Prenatal Tobacco Use: Auditory Processing and Language

描述(由申请人提供)：将在340名婴儿产后24个月的队列中评估孕妇使用烟草对后代听觉处理、音素感知和早期语言的影响。怀孕期间吸烟仍然是一个公共卫生问题，高达20%的新生儿经历了这种潜在的致畸暴露。虽然与发育迟缓的关系已经得到很好的证实，但对行为和认知结果的影响，特别是在发育早期的影响，还没有得到很好的描述。这项研究将集中在发育早期对听觉信息和音素刺激的处理，同时控制接触其他药物(如酒精)以及也影响认知和语言发展的家庭和环境因素。接触到大量围产期人口将能够调查重度吸烟(每天30支)，并确定烟草烟雾暴露水平与影响发育结果的因素之间的剂量-反应关系。烟草暴露量将通过母亲自我报告(即每天吸烟数量)和生物措施(即母亲和婴儿可替宁水平，尼古丁的一个生物标记物)来衡量。样本将被分层，以允许包括那些否则无法识别的重度吸烟者。将包括四个级别的使用：无、10至19支/天、20至29支/天和30支/天以上。家庭将在出生后招募，并跟踪到24个月，在6个月、15个月和24个月时进行实验室访问。听觉处理和音素感知将使用信息处理方法和心理生理学结果衡量标准进行操作。早期语言技能将使用自然语言样本的转录(SALT)以及标准化的交流措施和父母的语言发展报告进行综合评估。烟草烟雾暴露(包括出生后环境暴露)预计会在前24个月对听觉和音素处理技能产生负面影响，并与特定的语言延迟有关。所有分析将控制其他对结果的影响(即酒精暴露、护理潜力、护理质量，包括语言环境、儿童健康和听力)。

DESCRIPTION (provided by applicant): The impact of tobacco use by pregnant women on auditory processing, phonemic perception and early language in offspring will be evaluated in a cohort of 340 infants followed to 24 months postpartum. Tobacco smoking during pregnancy continues to be a public health problem with up to 20% of newborns experiencing this potentially teratogenic exposure. Although an association with growth retardation is well established, the impact on behavioral and cognitive outcomes, particularly early during development, has not been well described. This study will focus on processing of auditory information and phonemic stimuli early in development while controlling for exposure to other drugs (e.g., alcohol) and familial and environmental factors that also affect cognitive and language development. Access to a large perinatal population will allow the investigation of heavy smoking (>30 cigarettes/day) as well as determination of the dose-response relationship between levels of tobacco smoke exposure and factors affecting developmental outcome. Quantity of tobacco exposure will be measured both through maternal self-report (i.e., number of cigarettes/day) and biological measures (i.e., maternal and infant cotinine levels, a biomarker of nicotine). The sample will be stratified to allow inclusion of heavy smokers who would not be identified otherwise. Four levels of use will be included: None, 10 to 19 cigarettes/day, 20 to 29 cigarettes/day, and more than 30 cigarettes/day. Families will be recruited postnatally and followed to 24 months with laboratory visits at 6-, 15-, and 24 months. Auditory processing and phonemic perception will be operationalized using information processing methodology and psychophysiological outcome measures. Early language skills will be comprehensively evaluated using both transcriptions of natural language samples (SALT) and standardized measures of communication and parental report of language development. Tobacco smoke exposure (including postnatal environmental exposure) is predicted to negatively impact auditory and phonemic processing skills during the first 24 months and to be related to specific language delays. All analyses will control for other contributions to outcomes (i.e., Alcohol exposure, Caregiving potential, Quality of Caregiving, including language environment, Child Health and Hearing).