Teen Mothers’ Prenatal Cannabis Use and Co-Use with Tobacco

青少年母亲——产前大麻的使用以及与烟草的共同使用

• 批准号: 10576916
• 负责人: Natacha Marie De Genna
• 金额: $ 61.76万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-01 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10576916
• 关键词: Adolescent; Adult; Age; Attention; Attitude; Back; Behavior; Belief; Biological; Cannabis; Characteristics; Child Rearing; Cohort Studies; Computerized Medical Record; Data; Developed Countries; Development; Electronic Health Record; Environment; Family; Family Characteristics; First Pregnancy Trimester; Frequencies; Health Personnel; Human; Infant; Infant Development; Insurance Coverage; Interview; Link; Literature; Live Birth; Low Birth Weight Infant; Marijuana Dependence; Matched Group; Measures; Mediating; Medical; Medical Records; Memory; Mental Health; Methods; Mothers; Multivariate Analysis; Neonatal; Outcome; Participant; Pathway interactions; Pattern; Perinatal; Postpartum Period; Poverty; Pregnancy; Pregnancy in Adolescence; Premature Birth; Prenatal care; Prevention; Public Health; Race; Reporter; Research; Risk; Safety; Science; Second Pregnancy Trimester; Services; Social Conditions; Social Environment; Social Work; Standardization; Tablets; Teenagers; Temperament; Teratogens; Testing; Third Pregnancy Trimester; Time; Tobacco; Tobacco Dependence; Tobacco use; addiction; adverse birth outcomes; adverse outcome; behavioral outcome; cannabis use behavior; clinical practice; cognitive development; data warehouse; delivery complications; emotion regulation; environmental tobacco smoke exposure; fetal marijuana exposure; fetal tobacco exposure; girls; health disparity; infant outcome; innovation; longitudinal, prospective study; marijuana use; marijuana use in pregnancy; marijuana user; maternal outcome; multiple data sources; neurodevelopment; nicotine exposure; offspring; peer; perceived stress; perinatal cannabis use; post pregnancy; postnatal; pregnant; pregnant teen; prenatal; prenatal exposure; recruit; smoking cessation; social; social health determinants; stressor; substance use; teenage mother; timeline; tobacco exposure; unintended pregnancy; violence exposure

The science regarding the safety of cannabis use in pregnant teens urgently needs to catch up to the rapidly increasing acceptance, availability, and potency of today’s cannabis, along with increasing co-use of cannabis with tobacco. Pregnant teens may find it more difficult than pregnant adults to quit smoking tobacco and cannabis. Cannabis is three times more potent than the cannabis used in earlier cohort studies of adult mothers. Yet, older studies with adult mothers found subtle yet persistent effects of prenatal cannabis exposure (PCE) and prenatal tobacco exposure (PTE) on behavioral outcomes. This study is based upon the body of evidence showing striking differences between substance use in teen and adult mothers, recent societal changes in cannabis use, and the dangers of co-use with tobacco. It is crucial to determine whether cannabis and co-using pregnant teens differ from other pregnant teens, and to determine the effects of PCE and co-exposure on their infants and family functioning in the postpartum. Aim 1: Determine maternal and family characteristics associated with cannabis use and co-use with tobacco in pregnant adolescents from the 1st trimester through 6 and 12 months postpartum. Aim 2: Identify trimester-specific effects of exposures to PCE and co-use with tobacco on infant neurodevelopment and memory, as well as maternal mental health, perceived stress, and use of social services, controlling for baseline differences among pregnant adolescents. The proposed study uses a mixed-methods approach to investigate cannabis and tobacco use in teen mothers during and after pregnancy, factors associated with their persistence and desistance of cannabis and tobacco use, and the effects of PCE and co-use on mother and infant outcomes at delivery, 6, and 12 months. We will screen 1,120 pregnant teens for 1st trimester substance use, to recruit 620 girls for a prospective, longitudinal study. We will match these 4 groups on race, age, and insurance status: cannabis-only (PCE), tobacco-only (PTE), cannabis + tobacco (PCE+PTE), and non-users. Participants will be seen at the 2nd and 3rd trimesters, and 6 months postpartum. Delivery and neonatal data will be extracted from medical records for all live births, and data on medical and public services usage will be obtained from the electronic health record and the PA Department of Human Services Data Warehouse 12 months postpartum. Maternal substance use and functioning will be measured using Timeline Followback interviews, standardized assessments on tablets, and biological quantification. Infant development, temperament, and secondhand smoke exposure will be assessed 6 months postpartum. For a better understanding of pregnant and parenting teens’ beliefs, attitudes, and the social contexts of their cannabis and co-use with tobacco, a subsample (n=15/group) will complete qualitative interviews at each time point. The innovative combination of standardized assessments, rich qualitative data, biological quantification, electronic medical record, and public services data will provide robust and unbiased data of current perinatal cannabis use and co-use with tobacco in pregnant teens, associated maternal characteristics, and infant outcomes.

