Psychosocial and neurobiological stress and opioid use trajectories following pregnancy

摘要 母亲的阿片成瘾是一个重大的公共卫生问题，影响双方的健康和福祉。 孕期和产后期的母亲及其发育中的孩子。至关重要的是，塑造因素 孕妇在怀孕期间和出生后使用阿片类药物的轨迹尚不清楚。新兴研究 表明怀孕期间和产后第一年心理社会压力水平的升高可能 解释阿片类药物复发风险的增加，与更多的研究一致，这些研究记录了 应激在成瘾的启动和维持中的作用，以及一个新兴的工作重点 特别是在养育压力和成瘾方面。在目前的应用中，我们将采用短期的 纵向设计探讨孕期心理社会和育儿压力的生物行为机制 接受药物辅助治疗(MAT)治疗阿片类药物使用障碍且符合人口统计学特征的女性 没有接受垫子的孕妇。在怀孕期间，我们将测量心理社会压力和母亲的耐受性。 伴随着渴求和戒断症状的婴儿窘迫。分娩后，母亲们会 完成月度评估，以进一步确定心理社会和育儿压力的特征，并 上瘾症状。此外，母亲将在1个月和4个月时完成神经成像评估 产后识别对婴儿(和非婴儿)痛苦信号作出反应的神经机制。我们的 心理社会和育儿压力的生物行为特征将被用来预测 垫子粘附性。综上所述，这个R01应用程序用于鉴定一种新的生物行为表型 孕期和产后早期可能存在的心理社会和育儿压力 增加阿片类药物复发的风险。

Abstract Maternal opioid addiction is a significant public health concern, impacting the health and well-being of both mothers and their developing child during pregnancy and the postpartum period. Crucially, factors shaping maternal opioid use trajectories during pregnancy and after birth are not well understood. Emerging research indicates that elevated levels of psychosocial stress during pregnancy and the first year postpartum may explain increased risk for opioid relapse, consistent with a larger body of research that has documented the role of stress in the initiation and maintenance of addiction generally, and an emerging body of work focusing on parenting stress and addiction specifically. In the current application, we will employ a short-term longitudinal design to probe the biobehavioral mechanisms of psychosocial and parenting stress in pregnant women receiving medication assisted treatment (MAT) for opioid use disorder and demographically-matched pregnant women not receiving MAT. In pregnancy we will measure psychosocial stress and maternal tolerance of infant distress alongside characterizing craving and withdrawal symptoms. After delivery, mothers will complete monthly batteries of assessments to further characterize psychosocial and parenting stress and addiction symptoms. Additionally, mothers will complete neuroimaging assessments at 1 and 4 months postpartum to identify neural mechanisms of responding to infant (and non-infant) distress cues. Our biobehavioral characterization of psychosocial and parenting stress will then be employed in the prediction of MAT adherence. Taken together, this R01 application serves to identify a novel biobehavioral phenotype of psychosocial and parenting stress present in pregnancy and the early postpartum period that may confer increased risk for opioid relapse.