Maternal Lifestyle Study Phase 5

产前药物暴露仍然是一个重大的公共卫生问题，影响着数百万儿童，并给社会带来巨大的经济和社会负担。关于产前接触可卡因对进入青春期的儿童的心理、发育、医疗或身体结果的影响，人们知之甚少。产妇生活方式研究（MLS）是一项机构间合作，涉及国家儿童健康和人类发展研究所和国家药物滥用研究所。MLS在四个学术中心进行：迈阿密大学、田纳西大学孟菲斯分校、韦恩州立大学和布朗大学。MLS是迄今为止最大的产前药物暴露和儿童结局的临床前瞻性纵向研究。随访队列包括658名暴露儿童和730名对照儿童，他们已被研究至9岁，保留率为75%。MLS研究涉及一个独特的人群，因为它具有多部位成分、种族多样性和广泛的长期随访。一个目的是确定产前可卡因或其他产前药物暴露是否会导致12-15岁的不良心理和发育结果。这些结果包括物质使用（早期物质使用发作，吸烟，饮酒，物质滥用和成瘾），学术和认知缺陷（例如，不良的学校表现），生理反应，反社会行为（例如，犯罪），精神病理学，冒险行为（例如，青少年怀孕、性传播疾病）。保护因素的作用，如积极的养育和同伴关系也将进行调查。第二个目的是确定产前接触可卡因对12-15岁时身体和医疗结果的影响。这些结果包括身体生长和医学疾病，包括高血压、肥胖和代谢紊乱，这些可能起源于胎儿生命，并可能与药物暴露对胎儿生长的影响有关。其他结局包括结构致畸作用（畸形）和神经系统疾病。除了研究产前可卡因接触情况外，MLS还研究在不利条件下成长的儿童，提供关于典型发育儿童和风险儿童发育的信息。彻底了解产前接触可卡因的后果和相关的产妇生活方式，对于制定治疗和公共政策举措是必要的。

DESCRIPTION (provided by applicant): Prenatal substance exposure continues to be a major public health problem that affects millions of children and places enormous financial and social burdens on society. Little is known about the effects of prenatal cocaine exposure on psychological, developmental, medical or physical outcomes in children entering adolescence. The Maternal Lifestyle Study (MLS) is an interagency collaboration involving the National Institute of Child Health and Human Development and the National Institute on Drug Abuse. MLS is being conducted in four academic centers: The University of Miami, University of Tennessee at Memphis, Wayne State University, and Brown University. MLS is the largest clinical prospective longitudinal study to date of prenatal drug exposure and child outcome. The follow-up cohort includes 658 exposed and 730 comparison children who have been studied through 9 years of age with 75% retention. The MLS study involves a unique population given its multi-site component, racial diversity, and extensive long-term follow up. One aim is to determine if prenatal cocaine, or other prenatal drug exposure, results in adverse psychological and developmental outcomes at 12-15 years. These outcomes include substance use (early substance use onset, smoking, alcohol consumption, and substance abuse and addiction), academic and cognitive deficits (e.g., poor school performance), physiological reactivity, antisocial behavior (e.g. delinquency), psychopathology, risk-taking behavior (e.g., adolescent pregnancy, sexually transmitted diseases). The role of protective factors such as positive parenting and peer relationships will also be investigated. A second aim is to determine the effects of prenatal cocaine exposure on physical and medical outcomes at 12-15 years. These outcomes include physical growth and medical illness, including hypertension, obesity and metabolic disorder, which may have their origins in fetal life, and may be related to the impact of drug exposure on fetal growth. Additional outcomes include structural teratogenic effects (dysmorphology), and neurological disorders. In addition to being a study of prenatal cocaine exposure, MLS is also a study of children growing up in adverse conditions, providing information on development in typically developing children and children at risk. A thorough understanding of the consequences of prenatal cocaine exposure and associated maternal lifestyles is necessary to the development of treatment and public policy initiatives.