Browsing by Author "Camerota, Marie"

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    Annual Research Review: Prenatal opioid exposure - a two-generation approach to conceptualizing neurodevelopmental outcomes.
    (Journal of child psychology and psychiatry, and allied disciplines, 2023-02) Conradt, Elisabeth; Camerota, Marie; Maylott, Sarah; Lester, Barry M
    Opioid use during pregnancy impacts the health and well-being of two generations: the pregnant person and the child. The factors that increase risk for opioid use in the adult, as well as those that perpetuate risk for the caregiver and child, oftentimes replicate across generations and may be more likely to affect child neurodevelopment than the opioid exposure itself. In this article, we review the prenatal opioid exposure literature with the perspective that this is not a singular event but an intergenerational cascade of events. We highlight several mechanisms of transmission across generations: biological factors, including genetics and epigenetics and the gut-brain axis; parent-child mechanisms, such as prepregnancy experience of child maltreatment, quality of parenting, infant behaviors, neonatal opioid withdrawal diagnosis, and broader environmental contributors including poverty, violence exposure, stigma, and Child Protective Services involvement. We conclude by describing ways in which intergenerational transmission can be disrupted by early intervention.
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    Prenatal and perinatal factors associated with neonatal neurobehavioral profiles in the ECHO Program.
    (Pediatric research, 2023-02) Camerota, Marie; McGowan, Elisabeth C; Aschner, Judy; Stroustrup, Annemarie; Karagas, Margaret R; Conradt, Elisabeth; Crowell, Sheila E; Brennan, Patricia A; Carter, Brian S; Check, Jennifer; Dansereau, Lynne M; DellaGrotta, Sheri A; Everson, Todd M; Helderman, Jennifer B; Hofheimer, Julie A; Kuiper, Jordan R; Loncar, Cynthia M; Marsit, Carmen J; Neal, Charles R; O'Shea, Thomas Michael; Pastyrnak, Steven L; Sheinkopf, Stephen J; Smith, Lynne M; Zhang, Xueying; Lester, Barry M

    Background

    Single-cohort studies have identified distinct neurobehavioral profiles that are associated with prenatal and neonatal factors based on the NICU Network Neurobehavioral Scale (NNNS). We examined socioeconomic, medical, and substance use variables as predictors of NNNS profiles in a multi-cohort study of preterm and term-born infants with different perinatal exposures.

    Methods

    We studied 1112 infants with a neonatal NNNS exam from the Environmental influences on Child Health Outcomes (ECHO) consortium. We used latent profile analysis to characterize infant neurobehavioral profiles and generalized estimating equations to determine predictors of NNNS profiles.

    Results

    Six distinct neonatal neurobehavioral profiles were identified, including two dysregulated profiles: a hypo-aroused profile (16%) characterized by lethargy, hypotonicity, and nonoptimal reflexes; and a hyper-aroused profile (6%) characterized by high arousal, excitability, and stress, with low regulation and poor movement quality. Infants in the hypo-aroused profile were more likely to be male, have younger mothers, and have mothers who were depressed prenatally. Infants in the hyper-aroused profile were more likely to be Hispanic/Latino and have mothers who were depressed or used tobacco prenatally.

    Conclusions

    We identified two dysregulated neurobehavioral profiles with distinct perinatal antecedents. Further understanding of their etiology could inform targeted interventions to promote positive developmental outcomes.

    Impact

    Prior research on predictors of neonatal neurobehavior have included single-cohort studies, which limits generalizability of findings. In a multi-cohort study of preterm and term-born infants, we found six distinct neonatal neurobehavioral profiles, with two profiles being identified as dysregulated. Hypo- and hyper-aroused neurobehavioral profiles had distinct perinatal antecedents. Understanding perinatal factors associated with dysregulated neurobehavior could help promote positive developmental outcomes.