1/4 Investigation of opioid exposure and neurodevelopment (iOPEN)

1/4 阿片类药物暴露和神经发育的调查 (iOPEN)

• 批准号: 10329053
• 负责人: Damien A Fair
• 金额: $ 26.73万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10329053
• 关键词: Address; Adolescent and Young Adult; Age; Alcohols; Behavior; Behavior assessment; Biological; Biology; Birth; Blood; Blood specimen; Brain; COVID-19 pandemic; Child; Child Development; Chronic; Chronic stress; Collection; Data Collection; Development; Economics; Enrollment; Environment; Event; Exposure to; Future Generations; Generations; Geography; Hair; Health Resources; Health Sciences; Heterogeneity; Human Milk; Hydrocortisone; Individual; Individual Differences; Infant; Infant Behavior; Infant Development; Infection; Inflammation; Inflammatory; Investigation; Longitudinal cohort; Marijuana; Maternal Health; Maternal and Child Health; Measurement; Measures; Mediator of activation protein; Medical; Medical center; Mental Health; Mothers; Nail plate; Natural Disasters; New York; Oregon; Participant; Pathway interactions; Perinatal; Pharmaceutical Preparations; Phase; Placenta; Postpartum Period; Pregnancy; Prevalence; Psychological Stress; Questionnaires; Recording of previous events; Research; Resources; Risk; SARS-CoV-2 infection; Saliva; Sampling; Site; Social isolation; Stress; Stressful Event; Subgroup; Terrorism; Testing; Time; Tobacco; Trauma; Umbilical Cord Blood; United States National Institutes of Health; Universities; Variant; Vermont; Viral; Washington; Work; antibody test; behavior observation; cognitive development; cytokine; demographics; depressive symptoms; fetal; follow-up; high risk; improved; infant outcome; interest; intergenerational; longitudinal course; longitudinal dataset; maternal stress; morphogens; multimodality; neurodevelopment; offspring; opioid exposure; pandemic disease; perinatal mental health; perinatal period; postnatal; pregnant; prenatal stress; preventive intervention; recruit; repository; sample collection; social; stress symptom; stressor; substance use; symptomatology; systemic inflammatory response; transmission process

PROJECT SUMMARY The ongoing COVID-19 pandemic has led to significant changes in social, economic and health resource availability and associated escalations in substance use and mental health problems. The consequences of the pandemic for pregnant and postpartum individuals and their offspring will reveal themselves over the next several decades as these children become adolescents and young adults. The current proposal seeks to take advantage of a unique opportunity to continue and enrich an ongoing data collection effort with potential to reveal mechanisms through which the COVID-19 pandemic may impact future generations. This proposal builds on a project at Oregon Health & Science University (OHSU), which is harmonized with data collection efforts at seven geographically-representative sites from the NIH HEALthy Brains and Cognitive Development study (HBCD) initiative, including New York University, Washington University in St. Louis, University of Pittsburgh, Cedars Sinai Medical Center, University of Vermont and Northwestern University (R34 DA05029-S1). The OHSU site has exceeded enrollment targets for this initial project (N=371 versus the proposed N=100), successfully captured longitudinal trajectories of maternal stress and depressive symptoms during the early phase of the pandemic, and met targets for collection of biological samples and behavioral observations of mother-infant dyads (N=40). The OHSU site also serves as a central repository for biological samples collected at several other sites. The current proposal seeks to expand and enrich the sample at OHSU by enrolling pregnant individuals at heightened risk for substance use during the perinatal period (N=50). We additionally propose to expand biological sample collection of blood, breastmilk, hair, nails and saliva to include a larger sample of mothers and infants (N=100), and to occur at four time points (pregnancy, and infant age 1-, 6-, and 12-months). Finally, we propose to collect birth samples, umbilical cord blood and placenta, in a subsample of these participants (N=50). The continued follow up of our current sample, additional enrollment of higher-risk pregnant individuals and enhanced biological sampling will allow us to: 1) characterize trajectories of and heterogeneity in maternal perinatal psychological stress during the pandemic and identify key contributing factors differentiating subgroups; 2) advance understanding of the prevalence, longitudinal course and contributing factors to maternal perinatal substance use during the pandemic; and 3) test the hypothesis that heightened maternal-placental-fetal inflammation may serve as a common pathway for effects of maternal psychological stress and substance use on infant development. Accomplishing these aims will advance understanding of intergenerational transmission of risk during times of chronic stress and reduced resource availability, such as the COVID-19 pandemic. By enhancing capacity to examine contributors to maternal stress and substance use and mechanisms of impact on infant development, this work can also aide in identification of targets for preventive interventions to improve maternal and child health.

项目摘要 持续的COVID-19大流行导致社会、经济和卫生资源发生重大变化 药物使用和心理健康问题的可用性以及相关的升级。的后果 孕妇和产后个体及其后代的大流行将在未来几年内显现出来 几十年来，这些儿童成为青少年和年轻人。目前的建议旨在利用 这是一个独特的机会，可以继续和丰富正在进行的数据收集工作， COVID-19大流行可能影响后代的机制。该提案建立在 俄勒冈州健康与科学大学（OHSU）的一个项目，该项目与七个国家的数据收集工作相协调。 美国国立卫生研究院健康大脑和认知发展研究（六溴环十二烷）的地理代表性地点 倡议，包括纽约大学、圣路易斯华盛顿大学、匹兹堡大学、雪松大学 西奈医学中心，佛蒙特大学和西北大学（R34 DA 05029-S1）。 OHSU临床试验机构已超过该初始项目的入组目标（N=371 vs拟定N=100）， 成功捕捉到早期产妇压力和抑郁症状的纵向轨迹 在大流行的第一阶段，完成了收集生物样本和行为观察的目标。 母婴配对（N=40）。OHSU站点还作为收集的生物样本的中央储存库 在其他几个地方。目前的建议旨在扩大和丰富的样本在OHSU通过招收 围产期物质使用风险较高的孕妇（N=50）。我们另外 建议扩大血液、母乳、头发、指甲和唾液的生物样本收集， 母亲和婴儿的样本（N=100），并在四个时间点（妊娠，婴儿年龄1，6， 12个月）。最后，我们建议收集出生样本，脐带血和胎盘，在一个子样本， 这些参与者（N=50）。继续跟进我们当前的样本，额外招募高风险患者 怀孕的个体和增强的生物采样将使我们能够：1）表征 流行病期间产妇围产期心理压力的异质性，并确定关键的促成因素 区分亚组; 2）进一步了解患病率，纵向过程和贡献 大流行期间孕产妇围产期物质使用的因素;和3）测试假设， 母体-胎盘-胎儿炎症可能是影响母体心理因素的共同途径。 压力和物质使用对婴儿发育影响。实现这些目标将促进对 在长期紧张和可用资源减少的时期，风险的代际传递，例如 COVID-19大流行。通过加强审查造成产妇压力和药物使用的因素的能力， 以及对婴儿发育的影响机制，这项工作还可以帮助确定目标， 采取预防性干预措施，改善孕产妇和儿童健康。