Objective: To investigate the relationship between prenatal maternal alcohol consumption and the risk of attention deficit hyperactivity disorder (ADHD), the strengths and difficulties questionnaire (SDQ) score and abnormal hyperactivity score in seven-year-old children. Methods: This study is a retrospective analysis of the Millennium Cohort Study (MCS). Questionnaires were used to gather data on gestational alcohol consumption when children were 9 months old and neurodevelopmental outcomes in offspring at 7 years of age (N = 13,004). Alcohol consumption was classified into never, light, moderate and heavy. Crude and adjusted logistic regression models were used for data analysis. Results: The total number of women who reported drinking alcohol in pregnancy (the light, moderate and heavy drinking group) was 3916 (30.1%). No significant association was found between light, moderate or heavy gestational alcohol consumption and ADHD (adjusted odds ratio [aOR] for light = 0.80, 95% confidence interval [CI] = [0.53,1.22], aOR for moderate = 0.83, [0.40, 1.74]; aOR for heavy = 1.27, [0.54, 2.98]); for abnormal SDQ score (aOR for light = 0.94, [0.78,1.13], aOR for moderate = 0.70, [0.49,1.00]; aOR for heavy = 1.08, [0.70, 1.66]); for abnormal Hyperactivity score (aOR for light = 1.02, [0.89,1.17]; aOR for moderate = 1.05, [0.82, 1.34]; aOR for heavy = 0.90, [0.62, 1.32]), in offspring. Conclusion: Light, moderate or heavy antenatal alcohol consumption was not associated with an increased susceptibility to ADHD or behavioural outcomes in this study. However, due to the limited number of cases we cannot rule out an increased risk of ADHD in relation to heavy alcohol consumption.

Introduction

Existing literature links prenatal alcohol exposure to numerous adverse neurodevelopmental outcomes in offspring (Carmichael Olson et al., 1997; Banerjee et al., 2007; Jones et al., 1973). Long-term neurobehavioral deficits, including hyperactivity, even at low doses of prenatal alcohol exposure have been demonstrated in animal literature (Riley, 1990; Sood et al., 2001). Conversely, there is conflicting evidence cited in the literature suggesting that low levels of maternal alcohol consumption in pregnancy (MACP) may not be associated with adverse neurodevelopmental and health outcomes in early childhood (Kelly et al., 2009; Kelly et al., 2012; Robinson et al., 2010; O’Leary et al., 2010; Alati et al., 2008; Eriksen et al., 2012; Testa et al., 2003; Gallagher et al., 2018). Attention deficit hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental disorder characterised by developmentally inappropriate and impairing inattention, impulsivity and/or overactivity (Thapar and Cooper, 2016). ADHD is the most common cognitive and behavioural disorder diagnosed among school children, with an estimated worldwide prevalence of 3.4% (Polanczyk et al., 2015) ADHD incurs a significant economic burden and is associated with subpar social, academic, adaptive and occupational functioning (Barkley, 2002; Banerjee et al., 2007; Gupte-Singh et al., 2017; Polanczyk et al. 2015).