Developmental Outcomes of Prenatal Exposure to MDMA ('E*

描述：（申请人提供） 3-4亚甲二氧基甲基苯丙胺（MDMA/摇头丸）在年轻人中的使用很普遍 在整个欧洲的成年人中， 在类似人群中， 胎儿暴露于MDMA对发育中的儿童的影响。使用MDMA也是 与可能对儿童产生负面影响的其他孕产妇风险因素有关 结果，如产妇神经心理缺陷增加， 心理困扰和潜在的改变护理行为。在 除了记录一系列婴儿结局外，拟议的研究旨在 评估结果的环境和产妇心理相关因素， 英国接触MDMA的儿童。拟议研究将实现 这一目标是通过在凯斯西储的研究人员之间建立伙伴关系， 储备大学在克利夫兰，俄亥俄州和社区研究合作伙伴在 英国东伦敦大学，MDMA使用普遍， 可以招募暴露于MDMA的婴儿的样本量。 150名婴儿（75名接触MDMA; 75名未接触）及其母亲将在 1个月、4个月、12个月、18个月和24个月， 生长、认知、运动、语言和行为结果。MDMA暴露将 通过母亲自我报告措施确定（并通过毛发证实 分析），所有儿童均来自同一种族/社会阶层。 母亲将在怀孕初期通过社区医生进行识别 尽可能或在分娩时使用，并评估药物使用量和频率 在每三个月。人口统计学、医疗和产前物质暴露将 从病历审查、临床访谈和毛发分析中注意到。 评估产妇心理状况的标准化问卷， 人格、社会支持、智力、生育史 将被管理。儿童游戏和母亲儿童的录像观察 将进行互动。 将通过一系列纵向调查， 混合模型分析和分层多重/逻辑回归分析， 描述暴露于MDMA的婴儿及其母亲2岁时的功能 以及MDMA和其他物质暴露对婴儿的相对影响 结果，产妇的心理功能，和生育的相互作用。 婴儿风险随时间的变化和预测模型，使用HLM或结构 方程模型，将被使用。该研究将提供 关于胎儿MDMA暴露的早期发育后遗症的信息， 母亲的心理状况和养育行为， 设计有效的孕产妇药物治疗和儿童干预计划。

DESCRIPTION: (provided by applicant) 3-4Methylenedioxymethamphetamine (MDMA/Ecstasy) use is widespread among young adults throughout Europe and increasing in popularity in the United States among similar populations with resultant concern over the long-term negative effects of fetal MDMA exposure on the developing child. Use of MDMA is also associated with other maternal risk factors which can negatively affect child outcomes, such as increased maternal neuropsychological deficits, greater psychological distress, and potentially altered care-giving behavior. In addition to documenting a range of infant outcomes, the proposed study aims to assess environmental and maternal psychological correlates of outcomes in MDMA-exposed children in the United Kingdom. The proposed study will achieve this aim through establishing a partnership between researchers at Case Western Reserve University in Cleveland, Ohio and community research partners at the University of East London, England where MDMA use is prevalent and an adequate sample size of MDMA exposed infants can be recruited. 150 infants (75 MDMA-exposed; 75 non-exposed) and their mothers will be seen at 1 month, 4 months, 12 months, 18 and 24 months and assessed on measures of growth, cognitive, motor, language, and behavioral outcomes. MDMA exposure will be determined by maternal self-report measures (and corroborated by hair analysis), with all children drawn from the same race/social class population. Mothers will be identified through community physicians as early in pregnancy as possible or at child birth and substance use quantity and frequency assessed at each trimester. Demographic, medical, and prenatal substance exposure will be noted from chart review and clinical interview and hair analysis. Standardized questionnaires assessing maternal psychological status, personality, social supports, intellectual ability, and history of caregiving will be administered. Videotaped observations of child play and maternal child interactions will be conducted. Data will be evaluated descriptively, and through a series of longitudinal mixed model analyses and hierarchical multiple/logistic regression analyses to describe the functioning of MDMA-exposed infants and their mothers to 2 years of age, and the relative impact of MDMA and other substance exposures to infant outcomes, maternal psychological functioning, and caregiving interactions. Changes over time and predictive models of infant risk, using HLM or structural equation models, will be utilized. The proposed research will provide information about the early developmental sequelae of fetal MDMA-exposure and maternal psychological status and caregiving behaviors which can guide the design of effective maternal drug treatment and child intervention programs.