Prenatal Methamphetamine Exposure and Child Development in New Zealand and USA

描述(申请人提供)：本申请是对PAS-03-023国际药物成瘾研究合作项目的响应。我们收到了一份行政补充资料，将新西兰奥克兰添加到我们关于产前接触甲基苯丙胺(MA)对儿童结局影响的多站点婴儿发育、环境和生活方式(IDEAL)纵向研究中。我们已经建立了一个社区研究网络(CRN)，其中包括四个临床研究伙伴(CRP)，他们来自爱荷华州、俄克拉何马州、加利福尼亚州和夏威夷的不同研究人群，这些地区孕妇使用MA很普遍，这项为期3年的纵向研究的数据收集工作已经在进行中。该补编提供了资金，用于招募新生儿并对新西兰队列进行为期1个月的评估。这项研究的目的是将新西兰队列的纵向随访延长到3年。新西兰的招募工作正在进行中，预计将有240名接触过MA的受试者进行匹配比较。这项拟议研究的纵向方案包括1年、2年和3年的年度访视和2.5年的家访。对儿童的测量包括唤醒调节、认知、社会关系、神经运动、神经内分泌功能、行为问题和医疗状况等领域。衡量心理社会风险因素的方法包括照顾环境和照顾者特征。在控制了包括其他药物使用在内的协变量的情况下，我们将检验与产前MA暴露对儿童结局的影响有关的假设；与心理社会风险因素在产前MA暴露对儿童结局影响的中介作用有关的假设。奥克兰的队列将与更大的理想样本一起单独进行分析。随着新西兰奥克兰加入理想研究，作为第五个CRP，我们将：(1)增加理想研究的样本量；(2)通过研究MA纯度的变异性较小且使用频率高于其他理想地点的人群，增加产前MA暴露对婴儿结局的可观察影响；(3)增加我们对文化养育和户外安置问题的作用的理解，包括关于MA暴露儿童结局的社会政策；以及(4)为我们理解产前MA暴露对儿童结局的影响做出国际贡献。拟议的研究将促进我们对这一新出现的问题的科学理解，并增强我们为这些儿童制定适当干预措施的能力。

DESCRIPTION (provided by applicant): This application is in response to PAS-03-023 International Research Collaboration on Drug Addiction. We had received an administrative supplement that added Auckland, New Zealand to our multisite Infant Development, Environment And Lifestyle (IDEAL) longitudinal study of the effects of prenatal methamphetamine (MA) exposure on child outcome. We have already established a Community Research Network (CRN) that includes four Clinical Research Partners (CRPs), from diverse study populations in Iowa, Oklahoma, California, and Hawaii where MA use by pregnant women is prevalent and where data collection for this 3-year longitudinal study is already underway. The supplement provided funds to recruit and conduct newborn and 1-month assessments of the New Zealand cohort. The purpose of this study is to extend the longitudinal follow up of the New Zealand cohort to 3 years. Recruitment in New Zealand is underway and 240 subjects with MA exposure and matched comparisons are anticipated. The longitudinal protocol of the proposed study includes annual visits at 1, 2, and 3 years and a home visit at 2.5 years. Measures of child include domains of arousal regulation, cognition, social relationships, neuromotor, neuroendocrine function, behavior problems and medical status. Measures of psychosocial risk factors include caregiving context and caregiver characteristics. We will test hypotheses related to the effects of prenatal MA exposure on child outcome when covariates including other drug use are controlled; hypotheses related to the role of psychosocial risk factors mediating effects of prenatal MA exposure on child outcome. The Auckland cohort will be analyzed separately and together with the larger IDEAL sample. With Auckland, New Zealand added to the IDEAL study as a fifth CRP, we will: (1) Increase the sample size of the IDEAL study; (2) Increase the observable effects of prenatal MA exposure on infant outcome by studying a group with less variability in the purity of MA and with a higher frequency of use than in other IDEAL sites; (3) Increase our understanding of the role of cultural childrearing and out-of-home placement issues, including social policy on the outcome of MA exposed children, and (4) Make an international contribution to our understanding of the effect of prenatal MA exposure on child outcome. The proposed study will advance our scientific understanding of this emerging problem and enhance our ability to develop appropriate interventions for these children.