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: 9017986
• 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/9017986
• 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; Child Rearing; 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; 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; behavioral outcome; biobehavior; caregiving; cell injury; cognitive function; design; environmental tobacco smoke exposure; fetal; high risk; improved; infancy; infant monitoring; infant outcome; motor control; non-smoker; parental role; pregnant; premature; prenatal; prenatal exposure; prospective; 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）：即使有所有已知的健康风险，最近的证据表明，怀孕期间高达15％的女性吸烟，而在发现自己怀孕的妇女中只有18-25％的妇女会停止。尼古丁的产前消费与许多严重的健康问题以及童年的行为和认知障碍有关。因此，在模式变得稳定且更难改变之前，从生命的早期几个月中识别和治疗处于风险的儿童非常重要。可以通过适当的干预措施来减轻不利的结果，但首先必须更仔细地检查产前暴露与不良的社会情感和认知结果和轨迹的特定机制。拟议的试点研究旨在阐明这种机制。将探索产前暴露于香烟的途径与婴儿社会情感和认知结果在9个月之间的途径，重点是婴儿睡眠的中介作用。此外，这项研究旨在检查婴儿的路径是否与护理的关系有所不同，并将试图区分一般的护理行为（即敏感性）和在睡前/夜晚的行为的影响，这可能会通过其对婴儿睡眠质量的影响影响结果。当前的研究将在怀孕的第二个三个月（80名吸烟者，40名非吸烟者）中招募120名妇女。在怀孕期间，将评估孕妇香烟和其他药物使用，并将（出生时）收集和分析一块脐带，以评估产前暴露于尼古丁。此外，将分析婴儿唾液在每个年龄段目前暴露于环境烟雾中。在3个月的时间里，摄像机将在多个位置进行设置，以捕捉母亲在睡前和整夜的互动，以评估特定的护理人员的实践和情感上的可用性，并且婴儿将佩戴Actiwatch，在睡眠中记录7天的运动，并在9个月的婴儿生物行为，在行为，副交感神经的响应和挑战时，请及时努力。最后，将在3个月和9个月的年龄段关注者互动中记录在家中，以供以后的育儿行为编码。在此高风险人群中进行了拟议的前瞻性和纵向试点研究，并利用尖端方法评估胎儿和 婴儿香烟的暴露和睡眠观察度量将为在本奖项的后几年提交R01赠款提案的坚实基础。在此期间获得的知识还将为我的长期目标奠定基础，即为有风险的家庭开发干预措施。