Associations of maternal alcohol and non-prescribed substance use with early child growth

Background: Perinatal alcohol and non-prescribed substance use may be detrimental to foetal and infant growth. 

Aim: This observational study investigated how combined and continued alcohol and non-prescribed substance use throughout antenatal and 1-year postnatal periods were associated with adverse child length and weight outcomes up to 24 months. 

Setting: Data from participants (n = 1098) with information on alcohol and non-prescribed substance use and infant and child outcomes, were drawn from a prospective birth cohort in the Drakenstein Child Health Study (DCHS), conducted in the Western Cape province of South Africa. 

Methods: Generalised estimating equations were conducted on standardised child length and weight outcomes at 12, 18 and 24 months. 

Results: Non-prescribed substances consisted mostly of tobacco use (77%). Child length and weight were significantly lower in those exposed to the combined use of alcohol and substances compared to no-use and all other use groups (p < 0.001), as confirmed by multivariable analyses. Child length and weight were also significantly lower in those exposed to alcohol and/or substance use throughout the antenatal and 1-year postnatal periods, as confirmed by multivariable analyses. 

Conclusion: Interventions to address the potential long-term adverse effects of combined alcohol and substance use particularly tobacco use, as well as continuous use throughout antenatal and early postnatal periods on subsequent child growth, are needed. Contribution: This study has contributed to the field by showing that combined and continued use of alcohol and other substances during pregnancy and postpartum is associated with impaired early child growth.