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Risk factors for substance use in pregnant women in South Africa

Bavanisha Vythilingum, Annerine Roos, Sheila C Faure, Lut Geerts, Dan J Stein

Abstract


Objectives. To study the prevalence of alcohol and substance use in a South African antenatal population and its correlates with socio-demographic factors, depression and perceived stress.

Methods. A prospective self-report study on all women presenting for their first antenatal visit who consented to the study at a midwife obstetric unit (MOU) in the East Metropole district, Cape Town, using the Alcohol Use Disorders Identification Test (AUDIT), Drug Use Disorders Identification Test (DUDIT), Edinburgh Depression Scale (EDS) and Perceived Stress Scale (PSS). Statistical analyses using the chi-square test, separate one-way analyses of variance (ANOVA) and logistic regression analyses were performed as appropriate. Outcome measures were depression, alcohol use and substance use.

Results. The questionnaire was completed by 323 women. During pregnancy 36.8% of women smoked, 20.2% used alcohol and 4% used substances. Using EDS cut-off scores of 12 and 15, respectively, 48.9% and 33.6% of the sample had scores consistent with major depression. An EDS cut-off score of 12 was significantly associated with both alcohol use (25.9% v. 15.2%, p=0.019) and risky drinking (76.9% v. 36.8%, p=0.04), while an EDS cut-off score of 15 was significantly associated with substance use (8.2% v. 1.4%, p=0.004) as well as alcohol dependence (23.1% v. 3.1%).

Conclusions. We found high rates of both alcohol abuse and antenatal depression, and a significant association between depression, substance use and alcohol abuse; EDS scores greater than 12 could be used to identify women at risk of alcohol dependence and/or substance abuse.

Authors' affiliations

Bavanisha Vythilingum, Department of Psychiatry, University of Cape Town, and MRC Research Unit on Anxiety and Stress Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Western Cape

Annerine Roos, MRC Research Unit on Anxiety and Stress Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Western Cape

Sheila C Faure, MRC Research Unit on Anxiety and Stress Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Western Cape

Lut Geerts, Department of Obstetrics and Gynaecology, Stellenbosch University, Tygerberg, Western Cape

Dan J Stein, Department of Psychiatry, University of Cape Town, and MRC Research Unit on Anxiety and Stress Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Western Cape

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Keywords

Epidemiology, pregnancy, substance use, alcohol, depression

Cite this article

South African Medical Journal 2012;102(11):851-854. DOI:10.7196/SAMJ.5019

Article History

Date submitted: 2011-05-17
Date published: 2012-09-14

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