Elucidating Mechanisms of Pregnancy's Protective Effect on Drug Abuse Using Integrated Data Analysis

利用综合数据分析阐明怀孕对药物滥用的保护作用机制

• 批准号: 10357793
• 负责人: Suena Huang Massey
• 金额: $ 56.79万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-01 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10357793
• 关键词: Adoption; Attenuated; Awareness; Characteristics; Child; Child Rearing; Clinical; Code; Cognition; Cognitive; Complex; Conceptions; Data; Data Analyses; Data Set; Development; Developmental Process; Drug Exposure; Drug abuse; Drug usage; Epidemiologist; Epidemiology; Event; Experimental Designs; Failure; Foundations; Future; Goals; Gold; Individual; Interruption; Intervention; Interview; Investigation; Investments; Knowledge; Link; Longevity; Measures; Mediator of activation protein; Methodology; Mothers; Multiple Pregnancy; National Institute of Drug Abuse; Nature; Outcome; Parents; Pathway interactions; Pattern; Persons; Pharmaceutical Preparations; Pregnancy; Pregnant Women; Prevention; Process; Psychiatrist; Public Health; Risk; Role; Sampling; Scientist; Second Pregnancy Trimester; Smoker; Smoking; Smoking Behavior; Smoking Cessation Intervention; Social Processes; Substance abuse problem; Testing; Time; To specify; Tobacco; Woman; Work; addiction; base; behavior change; cardiovascular disorder prevention; caregiving; child bearing; cigarette smoking; cohort; design; experience; fetal tobacco exposure; financial incentive; improved; innovation; insight; novel; offspring; person centered; precision medicine; prenatal; prenatal exposure; prenatal intervention; protective effect; psychosocial; smoking cessation; smoking during pregnancy; social; substance use; therapy design; tool; unborn child

PROJECT SUMMARY/ABSTRACT The notable protective effect of pregnancy on women’s tobacco and other drug use is a common yet understudied phenomenon in which addictive processes are temporarily attenuated in the absence of treatment. Identifying underlying mechanisms would provide novel insights into how addictive processes could be more effectively disrupted. To accelerate progress towards this goal and overcome methodologic limitations of prior studies, we repurpose multiple existing datasets with unique features to accomplish our aims. Specifically, we will: 1. Utilize a within-person design to estimate the unique “effect” of pregnancy, and salient events of pregnancy, on smoking behavior within a single pregnancy. 2. Isolate and estimate the impact of general and parenting-related developmental influences on smoking by examining between-pregnancy differences in a subset of women who were assessed on two pregnancies. 3. Examine the role of prenatal reflective functioning, coded from existing gold-standard qualitative interviews, in pregnancy’s protective effect on smoking. Aims 1 & 2 will provide the first ever estimates of precisely when and how pregnancy interacts with smoking behavior, setting the stage for future work to specify novel intervention targets. As reflective functioning is known to be malleable in substance using pregnant women, understanding its role in pregnancy-associated change in smoking will provides the foundation for novel smoking cessation interventions. This innovative proposal blends hypotheses generated from Dr. Massey’s (MPI) day-to-day clinical work as an addiction psychiatrist with the cutting-edge quantitative and methodological expertise necessary to rigorously test these hypotheses provided by epidemiologist Dr. Allen (MPI). Cohorts to be integrated contain short-term (within pregnancy) and long-term (across multiple pregnancies) longitudinal data, state-of-the-art drug exposure measures, and both qualitative and quantitative maternal data contributed by an experienced team of established developmental scientists: Drs. Neiderhiser (Co-I), Eiden (Co-I), and Wakschlag (Co-I). As data were originally developed with NIDA’s support to examine drug-exposed children, they are uniquely suited to examine drugs alone, and in combination. Knowledge from this study is needed to improve and personalize prenatal interventions and to guide future investigations of exposure-related offspring outcomes. Elucidating mechanisms underlying pregnancy’s protective effect on drug use also informs a broader understanding of how social processes successfully compete with addictive processes.

项目概要/摘要 怀孕对女性吸烟和其他药物使用具有显着的保护作用，这是一个常见的现象 尚未充分研究的现象，即成瘾过程在缺乏药物的情况下暂时减弱 治疗。识别潜在机制将为成瘾过程如何发挥作用提供新的见解 受到更有效的干扰。 为了加速实现这一目标并克服先前研究的方法学局限性，我们 重新利用多个具有独特功能的现有数据集来实现我们的目标。具体来说，我们将： 1. 利用内部设计来估计怀孕的独特“影响”以及怀孕期间的显着事件 怀孕期间的吸烟行为。 2. 分离并估计一般和养育相关的发育影响对吸烟的影响 检查对两次怀孕进行评估的一部分妇女的怀孕间差异。 3. 检查产前反思功能的作用，根据现有的黄金标准定性访谈进行编码， 怀孕对吸烟的保护作用。 目标 1 和 2 将首次准确估计怀孕何时以及如何与吸烟相互作用 行为，为未来工作确定新的干预目标奠定基础。由于反思功能是 已知对孕妇具有可塑性的物质，了解其在妊娠相关的作用 吸烟的变化将为新型戒烟干预措施奠定基础。 这项创新提案融合了 Massey 博士 (MPI) 日常临床工作中产生的假设： 成瘾精神病学家，拥有必要的尖端定量和方法专业知识 严格检验流行病学家 Allen 博士 (MPI) 提供的这些假设。要整合的队列包含 短期（怀孕期间）和长期（多次怀孕）纵向数据，最先进的 药物暴露测量，以及由经验丰富的母亲提供的定性和定量数据 成熟的发展科学家团队：博士。 Neiderhiser (Co-I)、Eiden (Co-I) 和 Wakschlag (Co-I)。 由于数据最初是在 NIDA 的支持下开发的，用于检查接触药物的儿童，因此它们是 非常适合单独和组合检查药物。需要从这项研究中获得知识来改进 个性化产前干预并指导未来对暴露相关后代的调查 结果。阐明妊娠对药物使用的保护作用的潜在机制也为研究提供了信息。 更广泛地了解社会过程如何成功地与成瘾过程竞争。