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Epidemiology
Research
Maternal alcohol use disorder and child school attendance outcomes for non-Indigenous and Indigenous children in Western Australia: a population cohort record linkage study
  1. Katherine Hafekost1,
  2. David Lawrence2,
  3. Colleen O’Leary3,
  4. Carol Bower1,
  5. James Semmens4,
  6. Stephen R Zubrick1,2
  1. 1 Telethon Kids Institute, The University of Western Australia, Perth, Australia
  2. 2 Graduate School of Education, The University of Western Australia, Perth, Australia
  3. 3 Office of the Chief Psychiatrist, Western Australian Department of Health, Perth, Australia
  4. 4 Faculty of Health Science, Centre for Population Health Research, Curtin University, Perth, Australia
  1. Correspondence to Katherine Hafekost; katherine.hafekost{at}telethonkids.org.au

Abstract

Objectives Examine the relationship between maternal alcohol use disorder and child school attendance outcomes for non-Indigenous and Indigenous children in Western Australia.

Design Population cohort study.

Setting Routinely collected linked administrative health, education and child protection data.

Participants 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.

Primary outcome measure 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.

Results 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%).

Conclusions 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.

  • Alcohol
  • Education
  • Maternal Health

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-015650

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    Footnotes

    • Contributors CO, CB, JS and SRZ conceptualised the study and obtained funding. KH completed the analysis and drafted the manuscript. DL provided expert advice, both in statistical analysis and the drafting of the manuscript. All authors contributed to the final manuscript.

    • Funding The project is funded by an Australian Research Council Discovery Project (Project ID DP140101573).

    • Competing interests None declared.

    • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Ethics approval WA Department of Health Human Research Ethics Committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Data were provided by the Western Australian Department of Health, Data Linkage Branch. This information is confidential, and authors are bound by confidentiality agreements which prevent data sharing.