Published: February 27, 2020

O’Leary, C., Lawrence, D., Hafekost, K., Zubrick, S. R., & Bower, C. (2020). Maternal Alcohol-Use Disorder and Child Outcomes. Pediatrics.


Colleen O’Leary, David Lawrence, Katherine Hafekost, Stephen R. Zubrick, and Carol Bower.



Investigate the relationship between maternal alcohol-use disorder and multiple biological and social child outcomes, including birth outcomes, child protection, justice contact, and academic outcomes for both Indigenous and non-Indigenous children.


 Women with a birth recorded on the Western Australian Midwives Notification System (1983–2007) and their offspring were in scope. The exposed cohort were mothers with an alcohol-related diagnosis (International Classification of Diseases, Ninth Revision and International Classification of Diseases, 10th Revision) recorded in an administrative data set and their offspring (non-Indigenous: n = 13 969; Indigenous: n = 9635). The exposed cohort was frequency matched with mothers with no record of an alcohol-related diagnosis and their offspring (comparison cohort; non-Indigenous: n = 40 302; Indigenous: n = 20 533).


Over half of exposed non-Indigenous children (55%) and 84% of exposed Indigenous children experienced ≥1 negative outcome. The likelihood of any negative outcome was significantly higher for the exposed than the comparison cohort (non-Indigenous: 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 received a diagnosis during pregnancy (non-Indigenous: OR = 4.65 [95% CI = 3.87–5.59]; Indigenous: OR = 5.18 [95% CI = 4.10–6.55]); however, numbers were small.


The effects of maternal alcohol-use disorder are experienced by the majority of exposed children rather than a vulnerable subgroup of this population. These findings highlight the need for universal prevention strategies to reduce harmful alcohol use and targeted interventions to support at-risk women and children.