title: Alcohol and Other Drug Use during Pregnancy among Women Attending Midwife Obstetric Units in the Cape Metropole, South Africa.
abstract: Little is known about the nature and extent of alcohol and other drug (AOD) use among pregnant women in Cape Town, South Africa, despite the very high levels of AOD use in this part of the country. A cross-sectional survey was conducted among pregnant women attending 11 Midwife Obstetric Units (MOUs) in greater Cape Town. A two-stage cluster survey design was used. In total, 5231 pregnant women were screened to assess self-reported prevalence estimates. Of these, 684 (13.1%) were intentionally subsampled and completed an interviewer-administered questionnaire and provided a urine sample for biological screening. Urinalyses showed that 8.8% (95% CI: 6.7-10.9) of the subsample tested positive for at least one illicit drug. This is higher than the self-reported prevalence (3.6%). In addition, 19.6% (95% CI: 16.3-22.8) of the sub-sample tested positive for alcohol which is lower than the self-reported prevalence (36.9%). There are high levels of substance use among pregnant women attending public sector antenatal clinics. There is a need for routine screening for AOD use and appropriate responses depending on the women's level of risk.
authors.affiliation: Alcohol & Drug Abuse Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa.
authors.forename: Petal
authors.initials: P
authors.lastname: Petersen Williams
authors.affiliation: Biostatistics Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa ; Statistics and Population Studies Department, University of the Western Cape, P.O. Box X17, Bellville 7535, South Africa.
authors.forename: Esmé
authors.initials: E
authors.lastname: Jordaan
authors.affiliation: Health Systems Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa ; Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Falmouth Building, Medical Campus, Observatory 7925, South Africa.
authors.forename: Catherine
authors.initials: C
authors.lastname: Mathews
authors.affiliation: Biostatistics Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa.
authors.forename: Carl
authors.initials: C
authors.lastname: Lombard
authors.affiliation: Alcohol & Drug Abuse Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa ; Department of Psychiatry, Stellenbosch University, P.O. Box 19063, Tygerberg 7505, South Africa.
authors.forename: Charles D H
authors.initials: CD
authors.lastname: Parry