The impact of parenthood on risk of registration for alcohol use disorder in married individuals: A Swedish population-based analysis

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T1 - The impact of parenthood on risk of registration for alcohol use disorder in married individuals

T2 - A Swedish population-based analysis

AU - Kendler, Kenneth S.

AU - Larsson Lönn, Sara

AU - Salvatore, Jessica E.

AU - Sundquist, Jan

AU - Sundquist, Kristina

PY - 2019/10

Y1 - 2019/10

N2 - BackgroundAlthough being married with children is associated with a reduced rate of alcohol use disorder (AUD), is this finding independent of a marital effect, different in mothers and fathers and potentially causal in effect.MethodsUsing Cox proportional hazards, we examined, in 1 252 237 married individuals, the association between a resident younger and older child and risk for AUD registration in national medical, criminal, and pharmacy registers. Using logistic regression, we analyzed, in 600 219 parents, within-person models comparing risk for AUD prior to first pregnancy v. with young children. We examined whether risk for AUD in 1302 parents after a first spousal AUD registration was reduced by having a young resident child.ResultsCompared with childless married individuals, resident younger children were associated with a reduced risk for AUD in mothers [hazard ratio (HR) 0.36, 95% confidence interval 0.31-0.41] and fathers (HR 0.66, 0.60-0.73). The reduced risk was attenuated but still significant for older children. Within-person models confirmed the protective effect of young children in mothers [odds ratio (OR) 0.49, 0.30-0.80] but yielded inconclusive results in fathers (OR 0.85, 0.58-1.25). After a first spousal registration for AUD, a resident young child was associated with a substantial reduction in risk for mothers and a weaker marginal effect in fathers.ConclusionIn married individuals, resident children are associated with a reduction in basal risk for AUD which is stronger in mothers than fathers and with younger v. older children. This effect is also evident during high-risk periods. In mothers, our results are consistent with a largely causal effect.

AB - BackgroundAlthough being married with children is associated with a reduced rate of alcohol use disorder (AUD), is this finding independent of a marital effect, different in mothers and fathers and potentially causal in effect.MethodsUsing Cox proportional hazards, we examined, in 1 252 237 married individuals, the association between a resident younger and older child and risk for AUD registration in national medical, criminal, and pharmacy registers. Using logistic regression, we analyzed, in 600 219 parents, within-person models comparing risk for AUD prior to first pregnancy v. with young children. We examined whether risk for AUD in 1302 parents after a first spousal AUD registration was reduced by having a young resident child.ResultsCompared with childless married individuals, resident younger children were associated with a reduced risk for AUD in mothers [hazard ratio (HR) 0.36, 95% confidence interval 0.31-0.41] and fathers (HR 0.66, 0.60-0.73). The reduced risk was attenuated but still significant for older children. Within-person models confirmed the protective effect of young children in mothers [odds ratio (OR) 0.49, 0.30-0.80] but yielded inconclusive results in fathers (OR 0.85, 0.58-1.25). After a first spousal registration for AUD, a resident young child was associated with a substantial reduction in risk for mothers and a weaker marginal effect in fathers.ConclusionIn married individuals, resident children are associated with a reduction in basal risk for AUD which is stronger in mothers than fathers and with younger v. older children. This effect is also evident during high-risk periods. In mothers, our results are consistent with a largely causal effect.

KW - Alcohol use disorder

KW - children

KW - epidemiology

KW - marriage

U2 - 10.1017/S0033291718002969

DO - 10.1017/S0033291718002969

M3 - Article

C2 - 30355386

AN - SCOPUS:85055552255

VL - 49

SP - 2141

EP - 2148

JO - Psychological Medicine

JF - Psychological Medicine

SN - 1469-8978

IS - 13

ER -