Electronic Cigarettes During Pregnancy: Impact on Fetal Development

怀孕期间电子烟：对胎儿发育的影响

• 批准号: 9755393
• 负责人: LAURA R STROUD
• 金额: $ 65.7万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9755393
• 关键词: 1-Butanol; 3-Dimensional; 3D ultrasound; Address; Age; Animals; Area; Arousal; Attention; Behavioral; Biological; Biological Markers; Birth; Birth Weight; Brain; Carbon Monoxide; Cephalic; Cerebellum; Child; Child Health; Cigarette; Clinical; Cohort Studies; Corpus Callosum; Cost efficiency; Cotinine; Data; Development; Dimensions; Discipline of obstetrics; Drug usage; Electronic cigarette; Environment; Exposure to; Fetal Development; Fetal Growth; Fetal Neurobehavioral Development; Fetus; Gestational Age; Goals; Growth; Harm Reduction; Head circumference; Human; Image; Infant; Informal Social Control; Investigation; Liquid substance; Literature; Longevity; Measures; Methods; Mothers; National Institute of Drug Abuse; Neonatal; Nicotine; Outcome; Postpartum Period; Pregnancy; Pregnant Women; Provider; Public Health; Publishing; Relative Risks; Reporting; Reproductive Health; Research; Resolution; Risk; Risk Marker; Sampling; Seminal; Smoking; Strategic Planning; Structure; System; Time; Tobacco; Tobacco-Associated Carcinogen; Toxic effect; Ultrasonography; Vaporizer; Woman; base; biobehavior; biological adaptation to stress; biomarker development; carcinogenicity; cigarette smoking; cohort; combustion product; developmental toxicity; electronic cigarette use; electronic cigarette user; fetal; frontal lobe; high risk infant; image processing; innovation; maternal cigarette smoking; neurobehavior; neurobehavioral; novel; pregnant; prenatal; prenatal exposure; prospective; recruit; relating to nervous system; social; tobacco products

Project Summary/Abstract While cigarette use has declined in the US, use of electronic cigarettes (e-cigs) has increased dramatically since their introduction to the US in 2007. Tremendous controversy has emerged regarding their potential risks (renormalizing smoking, dangers of e-liquids) versus potential for harm reduction (“clean” nicotine delivery sys- tem without tobacco combustion products). The question of risks vs harm reduction is even more salient during pregnancy due to impact of maternal use on both mother and fetus and evidence for vulnerabil- ity of the developing fetus to both nicotine and combustion products. Recent published reports reveal rates of e-cig use of 4-15% among pregnant women; pilot data from our group revealed doubling of prenatal e- cig use between 2012 and 2017. Given evidence of increasing e-cig use by pregnant women, known fetal tox- icity from nicotine, and a need for data to inform pregnant women and obstetric providers, research to deter- mine the impact and relative impact (vs cigarettes) of e-cigs on fetal development is urgently needed. To date, however, there are no published studies of the impact of e-cig use during pregnancy on fetal develop- ment. We propose the first study of the impact of e-cigs during pregnancy on the developing fetus, in- cluding markers of fetal growth and novel measures of fetal brain and neurobehavioral development. Our group pioneered combined use of real-time ultrasound and fetal actocardiography to characterize fetal neurobehavior. The advent of 3D ultrasound offers higher resolution fetal images and allows volumetric char- acterization of specific fetal brain structures. Seminal preliminary data from our group highlights feasibility of recruiting pregnant e-cig users as well as initial evidence for alterations in fetal growth, fetal fronto-cerebellar brain structures and fetal neurobehavioral development in e-cig users. The proposed study is an intensive pro- spective investigation of three groups of mother-fetus pairs: E-cig users, Cig users and Controls. Comprehen- sive measures of fetal growth, neural structures, and neurobehavioral development will be assessed over preg- nancy using 2D and 3D ultrasonography followed by neonatal ultrasound and neurobehavioral assessment. Maternal and fetal nicotine, combustion and carcinogenicity biomarkers will also be assessed. Our goals are to determine the impact of prenatal e-cigs on: (1) fetal growth and infant birth weight, (2) fetal/infant brain devel- opment, (3) fetal/infant neurobehavioral development. We will also explore: (4) associations between nicotine and toxicity biomarkers with fetal growth, brain and neurobehavioral development. The proposed study ad- dresses an urgent and unanswered public health question. Given increasing rates of e-cig use and the exquis- ite sensitivity of the developing fetus to disruptions in the prenatal environment, determining the risks and rela- tive risks of e-cig use in pregnancy is timely and offers potential to impact the health of reproductive age women and their children.

项目摘要/摘要 尽管美国的香烟使用量有所下降，但使用电子烟（E-cigs）已大大增加 自2007年向美国介绍以来。关于其潜在风险的巨大争议已经出现 （恢复吸烟，电子液体的危险）与减少伤害的潜力（“清洁”尼古丁递送系统 - 没有烟草混合物的TEM）。风险问题与减少危害的问题更加明显 在怀孕期间，由于产妇使用对母亲和胎儿的影响以及脆弱性证据 - 它是尼古丁和组合产品的发展胎儿。最近发表的报告揭示了 孕妇的电子烟的使用率为4-15％；来自我们小组的飞行员数据显示产前E-的两倍 2012年至2017年之间的CIG使用。鉴于孕妇增加电子烟的使用的证据，已知的胎儿毒物 - 尼古丁的ICITY，以及需要数据通知孕妇和产科提供者的数据，以确定的研究 迫切需要灌输电子烟的影响和相对影响（VS香烟）对胎儿发育的需要。 但是，迄今为止，还没有关于怀孕期间电子烟的影响对胎儿发育的影响 精神。我们提出了关于怀孕期间电子烟对发育中胎儿的影响的首次研究 包括胎儿生长的标志和胎儿脑和神经行为发育的新测量。 我们的小组的实时超声和胎儿遵守记录术的合并使用以表征胎儿 神经行为。 3D超声的冒险提供了更高分辨率的胎儿图像，并允许体积char- 特定胎儿脑结构的激活。我们小组的开创性初步数据突出了 招募怀孕的电子烟使用者以及最初证明胎儿生长的改变 电子烟使用者的脑结构和胎儿神经行为的发育。拟议的研究是一项密集的亲 三组母亲对的投资：电子烟的用户，CIG用户和控件。理解 将评估胎儿生长，神经结构和神经行为发育的测量 使用2D和3D超声检查，然后进行新生儿超声和神经行为评估。 也将评估母体和胎儿尼古丁，联合和致癌性生物标志物。我们的目标是 确定产前电子烟的影响：（1）胎儿生长和婴儿的出生体重，（2）胎儿/婴儿脑devel- Opment，（3）胎儿/婴儿神经行为发育。我们还将探索：（4）尼古丁之间的关联 以及具有胎儿生长，大脑和神经行为发育的毒性生物标志物。拟议的研究ad- 打扮一个紧急且未解决的公共卫生问题。鉴于电子烟的使用率不断增加，等效物 发育中的胎儿对在产前环境中的破坏的敏感性，确定风险和相关性 妊娠中使用电子烟的风险是及时的，并提供了影响复制年龄健康的潜力 妇女及其子女。