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We aimed to quantify their healthcare utilisation patterns compared to all other Danish children in this nationwide cohort study of children born 1997\u20132020, followed until Dec 31, 2022. Data was derived from eight national registers. Heavy prenatal alcohol exposure was defined by hospital contacts with 100% alcohol-attributable diagnoses given to mother or child, redeemed prescriptions for drugs to treat alcohol dependence, or enrollment into treatment clinics, one year before or during pregnancy. We estimated age- and sex-specific rates and incidence rate ratios (IRRs) for use of somatic and psychiatric hospitals, and use of general practice (GP), and risk ratio (RR) for participation in the GP-based preventive child health programme. Of 1,457,962 children followed for 17,778,705 person-years, 5898 (0.4%) were heavily prenatal alcohol exposed. Exposed children had higher use of GP and hospitals compared to reference children, particularly notable for psychiatric hospital contacts with IRR for respectively ages 0\u20135, 6\u201311 and 12\u201318 years of 3.55 (2.98\u20134.24), 2.68 (2.41\u20132.98), and 2.19 (1.95\u20132.46); and for planned outpatient contacts 2.01 (1.92\u20132.10), 1.29 (1.21\u20131.37), and 1.20 (1.12\u20131.28). Despite higher healthcare use, participation in the preventive child health programme had a RR of 0.69 (95% CI 0.67\u20130.72) for exposed compared to reference children. The higher use of hospitals and GP, but lower participation in the child health programme underscores the long-term consequences and societal burden of heavy prenatal alcohol exposure, and leaves a need for awareness and adequate support to ensure health equity.<\/jats:p>","DOI":"10.1007\/s10654-025-01280-3","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T07:53:07Z","timestamp":1753343587000},"page":"1095-1104","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Heavy prenatal alcohol exposure and healthcare use during childhood and adolescence: a Danish nationwide cohort study 1997\u20132022"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3106-7270","authenticated-orcid":false,"given":"Julie Marie","family":"Winckler","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9402-1317","authenticated-orcid":false,"given":"Kathrine Kold","family":"S\u00f8rensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7061-3767","authenticated-orcid":false,"given":"Katrine","family":"Strandberg-Larsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2892-6131","authenticated-orcid":false,"given":"Christian","family":"Torp-Pedersen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3868-106X","authenticated-orcid":false,"given":"Ulrik Schi\u00f8ler","family":"Kesmodel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6162-5205","authenticated-orcid":false,"given":"Mikkel Porsborg","family":"Andersen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5257-7448","authenticated-orcid":false,"given":"Marcella","family":"Broccia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"issue":"2","key":"1280_CR1","doi-asserted-by":"publisher","first-page":"e20154256","DOI":"10.1542\/peds.2015-4256","volume":"138","author":"HE Hoyme","year":"2016","unstructured":"Hoyme HE, Kalberg WO, Elliott AJ, Blankenship J, Buckley D, Marais AS. m.fl. 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Other authors report no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Approval for use of data sources for research purposes was granted by the data responsible institute in the Capital Region of Denmark (approval no. P\u20132019\u2013280) in accordance with the Danish Data Protection Act and the General Data Protection Regulation. Ethical committee approval or patient consent is not required for register-based studies that are performed for the sole purpose of statistics and scientific research in Denmark.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}