Paternal alcohol consumption, family transition and child development in a former Soviet country.

BACKGROUND Although major societal changes have been observed in former Soviet countries, the child health consequences of these changes have rarely been studied. METHODS We examined the associations of paternal alcohol consumption and family transitions with cognitive ability and behaviour problems among healthy, early school-age Belarusian children. Our study is based on follow-up of children aged 6.5 years participating in a cluster-randomized trial of a breastfeeding promotion intervention. Paternal alcohol consumption was measured at follow-up and classified into three categories: at least weekly consumption of heavy (≥ 6 standard units per occasion), moderate (4-5 units per occasion), or light (≤ 3 units per occasion) or infrequent drinking. Family transition from birth to age 6.5 years was categorized into living stably with an intact family, having transitioned into a stepfamily, having transitioned into a single-parent family and living stably with a single-parent family. Mean differences in intelligence quotient (IQ) measured with the Wechsler Abbreviated Scales of Intelligence and in behaviour problems measured with the Strengths and Difficulties Questionnaire were compared according to paternal alcohol and family transition, after controlling for a wide range of confounding factors. RESULTS Children whose fathers were moderate or heavy drinkers with at least weekly alcohol consumption showed 1.5-2.5 points lower mean IQ scores and greater behaviour problems (range 0.1-0.3 SD) compared with those whose fathers were light or infrequent drinkers. Compared with children from stable intact families, children who transitioned into stepfamilies had 1 point lower IQ and greater behaviour problems by 0.1-0.4 SD, and children from stable single-parent families or with transition into single-parent families showed no cognitive deficit but greater behaviour problems (range 0.1-0.3 SD). CONCLUSIONS The sharp rise in both alcohol consumption and divorce/re-marriage rates in former Soviet countries may have negative consequences for cognitive and behavioural development in children.