关于怀孕青少年使用大麻安全性的科学迫切需要跟上快速发展的步伐 当今大麻的接受度、可用性和效力不断提高，同时大麻的共同使用也不断增加 与烟草。怀孕的青少年可能会发现比怀孕的成年人更难戒烟，并且 大麻。大麻的效力是早期成年母亲队列研究中使用的大麻的三倍。 然而，对成年母亲的较早研究发现，产前接触大麻（PCE）会产生微妙但持久的影响 和产前烟草暴露（PTE）对行为结果的影响。这项研究基于大量证据 青少年母亲和成年母亲的物质使用之间存在显着差异，最近的社会变化 大麻的使用以及与烟草共同使用的危险。确定大麻和共同使用是否至关重要 怀孕青少年与其他怀孕青少年不同，并确定 PCE 和共同暴露对其的影响 婴儿和产后家庭的功能。目标 1：确定母亲和家庭特征 与怀孕第一个月至第六个月的怀孕青少年使用大麻和同时使用烟草有关 以及产后12个月。目标 2：确定四氯乙烯暴露对妊娠期的特定影响并与 烟草对婴儿神经发育和记忆力以及母亲心理健康、感知压力和使用的影响 社会服务，控制怀孕青少年之间的基线差异。拟议的研究使用 采用混合方法调查青少年母亲在怀孕期间和怀孕后使用大麻和烟草的情况， 与他们持续和停止使用大麻和烟草相关的因素，以及四氯乙烯的影响 以及共同使用对分娩时、6 个月和 12 个月时母婴结局的影响。我们将对 1,120 名怀孕青少年进行筛查 针对孕早期药物使用情况，招募 620 名女孩进行前瞻性纵向研究。我们将匹配这 4 个 关于种族、年龄和保险状况的群体：仅大麻 (PCE)、仅烟草 (PTE)、大麻 + 烟草 （PCE+PTE）和非用户。参与者将在妊娠第二、第三个月以及产后 6 个月进行观察。 分娩和新生儿数据将从所有活产的医疗记录以及医疗和新生儿数据中提取。 公共服务的使用情况将从电子健康记录和 PA 人力部获得 服务数据仓库产后 12 个月。将测量母体物质的使用和功能 使用时间线追踪访谈、平板电脑标准化评估和生物量化。婴儿 将在产后 6 个月评估发育、气质和二手烟暴露情况。对于一个 更好地了解怀孕和育儿青少年的信仰、态度和大麻的社会背景 并与烟草共同使用，子样本（n=15/组）将在每个时间点完成定性访谈。这 标准化评估、丰富的定性数据、生物定量、电子化的创新组合 医疗记录和公共服务数据将提供当前围产期大麻使用的可靠且公正的数据 怀孕青少年与烟草的共同使用、相关的母亲特征和婴儿结局。

项目成果

Barriers to Diagnosis of Postpartum Depression among Younger Black Mothers.

年轻黑人母亲诊断产后抑郁症的障碍。

• DOI: 10.21203/rs.3.rs-2500330/v1
• 发表时间: 2023
• 期刊: Research square
• 作者: Dwarakanath,Megana;Hossain,Fahmida;Balascio,Phoebe;Moore,MikaelaC;Hill,AshleyV;DeGenna,NatachaM
• 通讯作者: DeGenna,NatachaM

Young black women's desired pregnancy and birthing support during coronavirus disease 2019 pandemic.

2019 年冠状病毒病大流行期间，年轻黑人女性渴望怀孕和分娩支持。

• DOI: 10.1016/j.ssmqr.2023.100333
• 发表时间: 2023
• 期刊: SSM. Qualitative research in health
• 作者: Hill,AshleyV;Balascio,Phoebe;Moore,Mikaela;Hossain,Fahmida;Dwarkananth,Megana;DeGenna,NatachaM
• 通讯作者: DeGenna,NatachaM

Experiences of postpartum mental health sequelae among black and biracial women during the COVID-19 pandemic.

• DOI: 10.1186/s12884-023-05929-3
• 发表时间: 2023-09-04
• 期刊: BMC pregnancy and childbirth
• 影响因子: 3.1

Pandemic stressors and vaccine hesitancy among young, pregnant Black people: A qualitative study of health disparities during a global pandemic.

年轻怀孕黑人的流行病压力源和疫苗犹豫：全球流行病期间健康差异的定性研究。

• DOI: 10.1002/bdr2.2262
• 发表时间: 2023
• 期刊: Birth defects research
• 影响因子: 2.1
• 作者: DeGenna,NatachaM;Hossain,Fahmida;Dwarakanath,Megana;MsBalascio,Phoebe;MsMoore,Mikaela;Hill,AshleyV
• 通讯作者: Hill,AshleyV