Prenatal Tobacco Use: Auditory Processing and Language

描述（由申请方提供）：将在一组340名婴儿中评价孕妇吸烟对后代听觉处理、音素感知和早期语言的影响，随访至产后24个月。怀孕期间吸烟仍然是一个公共卫生问题，多达20%的新生儿经历这种潜在的致畸性暴露。虽然与生长迟缓的关联已经很好地建立，但对行为和认知结果的影响，特别是在发育早期，尚未得到很好的描述。这项研究将集中在听觉信息和音素刺激的处理早期发展，同时控制暴露于其他药物（例如，酒精）以及家庭和环境因素也会影响认知和语言发展。接触大量围产期人口将允许调查重度吸烟（>30支/天）以及确定烟草烟雾暴露水平与影响发育结果的因素之间的剂量反应关系。烟草暴露量将通过母亲自我报告（即，香烟数量/天）和生物测量（即，母亲和婴儿的可替宁水平，尼古丁的生物标志物）。将对样本进行分层，以纳入否则无法识别的重度吸烟者。将包括四个使用水平：无、10至19支/天、20至29支/天和超过30支/天。将在出生后招募家庭，并随访至24个月，在6个月、15个月和24个月时进行实验室访视。听觉处理和音位知觉将使用信息处理方法和心理生理结果的措施操作。早期语言技能将使用自然语言样本的transmittance（SALT）和标准化的沟通措施和语言发展的父母报告进行全面评估。烟草烟雾暴露（包括出生后的环境暴露）预计会对前24个月的听觉和语音处理技能产生负面影响，并与特定的语言延迟有关。所有分析将控制对结果的其他贡献（即，酒精暴露，照顾潜力，照顾质量，包括语言环境，儿童健康和听力）。

DESCRIPTION (provided by applicant): The impact of tobacco use by pregnant women on auditory processing, phonemic perception and early language in offspring will be evaluated in a cohort of 340 infants followed to 24 months postpartum. Tobacco smoking during pregnancy continues to be a public health problem with up to 20% of newborns experiencing this potentially teratogenic exposure. Although an association with growth retardation is well established, the impact on behavioral and cognitive outcomes, particularly early during development, has not been well described. This study will focus on processing of auditory information and phonemic stimuli early in development while controlling for exposure to other drugs (e.g., alcohol) and familial and environmental factors that also affect cognitive and language development. Access to a large perinatal population will allow the investigation of heavy smoking (>30 cigarettes/day) as well as determination of the dose-response relationship between levels of tobacco smoke exposure and factors affecting developmental outcome. Quantity of tobacco exposure will be measured both through maternal self-report (i.e., number of cigarettes/day) and biological measures (i.e., maternal and infant cotinine levels, a biomarker of nicotine). The sample will be stratified to allow inclusion of heavy smokers who would not be identified otherwise. Four levels of use will be included: None, 10 to 19 cigarettes/day, 20 to 29 cigarettes/day, and more than 30 cigarettes/day. Families will be recruited postnatally and followed to 24 months with laboratory visits at 6-, 15-, and 24 months. Auditory processing and phonemic perception will be operationalized using information processing methodology and psychophysiological outcome measures. Early language skills will be comprehensively evaluated using both transcriptions of natural language samples (SALT) and standardized measures of communication and parental report of language development. Tobacco smoke exposure (including postnatal environmental exposure) is predicted to negatively impact auditory and phonemic processing skills during the first 24 months and to be related to specific language delays. All analyses will control for other contributions to outcomes (i.e., Alcohol exposure, Caregiving potential, Quality of Caregiving, including language environment, Child Health and Hearing).