Maternal Lifestyle Study Phase 5

描述（由申请人提供）：产前物质暴露仍然是一个重大的公共卫生问题，影响到数百万儿童，并给社会带来巨大的经济和社会负担。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知之甚少。产妇生活方式研究是一项机构间合作，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，这些儿童在9岁之前的保留率为75%。MLS研究涉及一个独特的人群，因为它的多地点组成，种族多样性和广泛的长期随访。目的之一是确定产前可卡因或其他产前药物暴露是否会导致12-15岁时不良的心理和发育结果。这些后果包括药物使用（早期药物使用、吸烟、饮酒、药物滥用和成瘾）、学业和认知缺陷（如学习成绩差）、生理反应、反社会行为（如犯罪）、精神病理、冒险行为（如少女怀孕、性传播疾病）。保护因素的作用，如积极的父母教育和同伴关系也将被调查。第二个目标是确定产前可卡因暴露对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疗疾病，包括高血压、肥胖和代谢紊乱，这些可能起源于胎儿生活，并可能与药物暴露对胎儿生长的影响有关。其他结果包括结构性致畸效应（畸形）和神经系统疾病。除了对产前可卡因暴露的研究外，MLS也是对在不利条件下成长的儿童的研究，为正常发育儿童和危险儿童的发展提供信息。彻底了解产前可卡因暴露的后果和与之相关的产妇生活方式，对于制定治疗和公共政策倡议是必要的。

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.