Maternal Lifestyle Study Phase 5

描述(申请人提供)：产前暴露物质仍然是影响数百万儿童的重大公共卫生问题，并给社会带来巨大的经济和社会负担。关于出生前接触可卡因对进入青春期的儿童的心理、发育、医学或生理结果的影响，人们知之甚少。母亲生活方式研究(MLS)是国家儿童健康和人类发展研究所和国家药物滥用研究所的跨机构合作。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是迄今为止关于产前药物暴露和儿童结局的最大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，他们接受了9岁的研究，保留了75%。MLS的研究涉及一个独特的人群，因为它的多地点组成部分、种族多样性和广泛的长期跟踪。一个目标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。这些结果包括药物使用(早期药物使用、吸烟、饮酒、药物滥用和成瘾)、学习和认知缺陷(如学习成绩差)、生理反应、反社会行为(如青少年犯罪)、精神病理学、冒险行为(如青少年怀孕、性传播疾病)。积极的父母教养和同伴关系等保护性因素的作用也将得到调查。第二个目标是确定产前可卡因暴露对12-15岁的身体和医疗结果的影响。这些结果包括身体发育和包括高血压、肥胖症和代谢紊乱在内的医学疾病，这些疾病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畸形效应(畸形)和神经障碍。除了是一项关于产前可卡因暴露的研究外，MLS也是一项关于在不利条件下成长的儿童的研究，提供有关典型发育中儿童和处于危险中的儿童的发育信息。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.