Investigating the Impact of Prenatal Co-Exposure to Marijuana and Tobacco on Infant Neurobehavior Restricted; Files Only

Stanfield, Jocelyn (Spring 2020)

Permanent URL: https://etd.library.emory.edu/concern/etds/qv33rx775?locale=zh
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Abstract

Prevalence rates for substance exposure during pregnancy are increasing, with tobacco and marijuana being the two most common substances used prenatally. Animal studies have found an additive interaction between THC and nicotine, the primary psychoactive ingredients in marijuana and tobacco, respectively. Although few human studies have examined this association, preliminary work has demonstrated that mothers who co-use during pregnancy have infants who are at significantly greater risk for neurobehavioral vulnerabilities (emotion dysregulation, lower attention, higher impulsivity, etc.) than non-exposed infants. Although biological sex has been explored as a moderator, studies have yet to examine the moderating effects of socioeconomic status (SES) on the relationship between prenatal tobacco and marijuana co-exposure and infant neurobehavior. SES is an important moderator to consider because it influences mothers’ access to prenatal care and levels of stress during pregnancy. The current study fills these important gaps in the literature. Data was drawn from two longitudinal studies examining the impact of prenatal factors on birth outcomes and infant development. 96 mothers and their infants participated in the study (27 co-exposed, 21 exposed to tobacco only, and 48 not exposed). Biomarkers for tobacco and marijuana were collected during the first trimester of pregnancy. The NICU Network Neurobehavioral Scale (NNNS) was used to examine neurobehavior in the infants at 1 week old. Separate univariate analyses of variance were conducted to examine newborn attention, excitability, and self-regulation differences based on exposure group. No significant differences were found. However, socioeconomic status did moderate the effect of prenatal exposures on neonatal attention. As hypothesized, low SES infants saw greater deficits in attention if they were prenatally exposed to tobacco alone or tobacco and marijuana in tandem. Our findings suggest that tobacco exposure prenatally may be a more significant risk factor for infant neurobehavioral outcomes than prenatal marijuana exposure. Our results also emphasize the crucial role that socioeconomic factors during pregnancy may play in determining offspring behavior. 

Table of Contents

Introduction…………………………………………………………………………………..……1

            Marijuana……………………………………………………………………………….…2

            Tobacco…………………………………………………………………………………....3

            Co-Use of Marijuana and Tobacco…………………………………………………….….4

            Prenatal Substance Exposure and Fetal Development……………………………….…....4

            Prenatal Co-Exposure and Infant Neurobehavior………………………………….….......5

            Attention, Overactivity and Emotional Regulation…………………………………….....7

            Socioeconomic Status as a Moderator.................................................................................8

            The Current Study................................................................................................................9

Methods..........................................................................................................................................10

            Participants.........................................................................................................................10

            Procedure...........................................................................................................................10

                        Nicotine and Marijuana Exposure.........................................................................11

                        Newborn Neurobehavior........................................................................................11

Data Analytic Plan.............................................................................................................12

Results............................................................................................................................................13

            Preliminary Analysis..........................................................................................................13

            Prenatal Exposure and Infant Attention.............................................................................14

            Prenatal Exposure and Infant Self-Regulation...................................................................14

Prenatal Exposure and Infant Excitability.........................................................................15

Socioeconomic Status as a Moderator...............................................................................15

Discussion......................................................................................................................................15

            Limitations and Strengths..................................................................................................18

            Future Directions...............................................................................................................19

            Conclusion.........................................................................................................................20

References......................................................................................................................................21

Tables and Figures.........................................................................................................................30

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