Prenatal Cigarette Exposure: The Role of Sleep and Parenting for Infant Outcomes

产前吸烟：睡眠和养育对婴儿结局的作用

• 批准号: 8635418
• 负责人: Cathi Barbra Propper
• 金额: $ 16.18万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-03-15 至 2019-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8635418
• 关键词: Age; Age-Months; Alcohol or Other Drugs use; Applications Grants; Attention deficit hyperactivity disorder; Award; Behavior; Behavioral; Birth; Blood Circulation; Carbon Monoxide; Caregivers; Chemicals; Child; Childhood; Cigarette; Code; Cognitive; Conduct Disorder; Congenital Heart Defects; Consumption; Development; Dopamine; Emotional; Environmental Tobacco Smoke; Exposure to; Failure; Family; Fetal Tissues; Fetus; Foundations; Future; Goals; Hand; Health; Home environment; Impaired cognition; Infant; Intervention; Knowledge; Language Development; Lead; Life; Link; Location; Measures; Mediating; Memory; Mentors; Methods; Mothers; Movement; Neuraxis; Nicotine; Norepinephrine; Outcome; Oxygen; Parenting behavior; Parents; Pathway interactions; Patient Self-Report; Pattern; Physiological; Pilot Projects; Placenta; Population; Pregnancy; Prevention program; Process; Public Health; Recruitment Activity; Regulation; Reporting; Rest; Risk; Role; Running; Saliva; Second Pregnancy Trimester; Sleep; Smoke; Smoker; System; Tobacco smoke; Toxin; Training; Umbilical cord structure; Video Recording; Woman; Work; adverse outcome; behavioral health; behavioral impairment; biobehavior; caregiving; cell injury; cigarette smoking; cognitive function; design; fetal; high risk; improved; infancy; infant monitoring; infant outcome; motor control; non-smoker; parental role; pregnant; premature; prenatal; prenatal exposure; prospective; public health relevance; response; sleep regulation; smoking intervention; social

DESCRIPTION (provided by applicant): Even with all of the known health risks, recent evidence suggests that up to 15% of women smoke during pregnancy and only 18-25% of women who smoke will stop when they find out they are pregnant. Prenatal consumption of nicotine has been correlated with a number of severe health issues, as well as behavioral and cognitive impairments in childhood. Therefore, it is of great importance to identify and treat children at risk from the early months of life before patterns become stable and more difficult to change. Adverse outcomes could be mitigated by appropriate interventions, but first the specific mechanisms that link prenatal exposure to poor social-emotional and cognitive outcomes and trajectories must be more closely examined. The proposed pilot study aims to elucidate such mechanisms. Pathways between prenatal exposure to cigarettes and infant social-emotional and cognitive outcomes at 9 months will be explored, with a focus on the mediating role of infant sleep. In addition, this study aims to examine whether paths differ for infants as a function of caregiving, and will attempt to differentiate between the effects of general caregiving behavior (i.e., sensitivity) and behavior at bedtime/through the night, which might influence outcomes via its effect on infant sleep quality. The current study will recruit 120 women during their second trimester of pregnancy (80 smokers, 40 non-smokers). Maternal cigarette and other substance use will be assessed during pregnancy, and a piece of the umbilical cord will be collected and analyzed (at birth) to evaluate prenatal exposure to nicotine. Moreover, infant saliva will be analyzed for current exposure to environmental tobacco smoke at each age. At 3 months, video cameras will be set-up in multiple locations to capture parent-infant interactions at bedtime and through the night to evaluate specific caregiver practices and emotional availability, and infants will wear an Actiwatch, to record movement during sleep, for seven days, and at 9 months infant biobehavioral functioning (behavioral, parasympathetic, sympathetic response at rest and during challenge) and cognitive functioning will be assessed. Finally, At 3 and 9 months of age caregiver-infant interactions will be video recorded in the home for later coding of parenting behavior. Mentored training in conducting the proposed prospective and longitudinal pilot study within this high-risk population, as well as utilizing cutting edge methods for assessing fetal and infant cigarette exposure and observational measures of sleep, will establish a strong foundation for submitting an R01 grant proposal in the latter years of this award. The knowledge gained over this period will also lay the groundwork for my long-term goal of developing interventions for families at risk.

描述（由申请人提供）：即使存在所有已知的健康风险，最近的证据表明，高达 15% 的女性在怀孕期间吸烟，只有 18-25% 的吸烟女性在发现自己怀孕后会停止吸烟。产前摄入尼古丁与许多严重的健康问题以及儿童时期的行为和认知障碍有关。因此，在模式变得稳定且更难以改变之前，从生命的最初几个月起识别和治疗处于危险中的儿童非常重要。通过适当的干预措施可以减轻不良后果，但首先必须更仔细地研究将产前暴露与不良社会情感和认知结果和轨迹联系起来的具体机制。拟议的试点研究旨在阐明此类机制。将探讨产前接触香烟与 9 ​​个月婴儿社交情感和认知结果之间的关系，重点关注婴儿睡眠的中介作用。此外，本研究旨在检查婴儿的路径是否因护理而有所不同，并将尝试区分一般护理行为（即敏感性）和就寝时间/整夜行为的影响，这可能通过对婴儿睡眠质量的影响来影响结果。目前的研究将招募 120 名怀孕中期的女性（80 名吸烟者，40 名不吸烟者）。将在怀孕期间评估母亲的香烟和其他物质使用情况，并将收集并分析（出生时）一段脐带，以评估产前接触尼古丁的情况。此外，还将分析婴儿唾液，了解每个年龄段当前接触环境烟草烟雾的情况。 3 个月时，将在多个地点安装摄像机，以捕捉睡前和夜间的亲子互动，以评估具体的护理人员做法和情绪可用性，婴儿将佩戴 Actiwatch，记录睡眠期间的运动，持续 7 天；9 个月时，将评估婴儿的生物行为功能（休息时和挑战期间的行为、副交感、交感反应）和认知功能。最后，在 3 个月和 9 个月大时，护理人员与婴儿的互动将在家中录制视频，以便以后对养育行为进行编码。指导培训，在这一高危人群中进行拟议的前瞻性和纵向试点研究，以及利用尖端方法评估胎儿和 婴儿香烟暴露和睡眠观察测量，将为在该奖项的后几年提交 R01 拨款提案奠定坚实的基础。在此期间获得的知识也将为我为高危家庭制定干预措施的长期目标奠定基础。