Maternal Alcohol-Use Disorder and Child Outcomes

Heavy maternal alcohol use has been shown to increase the risk of negative child outcomes. These poor outcomes have been attributed to both the biological effects of alcohol exposure in utero and social or environmental factors. Adverse biological outcomes include being born very preterm or small for gestational age, whereas social or environmental outcomes include having an increased risk of poor academic achievement, poor attendance, or contact with the justice system. However, studies have not yet established what proportion of children who were exposed to heavy maternal alcohol use experience multiple adverse outcomes. This study aimed to examine the relationship between maternal alcohol-use disorder and the co-occurrence of numerous adverse outcomes. This study used live birth data and linked administrative data on children born to women from the Western Australia Midwives Notification System between 1983 and 2007. The exposed cohort were mothers who had an alcohol-related diagnosis and their children (nonindigenous offspring: n = 13,969; indigenous offspring: n = 9635). The comparison cohort included those with no record of an alcohol-related diagnosis and their children (nonindigenous: n = 40,302; indigenous: n = 20,533). The exposed mothers were frequency matched with comparison mothers based on maternal age, indigenous status, and year of the child's birth. More children in the exposed cohort experienced at least 1 negative outcome (nonindigenous: 53.4%; indigenous: 84.0%) versus those in the comparison cohort (nonindigenous: 31.2%; indigenous: 68.0%). The odds of having any negative outcome was 2.67 times greater in the exposed cohort versus the comparison cohort (nonindigenous: odds ratio [OR], 2.67 [95% confidence interval {CI}, 2.56 2.78]; indigenous: OR, 2.67 [95% CI, 2.50 2.85]). The odds were greatest for children whose mothers were diagnosed with an alcohol disorder during pregnancy (nonindigenous: OR, 4.65 [95% CI, 3.87 5.59]; indigenous: OR, 5.18 [95% CI, 4.10 6.55]). In conclusion, children of mothers with an alcohol-related diagnosis are at higher risk of having multiple negative outcomes. Efforts to prevent, identify, and treat alcohol-related problems in women of childbearing age or who are pregnant are necessary to prevent harm to their offspring.