This is the first meta-analysis reporting on rates of externalizing disorders in PAE and comparing these rates with those from a meta-analysis examining the same disorders in COA. Consistent with our hypothesis, the LOR was significantly higher for ADHD in PAE studies compared to the LOR for ADHD in COA. Importantly, the LOR was significantly higher even for the specific comparison of PAE studies compared to studies reporting on children with an AD mother, despite the fact that PAE studies did not exclude based on maternal alcohol dependence and COA studies did not exclude based on prenatal alcohol exposure. The LOR in studies reporting on offspring with an AD mother was not significantly higher than the LOR in studies reporting on offspring with an AD father, indicating that there is no evidence of increased risk of ADHD in offspring of AD mothers compared to AD fathers, despite the potential confound that most COA studies did not exclude based on likely maternal consumption during pregnancy. Contrary to our hypothesis, the comparisons of LORs for ODD revealed slightly higher LOR in COA studies compared to PAE studies, and no significant difference for CD.
