With regard to mental health outcomes, the strongest associations were with hyperactivity/inattention. This association was reflected across both parent and teacher ratings and was not contingent upon daily drinking during pregnancy. There are inconsistent findings about the association between prenatal alcohol exposure and childhood hyperactivity and inattention problems [18, 26, 27]. This might reflect methodological issues—although recommendations have been made for research that separates out risk from regular drinking versus episodic binge-pattern drinking [2], few studies have separated these out to specifically examine the association between binge-pattern drinking during pregnancy and hyperactivity and inattention problems [10, 18]. Some studies have conflated frequency (e.g. daily) and pattern (e.g. binge episodes) of drinking or have ascertained prenatal alcohol exposure status postnatally [8, 13, 15, 16, 28]. Some studies suggest the possibility that the mental health risk to children prenatally exposed to alcohol mainly reflects conduct and emotional problems [15, 16, 28, 29]. Although, for girls, we also found higher levels of parent-rated conduct problems, these findings did not extend to teacher ratings.
