobehavioral Scale (NNNS) administration through colleagues in Providence, R.I. Basic research training in study design, methodology development, data base management, and data analysis will be provided through mentorship from several faculty at JHU School of Medicine in the Departments of Psychiatry and Medicine. In addition, coursework in Maternal and Child Health as well as clinical trial and laboratory-based research will be completed, as will grant writing courses and seminars. Throughout the 5-year funding period, acquired skills and knowledge will be applied through the development and conduct of several small-scale research studies. Specifically, four studies are proposed to examine: (1) Fetal neurobehavior in methadone maintained pregnancies at peak versus trough plasma levels, (2) Fetal neurobehavior in high dose (greater than 60 mg) versus low dose (less than 40 mg) methadone maintained pregnancies. (3) Fetal neurobehavior in methadone versus buprenorphine maintained pregnancies, (4) Methadone maintenance and breastfeeding. Across studies 1-3, substance exposed fetal neurobehavioral status will be compared to infant neurobehavioral status post-delivery. Clinical correlates will be elucidated in an effort to better understand and improve medical care for opiate-exposed newborns. In particular, Dr. Jansson hopes to elucidate variables that identify infants at greatest risk for neurobehavioral problems. Upon completing the 5-year funding period, Dr. Jansson plans to have written an RO1 grant application to pursue research ideas identified during KO8 funding.