Fetal and Infant Neurobehavior in Opiate Dependent Women

阿片类药物依赖妇女的胎儿和婴儿神经行为

• 批准号: 7493105
• 负责人: LAUREN M JANSSON
• 金额: $ 38.44万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7493105
• 关键词: Address; Affect; Arts; Award; Buprenorphine; Characteristics; Collaborations; Collection; Coupling; Data; Data Analyses; Dependency; Development; Dose; Double-Blind Method; Drug Addiction; Drug usage; Fetal Movement; Fetus; Funding; Goals; Heart Rate; Hour; Individual; Individual Differences; Infant; Investigation; Knowledge; Laboratories; Link; Maternal Physiology; Measures; Mediating; Mental Depression; Mentored Clinical Scientist Award; Methadone; National Institute of Drug Abuse; Nature; Neonatal; Neonatal Abstinence Syndrome; Neurobiology; Newborn Infant; Opiates; Opioid; Outcome; Patient currently pregnant; Physiological; Population; Pregnancy; Pregnant Women; Principal Investigator; Randomized Controlled Trials; Research; Research Personnel; Risk; Severities; Site; Systems Analysis; Techniques; Technology; Therapeutic; Treatment Protocols; Variant; Woman; Work; base; computerized; dosage; falls; fetal; neurobehavior; neurobehavioral; neurophysiology; prenatal; programs; response

DESCRIPTION (provided by applicant): Methadone is widely used for the treatment of opioid dependent pregnant women, yet little is known about its effects on the developing fetus. Previous research by this group of investigators found that methadone treatment during pregnancy directly impacts fetal neurophysiology independently of maternal physiology. Maternal methadone administration was associated with significant depression in fetal neurobehaviors. This proposal seeks to: 1) Determine the effect of methadone treatment during pregnancy on maternal and fetal neurobehavioral functioning at trough and peak maternal methadone levels using single dose methadone therapy. This includes controlling for covariates such as individual maternal and fetal factors, which mediate or moderate these effects, and of factors that may potentiate the expression of neonatal abstinence syndrome. 2) Determine whether split dose methadone therapy for pregnant women lessens or ameliorates the previously observed deleterious effects of single dose treatment on maternal physiologic and fetal neurobehavioral functioning. 3) Determine the effects of buprenorphine treatment on maternal physiologic and fetal neurobehavioral functioning and compare them to those found in opioid dependent pregnant women treated with methadone. This aspect of the proposal will be in collaboration with the NIDA funded multi-site, double blind, randomized controlled study evaluating the effect of buprenoprphine versus methadone on neonatal outcome. The project will utilize a state-of-the-art computerized fetal actocardiograph and data analysis program to simultaneously evaluate fetal movement and heart rate, the interaction between the two (coupling) and maternal physiologic parameters; build upon pilot data obtained from a Mentored Clinical Scientist award received by the PI, and bring together the expertise of three established research teams. Information gained from this proposal has the potential to significantly impact the way in which we treat the difficult and high-risk population of opiate dependent pregnant women.

描述（由申请人提供）： 美沙酮被广泛用于治疗阿片类药物依赖的孕妇，但人们对其对发育中的胎儿的影响知之甚少。这组研究人员以前的研究发现，怀孕期间的美沙酮治疗直接影响胎儿的神经生理学，而不依赖于母体的生理学。母亲服用美沙酮与胎儿神经行为的显著抑郁相关。这项建议旨在：1）确定在妊娠期间使用单剂量美沙酮治疗在母体美沙酮水平的谷值和峰值时美沙酮治疗对母体和胎儿神经行为功能的影响。这包括控制协变量，如个别母亲和胎儿的因素，介导或缓和这些影响，并可能加强新生儿禁欲综合征的表达的因素。2)确定是否分割剂量美沙酮治疗孕妇减少或改善以前观察到的有害影响，单剂量治疗对产妇的生理和胎儿的神经行为功能。3)确定丁丙诺啡治疗对母体生理和胎儿神经行为功能的影响，并将其与接受美沙酮治疗的阿片类药物依赖孕妇进行比较。该提案的这一方面将与NIDA资助的多地点，双盲，随机对照研究合作，评估丁丙诺啡与美沙酮对新生儿结局的影响。该项目将利用最先进的计算机化胎儿心电图仪和数据分析程序，同时评估胎动和心率，两者之间的相互作用（耦合）和母体生理参数;建立在从PI获得的指导临床科学家奖获得的试点数据基础上，并汇集了三个已建立的研究团队的专业知识。从该提案中获得的信息有可能对我们治疗阿片类药物依赖孕妇这一困难和高危人群的方式产生重大影响。