Rose-Jacobs Ruth, Richardson Mark A, Buchanan-Howland Kathryn, Chen Clara A, Cabral Howard, Heeren Timothy C, Liebschutz Jane, Forman Leah, Frank Deborah A
Boston University School of Medicine, Department of Pediatrics, 72 East Concord St, Boston, MA 02118, United States; Boston Medical Center, Department of Pediatrics,1 Medical Center Place, Boston, MA, 02118, United States.
Boston University, Department of Psychological & Brain Sciences,648 Beacon Street, Boston, MA, 02215, United States.
Drug Alcohol Depend. 2017 Jul 1;176:169-175. doi: 10.1016/j.drugalcdep.2017.02.022. Epub 2017 May 10.
Executive functioning (EF), an umbrella construct encompassing gradual maturation of cognitive organization/management processes, is important to success in multiple settings including high school. Intrauterine tobacco exposure (IUTE) correlates with negative cognitive/behavioral outcomes, but little is known about its association with adolescent EF and information from real-life contexts is sparse. We evaluated the impact of IUTE on teacher-reported observations of EF in urban high school students controlling for covariates including other intrauterine and adolescent substance exposures.
A prospective low-income birth cohort (51% male; 89% African American/Caribbean) was followed through late adolescence (16-18 years old). At birth, intrauterine exposures to cocaine and other substances (52% cocaine, 52% tobacco, 26% marijuana, 26% alcohol) were identified by meconium and/or urine assays, and/or maternal self-report. High school teachers knowledgeable about the student and unaware of study aims were asked to complete the Behavior Rating Inventory of Executive Functioning-Teacher Form (BRIEF-TF) annually.
Teachers completed at least one BRIEF-TF for 131 adolescents. Multivariable analyses included controls for: demographics; intrauterine cocaine, marijuana, and alcohol exposures; early childhood exposures to lead; and violence exposure from school-age to adolescence. IUTE was associated with less optimal BRIEF-TF Behavioral Regulation scores (p <0.05). Other intrauterine substance exposures did not predict less optimal BRIEF-TF scores, nor did exposures to violence, lead, nor adolescents' own substance use.
IUTE is associated with offspring's less optimal EF. Prenatal counseling should emphasize abstinence from tobacco, as well as alcohol and illegal substances.
执行功能（EF）是一个涵盖认知组织/管理过程逐渐成熟的综合性概念，对于包括高中在内的多种环境中的成功都很重要。子宫内烟草暴露（IUTE）与负面认知/行为结果相关，但关于其与青少年执行功能的关联知之甚少，且来自现实生活背景的信息也很稀少。我们评估了IUTE对城市高中学生教师报告的执行功能观察结果的影响，并控制了包括其他子宫内和青少年物质暴露在内的协变量。
对一个前瞻性低收入出生队列（51%为男性；89%为非裔美国人/加勒比人）进行跟踪，直至青春期后期（16 - 18岁）。在出生时，通过胎粪和/或尿液检测和/或母亲自我报告确定子宫内可卡因和其他物质的暴露情况（52%为可卡因，52%为烟草，26%为大麻，26%为酒精）。每年要求了解学生情况且不知道研究目的的高中教师完成执行功能行为评定量表 - 教师版（BRIEF - TF）。
教师为131名青少年至少完成了一份BRIEF - TF。多变量分析包括对以下因素的控制：人口统计学特征；子宫内可卡因、大麻和酒精暴露；儿童早期铅暴露；以及从学龄期到青春期的暴力暴露。IUTE与BRIEF - TF行为调节得分较低相关（p <0.05）。其他子宫内物质暴露并不能预测BRIEF - TF得分较低，暴力暴露、铅暴露以及青少年自身的物质使用情况也不能预测。
IUTE与后代执行功能较差有关。产前咨询应强调戒烟，以及戒酒和避免使用非法物质。
