The association between maternal and paternal substance use and child substance use, internalising and externalising problems: a systematic review and meta‐analysis

Background and aim There is substantial evidence showing an association between parental substance use and child substance use and/or mental health problems. Most research focuses upon maternal substance use, with the influence of fathers who use substance often being overlooked. We aimed to investigate the differential effects of maternal and paternal substance use upon children aged 0-18 years. Method We used systematic review methods to identify observational studies examining the association between either maternal or paternal substance use and child substance use and/or mental health problems. The odds ratio (OR) effect measure was used, for ease of computation. We used a random effects model with the inverse variance method to meta-analyse the findings from eligible studies. Findings We included 17 unique studies with a total of 47,374 child participants. Maternal and paternal substance use were both associated with increased odds of child any drug use (OR=2.09; 95% confidence interval (CI) [1.53, 2.86]; n=12,349 participants; three studies, and OR=2.86; 95% CI [1.25, 6.54]; n=5,692 participants; three studies, respectively), child alcohol problem use (OR=2.16; 95% CI [1.73, 2.71]; n=7,339 participants; four studies, and OR=1.70; 95% CI [1.36, 2.12]; n=14,219 participants; six studies), child externalising problems (OR=1.81; 95% CI [1.01, 3.22]; n=1,748 participants; three studies, and OR=1.60; 95% CI [1.18, 2.17]; n=2,508 participants; six studies), and child internalising problems (OR=1.60; 95% CI [1.25, 2.06]; n=1,748 participants; three studies, and OR=1.42; 95% CI [1.12, 1.81]; n=2,248 participants; five studies). Child any alcohol use was associated with maternal substance use only (OR=2.26; 95% CI [1.08, 4.70]; n=28,691 participants; five studies). Conclusion Both maternal and paternal substance use are associated with child substance use and mental health problems