1/4 Investigation of opioid exposure and neurodevelopment (iOPEN)

项目总结 持续的新冠肺炎疫情导致社会、经济和卫生资源发生重大变化 药物使用和精神健康问题的可获得性和相关升级。这场战争的后果 怀孕和产后个人及其后代的大流行将在接下来的几年里显现出来 几十年后，这些儿童成为青少年和青壮年。目前的提议旨在利用 这是一个独特的机会，可以继续和丰富正在进行的数据收集工作，有可能揭示 新冠肺炎大流行可能影响子孙后代的机制。这项建议建立在一个 俄勒冈健康与科学大学(OHSU)的项目，该项目与7个月的数据收集工作相协调 NIH健康大脑和认知发展研究(HBCD)的地理代表性地点 倡议，包括纽约大学、圣路易斯华盛顿大学、匹兹堡大学、锡达斯大学 佛蒙特州大学和西北大学西奈医学中心(R34 DA05029-S1)。 OHSU网站已经超过了这个初始项目的招生目标(N=371比建议的N=100)， 在早期成功捕捉到母亲应激和抑郁症状的纵向轨迹 大流行阶段，并达到了生物样本收集和行为观察的目标 母婴二联体(N=40)。OHSU站点也是收集的生物样本的中央储存库 在其他几个地点。目前的建议旨在通过招生来扩大和丰富OHSU的样本 围产期药物使用风险高的孕妇(N=50)。此外，我们还 建议扩大血液、母乳、头发、指甲和唾液的生物样本采集范围，以包括更大的 母亲和婴儿样本(N=100)，发生在四个时间点(怀孕和婴儿1-、6-和 12个月)。最后，我们建议收集出生样本，脐带血和胎盘，在一个子样本 这些参与者(N=50)。继续跟踪我们目前的样本，增加更高风险的投保 怀孕的个体和增强的生物采样将使我们能够：1)表征和 大流行期间孕产妇围产期心理压力的异质性并确定关键致病因素 区分亚组；2)增进对发病率、纵向病程和致病因素的了解 在大流行期间影响孕产妇围产期物质使用的因素；以及3)检验这一假设 母体-胎盘-胎儿炎症可能是母体心理影响的共同途径 压力和物质使用对婴儿发育的影响。实现这些目标将增进对 在长期压力和资源可获得性减少期间的风险代际传递，例如 新冠肺炎大流行。通过增强检查母亲压力和药物使用的贡献者的能力 和影响婴儿发育的机制，这项工作还可以帮助确定 采取预防性干预措施，改善孕产妇和儿童健康。

PROJECT SUMMARY The ongoing COVID-19 pandemic has led to significant changes in social, economic and health resource availability and associated escalations in substance use and mental health problems. The consequences of the pandemic for pregnant and postpartum individuals and their offspring will reveal themselves over the next several decades as these children become adolescents and young adults. The current proposal seeks to take advantage of a unique opportunity to continue and enrich an ongoing data collection effort with potential to reveal mechanisms through which the COVID-19 pandemic may impact future generations. This proposal builds on a project at Oregon Health & Science University (OHSU), which is harmonized with data collection efforts at seven geographically-representative sites from the NIH HEALthy Brains and Cognitive Development study (HBCD) initiative, including New York University, Washington University in St. Louis, University of Pittsburgh, Cedars Sinai Medical Center, University of Vermont and Northwestern University (R34 DA05029-S1). The OHSU site has exceeded enrollment targets for this initial project (N=371 versus the proposed N=100), successfully captured longitudinal trajectories of maternal stress and depressive symptoms during the early phase of the pandemic, and met targets for collection of biological samples and behavioral observations of mother-infant dyads (N=40). The OHSU site also serves as a central repository for biological samples collected at several other sites. The current proposal seeks to expand and enrich the sample at OHSU by enrolling pregnant individuals at heightened risk for substance use during the perinatal period (N=50). We additionally propose to expand biological sample collection of blood, breastmilk, hair, nails and saliva to include a larger sample of mothers and infants (N=100), and to occur at four time points (pregnancy, and infant age 1-, 6-, and 12-months). Finally, we propose to collect birth samples, umbilical cord blood and placenta, in a subsample of these participants (N=50). The continued follow up of our current sample, additional enrollment of higher-risk pregnant individuals and enhanced biological sampling will allow us to: 1) characterize trajectories of and heterogeneity in maternal perinatal psychological stress during the pandemic and identify key contributing factors differentiating subgroups; 2) advance understanding of the prevalence, longitudinal course and contributing factors to maternal perinatal substance use during the pandemic; and 3) test the hypothesis that heightened maternal-placental-fetal inflammation may serve as a common pathway for effects of maternal psychological stress and substance use on infant development. Accomplishing these aims will advance understanding of intergenerational transmission of risk during times of chronic stress and reduced resource availability, such as the COVID-19 pandemic. By enhancing capacity to examine contributors to maternal stress and substance use and mechanisms of impact on infant development, this work can also aide in identification of targets for preventive interventions to improve maternal and child health.