Hafekost Katherine, Lawrence David, O'Leary Colleen, Bower Carol, Semmens James, Zubrick Stephen R
Telethon Kids Institute, The University of Western Australia, Perth, Australia.
Graduate School of Education, The University of Western Australia, Perth, Australia.
BMJ Open. 2017 Jul 11;7(7):e015650. doi: 10.1136/bmjopen-2016-015650.
Examine the relationship between maternal alcohol use disorder and child school attendance outcomes for non-Indigenous and Indigenous children in Western Australia.
Population cohort study.
Routinely collected linked administrative health, education and child protection data.
Those in-scope for the study were women with a birth recorded on the Western Australian Midwives Notification System (1989-2007). Women who had an alcohol-related diagnosis (International Classification of Diseases Revisions 9/10) recorded on the Hospital Morbidity, Mental Health Inpatients and Outpatients, and Drug and Alcohol Office data sets formed the exposed group. The comparison cohort was frequency-matched to the exposed cohort based on maternal age within Indigenous status and child's year of birth.
Child's school attendance was obtained from the Department of Education (2008-2012). Poor attendance was defined as <80% attendance for non-Indigenous children and <60% attendance for Indigenous children.
11 430 exposed children and 26 850 unexposed children had a linked attendance record. Maternal alcohol use disorder was significantly associated with increased odds of poor attendance (non-Indigenous: OR=1.61, 95% CI 1.50 to 1.74; Indigenous: OR=1.66, 95% CI 1.54 to 1.79). With adjustment for maternal and child factors, there was no significant difference between the timing of alcohol diagnosis relative to pregnancy and attendance outcomes. The population attributable fraction was higher in the Indigenous cohort than the non-Indigenous cohort (6.0% vs 1.3%).
Maternal alcohol use disorder was associated with a significantly increased odds of poor school attendance for non-Indigenous and Indigenous children. There was no significant difference between the timing of diagnoses and odds of poor school attendance. This suggests that the effect of maternal alcohol use disorder may not be driven by the neurodevelopmental effects of alcohol exposure in utero, but may be mediated through family or social factors for which we were unable to adjust.
研究西澳大利亚州非原住民和原住民儿童的母亲酒精使用障碍与儿童上学出勤情况之间的关系。
人群队列研究。
常规收集的关联行政健康、教育和儿童保护数据。
纳入研究范围的是在西澳大利亚州助产士通报系统（1989 - 2007年）中有分娩记录的女性。在医院发病率、心理健康住院患者和门诊患者以及药物和酒精办公室数据集中有与酒精相关诊断（国际疾病分类第9/10版）记录的女性构成暴露组。根据原住民身份内的母亲年龄和儿童出生年份，将对照队列与暴露队列进行频率匹配。
儿童上学出勤情况来自教育部（2008 - 2012年）。出勤不佳定义为非原住民儿童出勤低于80%，原住民儿童出勤低于60%。
11430名暴露儿童和26850名未暴露儿童有关联的出勤记录。母亲酒精使用障碍与出勤不佳几率增加显著相关（非原住民：比值比=1.61，95%置信区间1.50至1.74；原住民：比值比=1.66，95%置信区间1.54至1.79）。在对母亲和儿童因素进行调整后，酒精诊断时间相对于怀孕时间与出勤结局之间没有显著差异。原住民队列中的人群归因分数高于非原住民队列（6.0%对1.3%）。
母亲酒精使用障碍与非原住民和原住民儿童上学出勤不佳几率显著增加相关。诊断时间与上学出勤不佳几率之间没有显著差异。这表明母亲酒精使用障碍的影响可能不是由子宫内酒精暴露的神经发育影响驱动的，而是可能通过我们无法调整的家庭或社会因素介导的。
