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Postpartum Smoking Relapse Prevention by Breastfeeding Promotion -

通过推广母乳喂养预防产后吸烟复吸 -

基本信息

批准号：
10019142
负责人：
Xiaozhong Wen
金额：
$ 1.44万
依托单位：
STATE UNIVERSITY OF NEW YORK AT BUFFALO
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-01-01 至 2021-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10019142
关键词：
Address Adrenal Glands Air Amygdaloid structure Anger Anxiety Applications Grants Attention Behavioral Brain Breast Feeding Child Child Care Child Development Child Health Conceptions Control Groups Cotinine Counseling Data Dopamine Education Emotional Enrollment Etiology Family Financial compensation Fostering Frequencies Fright Future Hand Hormonal Hormones Human Milk Hypothalamic structure Infant Infant Behavior Infant Development Infant Health Infant formula Intervention Investments Lactation Late pregnancy Life Massage Maternal Behavior Maternal and Child Health Mediating Mediation Mental Depression Milk Milk Ejection Monitor Mothers Neurosecretory Systems Oxytocin Pamphlets Pharmacology Pilot Projects Pituitary Gland Plasma Postpartum Period Pregnancy Pregnant Women Prenatal care Prolactin Public Health Randomized Randomized Controlled Trials Relapse Reporting Research Rewards Risk Role Skin Smoke Smoker Smoking Stimulus Stress Syringes System Testing Time Tobacco Uncertainty United States National Institutes of Health Urine Visit Woman biological adaptation to stress clinical practice craving disorder later incidence prevention environmental tobacco smoke exposure feeding feeding plan financial incentive follow-up group intervention incentive-based intervention innovation intervention program maternal stress milk production multi-component intervention negative affect novel strategies offspring peer postnatal prenatal prevent primary outcome protective effect psychologic response smoking abstinence smoking cessation smoking during pregnancy smoking relapse stressor success successful intervention suckling

项目摘要

About 23% of U.S. women smoke at conception, and 54% of them report quitting spontaneously during pregnancy. However, large numbers of women who quit during pregnancy return to smoking (“relapse”) after delivery, e.g., 45% and 81% relapse by 6 and 12 months postpartum, respectively. Postpartum smoking relapse not only limits benefits of smoking abstinence to the mother, but also has serious negative consequences for child health and development through tobacco metabolites in breast milk and ambient air. There is little success in preventing long-term (9 months or longer) postpartum smoking relapse by existing interventions. Breastfeeding mothers tend to have lower risk of postpartum smoking relapse than formula-feeding mothers, although the causality of this association is unclear. It is possible that ex-smoking mothers who are less likely to relapse choose to breastfeed longer. But the reverse may also be true, i.e., mothers who breastfeed may be less likely to relapse, partly due to the hormonal (high oxytocin and prolactin), emotional, and mother-infant relationship benefits resulting from breastfeeding. A randomized controlled trial to reduce postpartum smoking relapse by promoting breastfeeding may not only move the field forward by addressing the uncertainty of causality, but also yield a new approach to reducing the large public health problem of postpartum smoking relapse that has long lasting benefits for mothers and infants. We propose the first randomized controlled trial to reduce postpartum smoking relapse by breastfeeding promotion from late pregnancy to 6 months postpartum. We will enroll 60 pregnant women who successfully quit smoking within 3 months before or during this pregnancy (<28 weeks) and randomize them into either the breastfeeding intervention group (N=30) or the control group (N=30). The intervention group will receive multicomponent interventions consisting of prenatal breastfeeding education, postnatal lactation counseling, family/peer/employer support, contingent financial incentives, and early limited formula milk via syringe (optional for at-risk infants). The control group will receive only a brief pamphlet on breastfeeding education. The primary outcome is timing of postpartum smoking relapse verified by urine cotinine test. Specific Aim 1 is to examine the efficacy of breastfeeding promotion intervention on postpartum smoking relapse. Specific Aim 2 is to collect preliminary data regarding potential mediating mechanisms: increases in lactation hormones (plasma oxytocin and prolactin), enhancing mother-infant relationship (bonding and positive maternal and infant behaviors during interactions), and reductions in stress and negative affect. This innovative and feasible pilot study can yield promising preliminary data to strongly support our future application of a NIH R01 grant proposal that has the potential to reduce smoking-related harms to both the mother and the infant, and maximize the protective effects of breastfeeding on infant health and development.

