COCAINE EXPOSED INFANTS AND THEIR MOTHERS

描述：（申请人摘要） 在贫穷、城市、 在过去十年中， 胎儿接触可卡因对发育中的 孩子 母亲使用可卡因也与许多其他风险有关 可能对儿童结果产生负面影响的条件，例如 虐待/忽视儿童的风险，母亲心理压力更大， 改变照顾行为和暴力暴露 除了 记录学龄前和早期学龄儿童的一系列结果， 这项拟议中的研究旨在评估环境和产妇心理 可卡因暴露儿童的结果的相关性。 拟议的研究将是一项纵向、前瞻性、 调查（NIDA 07957）的医疗，环境和发展 在生命的头两年接触可卡因的相关性。 377 婴儿（195名接触可卡因; 182名未接触可卡因）及其母亲/照料者 将在4岁和6岁时进行观察，并进行标准化评估， 生长、认知、情感行为、语言和神经心理学 结果。 通过生物学（尿液/胎粪）和 自我报告措施，所有儿童来自同一种族/社会 类人群，并匹配极低出生体重状态。 出生时， 人口统计学，医疗，和产前药物滥用暴露注意到， 病历回顾临床访谈和胎粪分析 标准化 问卷评估产妇的心理状况，应对方式，社会 支持，智力和暴露于暴力， 以前的评估将被更新。 环境风险，包括 虐待/忽视、成长失败、离家安置以及特征 家庭环境，将被记录在整个。 录像 儿童游戏和母婴互动的观察将是 进行。 数据将通过一系列 MANOVAS/MANCOVAS（重复测量）和分层多指标 回归描述可卡因暴露儿童的功能， 学龄前和学龄前儿童，以及可卡因和 其他药物暴露对儿童结局、孕产妇心理功能、 和环境风险。 既往纵向研究的数据集将 与4年和6年数据合并，以评估随时间的变化和预测 婴儿风险模型，使用HLM或结构方程模型。 的 拟议的研究将提供有关长期儿童的信息， 胎儿可卡因暴露的发育后遗症与母亲心理 地位和照顾行为，可以指导有效的设计， 产妇药物治疗和儿童干预方案。

DESCRIPTION: (Applicant's Abstract) Cocaine use by pregnant women has stabilized at high rates in poor, urban, minority populations over the past decade, with resultant concern over the long-term negative effects of fetal cocaine exposure on the developing child. Maternal use of cocaine is also associated with numerous other risk conditions which can negatively affect child outcomes, such as increased risk for child abuse/neglect, greater maternal psychological distress, altered care-giving behavior, and violence exposure. In addition to documenting a range of child outcomes at preschool and early school ages, the proposed study aims to assess environmental and maternal psychological correlates of outcome in cocaine-exposed children. The proposed study will be a continuation of a longitudinal, prospective investigation (NIDA 07957) of the medical, environmental, and developmental correlates of cocaine exposure during the first two years of life. 377 infants (195 cocaine exposed; 182 non-exposed) and their mothers/care givers will be seen at 4 and 6 years of age, and given standardized assessments of growth, cognitive, emotional-behavioral, language, and neuropsychological outcomes. Cocaine exposure was determined by biologic (urine/meconium) and self-report measures, with all children drawn from the same race/social class population, and matched for very low birth weight status. At birth, demographic, medical, and prenatal substance abuse exposure were noted from chart review, clinical interview, and meconium analysis. Standardized questionnaires assessing maternal psychological status, coping style, social supports, intellectual ability, and exposure to violence which were previously assessed will be updated. Environmental risk, including abuse/neglect, growth failure, out of home placement, and characteristics of the home environment, will be documented throughout. Videotaped observations of child play and maternal child interactions will be conducted. Data will be evaluated descriptively, and through a series of MANOVAS/MANCOVAS (with repeated measures), and hierarchical multiple regression to describe the functioning of cocaine-exposed children at preschool and early school ages, and the relative impact of cocaine and other drug exposures to child outcomes, maternal psychological functioning, and environmental risk. Data sets from the prior longitudinal study will be merged with 4 and 6 year data to assess change over time and predictive models of infant risk, using HLM or structural equation models. The proposed research will provide information about long-term child developmental sequelae of fetal cocaine-exposure and maternal psychological status and care giving behaviors which can guide the design of effective maternal drug treatment and child intervention programs.