title: Risk factors for substance use in pregnant women in South Africa.
abstract: OBJECTIVE
  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.affiliation: Department of Psychiatry, University of Cape Town, Western Cape, South Africa. bavanisha.vythilingum@uct.ac.za
authors.forename: Bavanisha
authors.initials: B
authors.lastname: Vythilingum
authors.forename: Annerine
authors.initials: A
authors.lastname: Roos
authors.forename: Sheila C
authors.initials: SC
authors.lastname: Faure
authors.forename: Lut
authors.initials: L
authors.lastname: Geerts
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012307:Risk Factors; D057566:Self Report; D013019:South Africa / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult