{"doi":"10.1093/alcalc/agaf076","title":"Mandatory warning signs for alcohol use during pregnancy and birth and infant outcomes in southern United States: a quasi-experimental study","abstract":"INTRODUCTION: Policies mandating posting of signs warning of the risks of alcohol consumption during pregnancy (MWS-alcohol-pregnancy) are common in the United States Previous research suggests these policies are ineffective and relate to increased adverse infant and maternal outcomes. Research about MWS-alcohol-pregnancy using quasi-experiments is needed. MATERIALS AND METHODS: This study uses Vital Statistics birth certificate data and commercial insurance claims data from Merative MarketScan® and policy data from NIAAA's Alcohol Policy Information System. We systematically selected a treatment (Texas) and comparison (Florida) state for a quasi-experimental examination of effects of an MWS-alcohol-pregnancy policy going into effect in 2007. Difference-in-difference models compared changes in birthweight, low-birthweight, and infant injuries consistent with maltreatment from pre- to post-policy change between the treatment and comparison state. RESULTS: Mean birthweight decreased 4.06 g more from pre- to post-periods in the treatment as compared to the comparison (average treatment effect on the treated [ATET] -4.06, 95% CI -7.02, -1.09) state. The difference in the pre- to post-policy change in low-birthweight in the treatment relative to the comparison state was not statistically significant (ATET .0 pp, 95% CI -.0, .0). The pre- to post-policy change in infant maltreatment was .5 percentage points greater in the treatment relative to the comparison state (ATET .5 pp, 95% CI .2, .8). CONCLUSIONS: The MWS-alcohol-pregnancy policy was associated with lower birthweight and more infant maltreatment. This study provides further evidence that MWS-alcohol-pregnancy policies are mostly ineffective and possibly harmful.","journal":"Alcohol and Alcoholism","year":2025,"id":583651,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9248,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1267308,"name":"Alex Schulte","orcid":null,"position":1,"is_corresponding":false},{"id":974721,"name":"Sarah Raifman","orcid":"0000-0002-5025-2412","position":2,"is_corresponding":false},{"id":674355,"name":"Guodong Liu","orcid":"0000-0001-8683-0803","position":3,"is_corresponding":false},{"id":1496224,"name":"Claudia Zaugg","orcid":"0000-0001-7900-057X","position":4,"is_corresponding":false},{"id":672645,"name":"Meenakshi S. Subbaraman","orcid":"0000-0002-1336-7552","position":5,"is_corresponding":false},{"id":794304,"name":"Sarah C. M. Roberts","orcid":"0000-0002-7732-4607","position":0,"is_corresponding":true}],"reference_count":33,"raw_metadata":null,"created_at":"2026-07-19T02:59:07.970345Z","pmid":"41317082","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}