# ENRICH-2: Stress-Reactivity and Self-Regulation in Infants with Prenatal Alcohol Exposure

> **NIH NIH R01** · UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR · 2020 · $660,723

## Abstract

SUMMARY/ABSTRACT
The new clinical guidelines for diagnosing Fetal Alcohol Spectrum Disorders (FASD) list self-regulation as one
of the key behavioral deficits in children affected by prenatal alcohol exposure (PAE). There is a fundamental
gap in knowledge about the underlying mechanisms, spectrum, and severity of such deficits early in life and
the best analytical approaches to identify them. In addition, the effect of prenatal stress and postnatal
environment on PAE-induced alterations is poorly understood. In this renewal application of the Ethanol,
Neurodevelopment, Infant, and Child Health (ENRICH) study, we seek continuous support for our established
recruitment/retention pipeline, and propose new highly innovative studies of stress reactivity/regulation in
infants with PAE. The long-term goal is to identify indices of atypical brain development following PAE as early
as possible to enable early interventions. The objective of this application is to continue our focus on moderate
PAE and to evaluate PAE effects on infant stress reactivity/regulation and the mechanisms underpinning
altered hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS) functioning. We will
evaluate the relationship between PAE (exposure of interest), prenatal stress (moderator), biological measures
of HPA axis (mediators), and physiological and behavioral measures of stress reactivity/regulation in infants
(outcomes). The rationale for this proposal is driven by the conviction that HPA and ANS dysregulation leading
to altered stress reactivity/regulation in children with PAE might be the basis for some of the key PAE-induced
behavioral deficits, and increased vulnerability to secondary disabilities. The central hypothesis is that PAE will
be associated with heightened infant stress reactivity and poorer self-regulation (beyond the effect of prenatal
stress) through fetal programming of the HPA axis. This hypothesis has been formulated on the basis of
preclinical data at UNM and clinical data from the current funding cycle of ENRICH-1 and will be tested by
pursuing three specific aims, which evaluate the contributing effects of PAE on 1) Programming of the fetal
HPA axis, assessed as expression of key placental and umbilical cord markers of HPA axis; 2) Infant
physiological reactivity (heart rate variability [HRV]) dynamic changes during basal-stressor-recovery periods
assessed in the newborn period and at 6-months of age; 3) Infant behavioral reactivity and regulation
assessed in the newborn period and at 6-months of age. The comprehensive multi-systemic approach
employed in this study is highly innovative and has not previously been used. Innovation is further driven by
our focus on moderate PAE and ability to assess the trajectory of impaired stress reactivity/regulation
(newborn, 6-months evaluations) in a large prospective cohort study. This research is significant because it
involves comprehensive repeated-measures assessment of neuroendocri...

## Key facts

- **NIH application ID:** 10002158
- **Project number:** 5R01AA021771-08
- **Recipient organization:** UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
- **Principal Investigator:** Ludmila Nicole Bakhireva
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $660,723
- **Award type:** 5
- **Project period:** 2013-07-15 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10002158

## Citation

> US National Institutes of Health, RePORTER application 10002158, ENRICH-2: Stress-Reactivity and Self-Regulation in Infants with Prenatal Alcohol Exposure (5R01AA021771-08). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10002158. Licensed CC0.

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