BACKGROUND AND AIMS: Children are an important group harmed by others' alcohol consumption. This study 1) compared the risk of occurrence of child maltreatment among children exposed vs not exposed to parents with an alcohol-attributable hospitalisation or service use for mental health/addiction and 2) conducted sensitivity analyses to estimate the cases of child maltreatment that could be attributable to alcohol under two different conditions in New Zealand.

DESIGN, SETTING AND PARTICIPANTS: This cohort study was conducted among 58,359 children 0-17 years and their parents (years 2000-2017) using the Statistics New Zealand Integrated Data Infrastructure. The prevalence of hazardous drinking among parents was obtained from the New Zealand Health Survey 2017 (n = 13,869).

MEASUREMENTS: Survival analysis based on a Bayesian piecewise exponential model was used to estimate the risk of time-to-first substantiated child maltreatment event (identified from social service, hospital, mortality and police data) related to exposure to parents with an alcohol-attributable hospitalisation or who used a mental health/addiction service (vs no exposure). Potential confounders were included for parents and children. The sensitivity analyses i) estimated an alcohol-attributable admissions/service use fraction for maltreatment in 2017 and ii) calculated a population-attributable fraction using the relative risk from the cohort and prevalence of hazardous drinking (AUDIT 8+) among parents in 2017.

FINDINGS: There was a 65.1% increased risk of child maltreatment if a child was exposed to parents who had an alcohol-attributable hospitalised or mental health/addictions service use. The sensitivity analyses estimated that in 2017 14.6% and 11.4% of the documented cases of child maltreatment in New Zealand could be attributable to parents with severe or hazardous consumption.

CONCLUSION: In New Zealand, exposure to parents with an alcohol-attributable hospitalisation or service use is a risk factor for substantiated child maltreatment.