TY - JOUR PY - 2019// TI - Is the association between maternal alcohol consumption in pregnancy and pre-school child behavior and emotional problems causal? Multiple approaches for controlling unmeasured confounding JO - Addiction A1 - Lund, Ingunn Olea A1 - Eilertsen, Espen Moen A1 - Gjerde, Line C. A1 - Røysamb, Espen A1 - Wood, Mollie A1 - Reichborn-Kjennerud, Ted A1 - Ystrom, Eivind SP - 1004 EP - 1014 VL - 114 IS - 6 N2 - BACKGROUND AND AIMS: Hazardous drinking (i.e., alcohol consumption that places drinkers at risk for adverse health outcomes) during pregnancy is associated with adverse child outcomes. To address whether the associations are causal, we aimed to estimate the effect of maternal hazardous drinking during 1st trimester on offspring emotional and behavior problems throughout the preschool age. We adjust for, 1) measured confounding (e.g., smoking) 2) familial risk factors by sibling control design, and 3) non-shared environmental risk factors by using hazardous drinking the 3 months before pregnancy as an instrumental variable.

DESIGN: Prospective cohort study. Participants were recruited between 1999-2009 at ultrasound examination offered to all pregnant women in Norway. Data was collected during the 17th and the 30th week of gestation, and when the children were 1.5, 3 and 5 years old. SETTING: Norway (1999-2015). PARTICIPANTS: The sample consists of 14,639 mothers with 25,744,395 offspring siblings from the Norwegian Mother and Child Cohort Study. MEASUREMENTS: Respondents self-reported on: alcohol consumption, children's emotional problems (i.e. emotional reactive, anxiety/depression, somatic complaints) and children's behavioral problems (i.e. attention and aggressive behavior) throughout preschool age. We used longitudinal latent growth curve models to estimate the effect of maternal drinking during 1st trimester on offspring emotional and behavioral problems.

FINDINGS: Most associations were strongly reduced after controlling for both familial and measured environmental risk factors. After adjustment, exposed children were more emotionally reactive (β= 2.33; 95% CI 0.13:4.53) and had more somatic complaints (β=1.93;95%CI 0.09:3.77) at age three, but not at age five. Exposed children were less aggressive than unexposed siblings at age five (β=-2.27; 95%CI -4.02:-0.52).

CONCLUSIONS: Children exposed to their mothers' hazardous drinking during 1st trimester appear to be more emotionally reactive and have more somatic complaints at age three, but not at age five, and are less aggressive at age five, compared with unexposed siblings.

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Language: en

LA - en SN - 0965-2140 UR - http://dx.doi.org/10.1111/add.14573 ID - ref1 ER -