The effect of increased alcohol availability on alcohol-related health problems up to the age of 42 among children exposed in utero: a natural experiment

Alcohol Alcohol. 2018 Jan 1;53(1):104-111. doi: 10.1093/alcalc/agx069.

Abstract

Aim: To examine whether exposure to increased alcohol availability in utero is associated with later alcohol-related health problems.

Method: Register-linked population-based longitudinal study using data from a natural experiment setting, including 363 286 children born 1965-71. An experimental alcohol policy change was piloted in two regions of Sweden in 1967-68, where access to strong beer increased for 16-20 year old. Children exposed in utero to the policy change were compared to children born elsewhere in Sweden (excluding a border area), and to children born before and after the policy change. The outcome was obtained from the National Hospital Discharge Register using the Swedish index of alcohol-related inpatient care. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated by Cox regression analysis.

Results: The results suggest that children conceived by young mothers prior to the policy change but exposed to it in utero had a slightly increased risk of alcohol-related health problems later in life (HR 1.26, 95% CI 0.94-1.68). A tendency towards an inverse association was found among children conceived by older mothers (HR 0.88, 95% CI 0.74-1.06).

Conclusion: Results obtained from a natural experiment setting found no consistent evidence of long-term health consequences among children exposed in utero to an alcohol policy change. Some evidence however suggested an increased risk of alcohol-related health problems among the exposed children of young mothers.

MeSH terms

  • Adolescent
  • Adult
  • Alcohol-Related Disorders / epidemiology*
  • Alcohol-Related Disorders / psychology
  • Alcoholic Beverages / supply & distribution*
  • Beer
  • Child
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Health Status
  • Humans
  • Longitudinal Studies
  • Mothers
  • Pregnancy
  • Prenatal Exposure Delayed Effects / psychology*
  • Registries
  • Socioeconomic Factors
  • Sweden / epidemiology
  • Young Adult