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

项目摘要/摘要 鉴于不断恶化的统计数据，宫内接触阿片类药物正引起社会的重大关注 关于阿片类药物在育龄妇女中的使用和滥用情况。在过去的20年里， 全美阿片类药物使用率增加了300%，与阿片类药物相关的数量 死亡人数增加了约500%，新生儿禁欲的新生儿数量 综合症(NAS)增加了近400%。因此，阿片类药物危机是一种 使发育中的儿童面临显著增加风险的一系列不利条件 对于死亡率、妊娠小增长、早产、出生后发育不全和恶化 神经行为、学术和社会结果。新出现的数据表明，在子宫内 物质暴露与各种负面的健康和认知后果有关。我们 假设产前物质暴露与心理健康/认知之间的关联 结果是由出生前物质暴露对大脑发育的影响所中介的；我们 进一步假设背景环境变量，例如低SES、低母体 教育和高水平的压力暴露，缓解了这些发育后遗症。在这 链接提案我们将使用一系列行为和神经成像工具，从LATH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.