4/5 The Cumulative Risk of Substance Exposure and Early Life Adversity on Child Health Development and Outcomes

项目总结/摘要 由于统计数据不断恶化，子宫内暴露于阿片类药物引起了重大的社会关注 在育龄妇女中与类阿片有关的使用和滥用。在过去的20年里， 在美国，阿片类药物的使用率增加了300%以上，阿片类药物相关的人数增加了300%。 死亡人数增加了约500%，新生儿禁欲的人数 综合征（NAS）增加了近400%。因此，阿片类药物危机代表了一种 一系列不利条件，使发育中的儿童面临显著增加的风险 对于死亡率，小妊娠生长，早产，出生后未能茁壮成长和恶化 神经行为、学业和社会结果。新的数据表明，在子宫内， 物质接触与各种负面健康和认知结果有关。我们 假设产前物质暴露与心理健康/认知能力之间的联系 结果是由产前物质暴露对大脑发育的影响介导的;我们 进一步假设背景环境变量，如低社会经济地位，低孕产妇 教育和高水平的压力暴露，缓和这些发展后遗症。在这 我们将使用一组行为和神经成像工具，从晚些时候开始， 产前和延伸到学龄，以检查阿片类药物和逆境暴露的影响 关于发展。

Project Summary/Abstract In utero exposure to opioids is causing significant societal concern given the worsening statistics of opioid-related use and abuse in women of child-bearing age. Over the past 2 decades, the rate of opiate usage across the US has increased by >300%, the number of opioid-related deaths has increased by ~500% and the number of newborns with neonatal abstinence syndrome (NAS) has increased by almost 400%. Thus, the opioid crisis represents a constellation of adverse conditions that places the developing child at significantly increased risk for mortality, small gestational growth, preterm delivery, postnatal failure to thrive and worsened neurobehavioral, scholastic, and societal outcomes. Emerging data indicate that in utero substance exposure is associated with a variety of negative health and cognitive outcomes. We assume the association between prenatal substance exposure and mental health/cognitive outcomes is mediated by the impact of prenatal substance exposure on brain development; we further assume that background environmental variables, such as low SES, low maternal education and high levels of stress exposure, moderate these developmental sequelae. In this linked proposal we will use a battery of behavioral and neuroimaging tools, beginning late prenatal and extending into school age, to examine the effects of opioid and adversity exposure on development.