ArticleAlcohol and alcoholism (Oxford, Oxfordshire)2025
Mandatory warning signs for alcohol use during pregnancy and birth and infant outcomes in southern United States: a quasi-experimental study.
Article in Alcohol and alcoholism (Oxford, Oxfordshire), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionPolicies mandating posting of signs warning of the risks of alcohol consumption during pregnancy (MWS-alcohol-pregnancy) are common in the United States Previous research suggests these policies are ineffective and relate to increased adverse infant and maternal outcomes. Research about MWS-alcohol-pregnancy using quasi-experiments is needed. MATERIALS AND
methodsThis study uses Vital Statistics birth certificate data and commercial insurance claims data from Merative MarketScan® and policy data from NIAAA's Alcohol Policy Information System. We systematically selected a treatment (Texas) and comparison (Florida) state for a quasi-experimental examination of effects of an MWS-alcohol-pregnancy policy going into effect in 2007. Difference-in-difference models compared changes in birthweight, low-birthweight, and infant injuries consistent with maltreatment from pre- to post-policy change between the treatment and comparison state.
resultsMean birthweight decreased 4.06 g more from pre- to post-periods in the treatment as compared to the comparison (average treatment effect on the treated [ATET] -4.06, 95% CI -7.02, -1.09) state. The difference in the pre- to post-policy change in low-birthweight in the treatment relative to the comparison state was not statistically significant (ATET .0 pp, 95% CI -.0, .0). The pre- to post-policy change in infant maltreatment was .5 percentage points greater in the treatment relative to the comparison state (ATET .5 pp, 95% CI .2, .8).
conclusionsThe MWS-alcohol-pregnancy policy was associated with lower birthweight and more infant maltreatment. This study provides further evidence that MWS-alcohol-pregnancy policies are mostly ineffective and possibly harmful.
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