Paternal drinking in western China is associated with preschool children’s well-being: a cross-sectional SDQ study

Background: Limited evidence links paternal drinking (41.5% prevalence) to preschoolers' behavioral difficulties in Western China, necessitating Strengths and Difficulties Questionnaire-based studies to assess psychosocial outcomes. Method: From February 28 to March 5, 2025, a cross-sectional study enrolled 25,017 parent-child dyads across 189 public kindergartens in a western city, China, using stratified sampling. After excluding 2,408 non-parents and 1,397 dyads with invalid age data, 21,212 remained. Paternal alcohol intake was categorized as nondrinkers, ex-drinkers, or current drinkers (light [≤ 2.86 g/day], moderate [>2.86-20 g/day], heavy [>20-40 g/day]. Child mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ), with total difficulties (TDS >14 vs. ≤14) and prosocial behavior (PB 14; adjusted OR = 1.54, P