Longitudinal effects of prenatal cannabis and tobacco co-exposure and postnatal adversity on child regulation: The buffering role of sensitive parenting - PROJECT SUMMARY/ABSTRACT The current proposal is a secondary analysis of a multi-method, multi-timepoint longitudinal study examining developmental trajectories of autonomic reactivity and regulation with rich, multi-method assessments of prenatal cannabis and tobacco exposure. There is a large body of research that implicates prenatal tobacco exposure (PTE) as a risk factor for negative developmental outcomes. Relatively little research has examined the impact of prenatal co-exposure to tobacco and cannabis (PTCE), despite increasing rates of cannabis use and co-use with tobacco among pregnant persons. Preliminary findings indicate that co-exposure has a greater impact on underlying regulation than tobacco exposure alone. One important regulatory system is the parasympathetic nervous system (PNS), a branch of the autonomic nervous system that regulates body function. Our major goal is to examine the role of PTE, PTCE, and postnatal adversity in PNS functioning from infancy to early school age and examine the potential protective role of early sensitive parenting. The specific aims of this application are to 1) Examine change in PNS functioning across infancy to early school age; 2) Examine associations between prenatal substance exposure, postnatal adversity, and PNS functioning across time; and 3) Evaluate early sensitive parenting as a moderator. The sample consists of 247 caregiver-infant dyads (51% of mothers identified as Black, 31% White, 19% Hispanic, and 8% more than one race or other race/ethnicity) from low-income backgrounds who were recruited in the first trimester of pregnancy into one of three groups: PTE (n = 81, 58.02% male), PTCE (n = 97, 52.58% male), and demographically similar non- exposed dyads (n = 69, 47.83% male). Substance exposure was measured using calendar-based interviews, oral fluid assays, and infant meconium at delivery. PNS functioning was assessed during rest and in response to frustration at 9- and 16- months and at early school age. Postnatal adversity, a composite of maternal mood, stress, postnatal substance exposure, and the home environment was assessed at every time point. Sensitive parenting was measured during caregiver-child play interactions at 9- and 16-months and at early school age. To examine the study aims, a Random Intercept-Cross Lagged Panel Model (RI-CLPM) will disaggregate the within- and between-person variance in PNS functioning. Prenatal exposure group, early adversity, and moderation analyses with early sensitive parenting will be evaluated in the RI-CLPM. Exploratory analyses will use person-centered analyses to examine classes of PNS functioning trajectories, dose-response associations using continuous measures of exposure and fetal exposure via infant meconium, and the role of specific types of adversity. This study addresses several gaps in the literature including examination of prenatal co-exposure using multiple methods and evaluation of changes in PNS functioning over time in a sample experiencing high pre-to-postnatal adversities. Results will inform both timing and content of preventive interventions beyond substance use treatment for pregnant individuals.
