Effects of paternal alcoholism on the psycho-behavioural outcomes of the offspring: a systematic review and meta-analysis

Documented literature includes mixed interpretations of the impact of paternal alcoholism on psycho-behavioral well-being of offspring. A systematic review and a meta-analysis would facilitate the accurate establishment of this association. This review was done to evaluate the effects of paternal alcohol use disorder (AUD) or problem drinking (PD) on the psycho-behavioral well-being of the offspring at different stages of their lifecycle. This PROSPERO-registered review (CRD42018114754) was conducted by reviewing literature in MEDLINE, EMBASE and PsycINFO databases. A total of 29 articles out of 18113 were selected for data extraction after three selection rounds. Eleven were included in the meta-analyses for three numerically and one categorically assessed outcomes on internalizing behaviour, externalizing behaviour and anxiety. Heterogeneity, risk of bias and the certainty-of-evidence were assessed. Sensitivity analysis was done. Rev-Man (version 5.3) software and “GRADEproGDT” online applications were used. A narrative review was done with studies and sub-groups not included in the meta-analysis under five identified themes: depression and mood disorders, self-perceived mental health problems and personality, aggression, attention deficit hyperactive disorder and other problems. With meta-analyses, all outcomes demonstrated significant standardized mean differences or odds ratio with higher unfavourable values in the exposed group. 'Low' level GRADE certainty was assigned. In sensitivity analysis, associations of similar directions were observed. Narrative review reflected other negative psycho-behavioral consequences of children associated with paternal alcoholism, falling under the five identified themes. In conclusion, robust findings of the meta-analyses and narrative review suggest that paternal AUD and PD are associated with unfavourable psycho-behavioural consequences among their offspring at many stages of the life cycle.