大约 23% 的美国女性在受孕时吸烟，其中 54% 的女性表示在受孕期间自发戒烟怀孕。然而，大量在怀孕期间戒烟的女性在怀孕后又重新吸烟（“复吸”）。分娩后，例如，产后 6 个月和 12 个月分别有 45% 和 81% 复发。产后吸烟复吸不仅限制了母亲戒烟的好处，而且还带来严重的负面影响母乳和环境空气中的烟草代谢物对儿童健康和发育产生影响。现有的方法在预防长期（9个月或更长时间）产后吸烟复发方面收效甚微。干预措施。母乳喂养的母亲比配方奶喂养的母亲产后复吸的风险更低母亲们，尽管这种关联的因果关系尚不清楚。戒烟的妈妈们有可能复发可能性较小的人会选择更长时间的母乳喂养。但反之亦然，即母亲们母乳喂养可能不太可能复发，部分原因是荷尔蒙（高催产素和催乳素）、情绪、母乳喂养对母婴关系也有好处。一项旨在减少通过促进母乳喂养来控制产后吸烟复发可能不仅可以通过解决问题来推动该领域的发展因果关系的不确定性，但也产生了一种新的方法来减少巨大的公共卫生问题产后吸烟复发对母亲和婴儿有长期持续的好处。我们提出第一个随机对照试验，通过以下方式减少产后吸烟复发：从怀孕后期到产后 6 个月提倡母乳喂养。我们将招募60名孕妇怀孕前或怀孕期间（<28周）3个月内成功戒烟并将其随机化分为母乳喂养干预组（N=30）或对照组（N=30）。干预组将接受多方面干预措施，包括产前母乳喂养教育、产后哺乳咨询、家庭/同伴/雇主支持、或有经济激励以及早期有限配方奶注射器（高危婴儿可选）。对照组将仅收到一本关于母乳喂养的简短小册子教育。主要结果是通过尿液可替宁测试验证产后吸烟复发的时间。具体目标1是检验促进母乳喂养干预对产后的效果吸烟复发。具体目标 2 是收集有关潜在中介机制的初步数据：哺乳激素（血浆催产素和催乳素）增加，增强母婴关系（亲密关系）以及互动期间母亲和婴儿的积极行为），以及压力和负面情绪的减少。这项创新且可行的试点研究可以产生有希望的初步数据，为我们的未来提供强有力的支持 NIH R01 拨款提案的申请有可能减少与吸烟相关的危害母亲和婴儿，最大限度地发挥母乳喂养对婴儿健康和发育的保护作用。

项目成果

期刊论文数量（11）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Changes in e-cigarette and cigarette use during pregnancy and their association with small-for-gestational-age birth.

DOI：
10.1016/j.ajog.2021.11.1354
发表时间：
2022-05
期刊：
American journal of obstetrics and gynecology
影响因子：
9.8
作者：
通讯作者：

Prenatal predictors of postpartum depression trajectories from birth to 24 months amongst smoking women.

吸烟女性从出生到 24 个月的产后抑郁症轨迹的产前预测因素。

DOI：
10.1111/jocn.16019
发表时间：
2022-06
期刊：
Journal of clinical nursing
影响因子：
4.2
作者：
Frndak S;Syed S;Saleh J;Kocher M;Wen X
通讯作者：
Wen X

Potentially modifiable mediators for socioeconomic disparities in childhood obesity in the United States.

DOI：
10.1002/oby.23379
发表时间：
2022-03
期刊：
Obesity (Silver Spring, Md.)
影响因子：
0
作者：
Wen X;Mi B;Wang Y;Taveras EM;Bartashevskyy M
通讯作者：
Bartashevskyy M

Reducing fetal origins of childhood obesity through maternal smoking cessation during pregnancy: an intervention study.

通过母亲怀孕期间戒烟减少儿童肥胖的胎儿起源：一项干预研究。

DOI：
10.1038/s41366-018-0267-y
发表时间：
2019
期刊：
International journal of obesity (2005)
影响因子：
0
作者：
Wen,Xiaozhong;Eiden,RinaD;Justicia-Linde,FayeE;Wang,Youfa;Higgins,StephenT;Kong,KaiLing;Shittu,AbdalAzizT;Perkins,JacobM;Esadah,Priscilla;Mautner,TaylorE;Epstein,LeonardH
通讯作者：
Epstein,LeonardH

Personal exposure to benzene, toluene, ethylbenzene, and xylenes (BTEXs) mixture and telomere length: A cross-sectional study of the general US adult population.