Maternal Age, Trajectories of Substance Use, and Health Disparities

描述（由申请人提供）：年轻的母亲从事物质使用和艾滋病毒风险行为的比例较高，他们的孩子也更有可能从事这些行为和经历少女怀孕。早期意外怀孕表明，年轻母亲的后代在青春期从事无保护的性行为，使自己处于感染性病的危险之中。没有研究比较了母亲的物质使用模式之前，在育儿过程中，以检查母亲的年龄对物质使用的发展模式的影响，从其他混淆与母亲的年龄。本研究的目的是探讨母亲使用物质的轨迹作为母亲年龄对儿童危险行为和健康的影响的调节剂。 拟议的研究将利用2个现有的大型社区出生队列。在一个案例中，母亲在第一次产前评估时年龄为12-18岁。在另一组中，母亲年龄在18-42岁之间。最初研究的目的是检查产前物质使用的长期影响。两个队列均包括妊娠前、妊娠期间和妊娠后4个时间点（儿童6岁、10岁、14岁和16岁时）的母体物质使用数据。母研究收集了来自各种领域的数据，包括详细的人口统计学，心理和行为特征。更大的合并数据集将允许随着时间的推移使用先进和复杂的统计模型，并允许我们测试几个新的问题，如产妇年龄，药物使用和儿童健康按种族和性别分层。 我们的具体目标是（1）确定母亲的物质使用轨迹;（2）确定母亲在第一次生育时的年龄是否预测轨迹成员资格;（3）检查物质使用和生殖风险的种族差异;（4）调查母亲物质使用轨迹对不同种族青少年后代生殖风险的影响;以及（5）测试母亲使用物质是否会调节母亲年龄对不同种族青少年后代生殖风险的影响。 本申请的一个创新特点是，我们提出并测试了一个新的理论模型，母亲的年龄和母亲的物质使用对后代的早期生殖风险。这一模型以脆弱性模型和生命过程理论为基础，将有助于阐明母亲年龄与下一代危险行为和生殖健康之间的联系。该模型将为针对高危家庭的干预策略提供实证支持。该提案既省时又省钱，因为我们可以从两个出生队列中获得16年的前瞻性纵向数据。到目前为止，没有研究审查的作用，产妇年龄和长期模式的物质使用的育龄妇女，以确定如何产妇物质使用可能有助于早期儿童物质使用和青少年生殖风险。

DESCRIPTION (provided by applicant): Younger mothers engage in higher rates of substance use and HIV risk behaviors, and their children are also more likely to engage in these behaviors and experience teenage pregnancy. Early unplanned pregnancies suggest that offspring of younger mothers are engaging in unprotected sex during adolescence, placing themselves at risk for STDs. No studies have compared maternal patterns of substance use before and during childrearing to examine the effect of maternal age on developmental patterns of substance use in isolation from other confounds associated with maternal age. The goal of this study is to examine trajectories of maternal substance use as a moderator of the effect of maternal age on child risky behavior and health. The proposed study will take advantage of 2 large existing community-based birth cohorts. In one, the mothers were 12-18 years old at the first prenatal assessment. In the other, the mothers were 18-42 years old. The aims of the original studies were to examine the long-term effects of prenatal substance use. Both cohorts include data on maternal substance use prior to pregnancy, during pregnancy, and 4 time points after pregnancy (when the children were 6, 10, 14 and 16 years old). The parent studies collected data from a wide variety of domains, including detailed demographic, psychological and behavioral profiles. The larger combined dataset will permit advanced and complex statistical models of substance use over time, and permit us to test several new questions about maternal age, substance use and child health stratified by race and gender. Our specific aims are to (1) identify maternal trajectories of substance use; (2) determine if maternal age at first birth predicts trajectory membership; (3) examine racial differences in substance use and reproductive risk; (4) investigate the effect of maternal substance use trajectories on reproductive risk in adolescent offspring of different races; and (5) test if maternal substance use moderates the effect of maternal age on reproductive risk in adolescent offspring of different races. An innovative feature of this application is that we are proposing and testing a new theoretical model of maternal age and maternal substance use on early reproductive risk in offspring. This model is based on vulnerability models and life course theory, and will help elucidate the mechanisms linking maternal age to risky behavior and reproductive health in the next generation. This model will provide empirical support for targeted intervention strategies with at-risk families. The proposal is both time- and cost-effective because we have access to 16 years of prospective, longitudinal data from two birth cohorts. To date, no studies have examined the role maternal age and long-term patterns of substance use in childbearing women to determine how maternal substance use may contribute to early child substance use and adolescent reproductive risk.