Prenatal Methamphetamine Exposure and School Aged Outcome

描述（由申请人提供）：在美国，甲基苯丙胺（冰毒）的滥用迅速升级，使人们迫切需要了解怀孕期间使用冰毒对发育中的儿童的后果。据我们所知，IDEAL（婴儿发育环境和生活方式）是美国国立卫生研究院关于产前甲基苯丙胺暴露和儿童结局的唯一前瞻性纵向研究。这是IDEAL队列4-7年随访的竞争性更新申请。IDEAL数据收集点来自爱荷华州、俄克拉何马州、加利福尼亚州和夏威夷州的不同人群，这些地区孕妇普遍使用冰毒。我们对204名接触甲基苯丙胺的儿童和208名自出生以来就处于对照状态的儿童进行了跟踪，这些儿童目前正在24个月和30个月时完成评估。在这里，我们建议进行4-7年的随访，这是执行功能神经网络发育和儿童向学校过渡的重要年龄范围。我们的计划是研究一个相对狭窄的执行功能领域的结果，这些结果由已发表的临床前和临床文献以及我们自己的初步发现支持。我们还计划研究这些执行功能域如何影响学校相关的学术技能。我们的初步研究结果显示，产前暴露于甲基苯丙胺对胎儿生长的影响，以及出生至3岁期间的行为在唤醒调节、注意、抑制控制、动机和运动控制方面的影响，并且大量暴露于甲基苯丙胺会产生一些影响。这些影响表明运动发育和执行功能的前体可能受到产前甲基苯丙胺暴露的影响。我们还发现了社会经济地位低、家庭冲突、母亲精神状况和虐待可能性以及家庭外安置等社会心理风险因素的影响。在这项应用中，我们计划研究产前甲基苯丙胺暴露对新兴执行功能域的影响，包括高阶动机、注意、记忆、抑制控制、视觉运动整合和运动控制，以及产前甲基苯丙胺暴露的影响如何受到社会心理风险因素和产后被动药物暴露（如吸烟）的影响。

DESCRIPTION (provided by applicant): The rapidly escalating abuse of methamphetamine (METH) in the United States, places a sense of urgency on understanding the consequences of METH use during pregnancy for the developing child. To our knowledge, IDEAL (Infant Development Environment and Lifestyle) is the only prospective longitudinal NIH study of prenatal Methamphetamine exposure and child outcome. This is a competitive renewal application for the 4-7 year follow-up of the IDEAL cohort. The IDEAL data collection sites are from diverse populations in Iowa, Oklahoma, California, and Hawaii where METH use by pregnant women is prevalent. We have followed 204 Methamphetamine exposed and 208 Comparison children since birth who are now completing assessments at 24 and 30 months. Here, we propose a 4-7 year follow-up, an important age range when executive function neural networks develop and children make the critical transition to school. Our plan is to study a relatively narrow band of executive function domains outcomes supported by the published preclinical and clinical literature and our own preliminary findings. We also plan to study how these executive function domains affect school related academic skills. Our preliminary findings show effects of prenatal Methamphetamine exposure on fetal growth, and on behavior between birth and 3 years on arousal-regulation, attention, inhibitory control, motivation and motor control with some effects due to heavy Methamphetamine exposure. These effects suggest that motor development and precursors of executive function may be affected by prenatal Methamphetamine exposure. We also found effects of psychosocial risk factors including low SES, family conflict, maternal psychiatric status and abuse potential, and out of home placement. In this application, we plan to study the effects of prenatal Methamphetamine exposure on emerging executive function domains including higher order motivation, attention, memory, inhibitory control, visual motor integration, and motor control, and how the effects of prenatal Methamphetamine exposure are affected by psychosocial risk factors and by postnatal passive drug exposure (e.g. smoke).