Prenatal & Environment Tobacco Smoke (ETS) Exposure: Effects on Child Regulation

描述（由申请人提供）：这项纵向、多方法研究的目的是调查产前接触香烟对生命头两年自我调节能力发展的影响。由于大多数在怀孕期间吸烟的女性也有吸烟的伴侣，因此还将检查儿童接触环境烟草烟雾 (ETS) 的情况。接触香烟与许多监管结果有关，例如行为问题、品行障碍和儿童后期的注意力问题。然而，人们对接触香烟的儿童这些自我调节结果的发展途径或风险的调节因素和调节因素知之甚少。本研究的具体目的如下：1）检查产前和 ETS 暴露对儿童调节的直接影响； 2）检查产前暴露与语言发展之间的关系以及24个月时语言发展与自我调节之间的关系； 3) 检查养育方式作为香烟暴露与儿童结局之间关联的近端中介的作用，例如 9 个月和 16 个月时的反应性和调节以及 24 个月时的自我调节； 4）检查累积的家庭风险评分（包括养育方式）是否会调节吸烟暴露与儿童结局之间的关联。最终样本将包括 150 名在怀孕期间吸烟的女性和 100 名在产前未接触过 ETS 的不吸烟女性，并在产后进行 2 年随访。生理和行为反应及调节的评估将在 2、9 和 16 个月大时进行。这些包括自主神经测量，例如 2 个月睡眠期间的呼吸性窦性心律失常，以及 9 个月和 16 个月情感唤醒过程中的呼吸性窦性心律失常，以及反应性和唤醒调节的观察评估。此外，将在第 9 个月和第 16 个月时使用生理（例如心率）和观察措施对注意力集中进行评估。最后，将在 24 个月大时对幼儿的自我调节（努力控制、遵守、行为问题和规则内化）和语言发展进行评估。养育和风险变量将在每个年龄段进行评估，作为风险的潜在中介或调节因素。该研究以发展精神病理学框架和儿童发展交易模型为指导，强调多种风险途径。预计这项研究将丰富我们对吸烟母亲的孩子出现自我调节问题的途径以及接触香烟的幼儿结果异质性原因的理解。

DESCRIPTION (provided by applicant): The purpose of this longitudinal, multi-method study is to investigate the impact of prenatal exposure to cigarettes on the development of self-regulation over the first 2 years of life. Because most women who smoke cigarettes during pregnancy also have partners who smoke, children's exposure to environmental tobacco smoke (ETS) will also be examined. Cigarette exposure has been associated with a number of regulatory outcomes such as behavior problems, conduct disorder, and attention problems in later childhood. However, little is known about the developmental pathways to these self-regulatory outcomes among cigarette exposed children or about mediators and moderators of risk. Specific aims of this study are as follows: 1) examine direct effects of prenatal and ETS exposure on child regulation; 2) examine the association between prenatal exposure and language development and the association between language development and self-regulation at 24 months; 3) examine the role of parenting as the proximal mediator of the association between cigarette exposure and child outcomes such as reactivity and regulation at 9 and 16 months and self-regulation at 24 months; 4) examine if a cumulative family risk score, including parenting, moderates the association between cigarette exposure and child outcomes. The final sample will consist of 150 women who smoke during pregnancy and 100 non-smoking women with no ETS exposure recruited prenatally, and followed for 2 years postnatally. Assessments of physiological and behavioral reactivity and regulation will be conducted at 2, 9, and 16 months of age. These include autonomic measures such as respiratory sinus arrythmia during sleep at 2 months, and during affect arousing procedures at 9 and 16 months, as well as observational assessments of reactivity and regulation of arousal. In addition, assessments of focused attention using both physiolgoical (e.g., Heart Rate) and observational measures will be conducted at 9 and 16 months. Finally, assessments of toddler self-regulation (effortful control, compliance, behavior problems, and internalization of rules) and language development will be conducted at 24 months of age. Parenting and risk variables will be assessed at each age as potential mediators or moderators of risk. The study is guided by a developmental psychopathology framework and transactional models of child development emphasizing multiple pathways to risk. It is anticipated that this study will enrich our understanding of pathways to self-regulatory problems among children of cigarette smoking mothers and reasons for heterogeneity in outcomes among cigarette exposed toddlers.