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Background: Limited evidence links paternal drinking (41.5% prevalence) to preschoolers' behavioral difficulties in Western China, necessitating Strengths and Difficulties Questionnaire-based studies to assess psychosocial outcomes. Method: From February 28 to March 5, 2025, a cross-sectional study enrolled 25,017 parent-child dyads across 189 public kindergartens in a western city, China, using stratified sampling. After excluding 2,408 non-parents and 1,397 dyads with invalid age data, 21,212 remained. Paternal alcohol intake was categorized as nondrinkers, ex-drinkers, or current drinkers (light ≤ 2.86 g/day, moderate >2.86-20 g/day, heavy >20-40 g/day. Child mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ), with total difficulties (TDS >14 vs. ≤14) and prosocial behavior (PB 14; adjusted OR = 1.54, P <0.001) and reduced prosocial behavior (PB <6; adjusted OR = 1.43, P <0.001). Among current drinkers, dose-response patterns were evident: for TDS, odds rose from 1.21 for light drinking to 1.73 for heavy drinking, with each additional 100 g/week associated with 20% higher odds (P <0.001); For PB, the association with paternal alcohol intake was weak but statistically significant (OR = 1.01, p = 0.01), reflecting a flat trend without clear dose-response. Stratified analyses revealed stronger associations for TDS among boys, higher-income households, and children of non-working fathers; paternal effects were attenuated when mothers were current drinkers; for PB, maternal employment status was the sole significant modifier. Conclusions: Paternal current and ex-drinking were associated with adverse child mental health outcomes. Future longitudinal studies with interaction models and larger samples are needed to confirm mechanisms and refine high-risk subgroup identification.
Liu et al. (Fri,) studied this question.