Importance: Research has found associations of pregnancy-specific alcohol policies with increased low birth weight and preterm birth, but associations with other infant outcomes are unknown.

Question: What is the association of state-level pregnancy-specific alcohol policies with infant morbidities and maltreatment?

Findings: In this population-level cohort study of 1 432 979 birthing person–infant pairs in the US, most state-level pregnancy-specific alcohol policies were not associated with decreased odds of infant maltreatment or morbidities. The few policies that were associated with decreased odds of maltreatment or morbidities were associated with an increase in the odds of another adverse outcome.

Meaning: These findings suggest that state-level pregnancy-specific alcohol policies do not appear to be effective at reducing harms to infants.