Risk factors for substance use in pregnant women in South Africa

Vythilingum, Bavanisha; Roos, Annerine; Faure, Sheila; Geerts, L; Stein, Dan J.

doi:10.7196/samj.5019

Cited by 72 publications

(101 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is a high prevalence of antenatal psychological distress and depression, consistent with previous work in the Western Cape (Dewing et al, 2013, Hartley et al, 2011, Roos et al, 2013 and Tomlinson et al, 2014). Substance use, particularly tobacco and alcohol use, is common, again consistent with prior local work (Dewing et al, 2013, Petersen Williams et al, 2014 and Vythilingum et al, 2012). In addition, there is a high reported prevalence of IPV within this cohort, as has been previously found during pregnancy in South Africa (Groves et al, 2014).…”

Section: Discussionsupporting

confidence: 78%

Investigating the psychosocial determinants of child health in Africa: The Drakenstein Child Health Study

Stein

Koen

Donald

et al. 2015

Journal of Neuroscience Methods

131

217

View full text Add to dashboard Cite

Background Early life psychobiological and psychosocial factors play a key role in influencing child health outcomes. Longitudinal studies may help elucidate the relevant risk and resilience profiles, and the underlying mechanisms that impact on child health, but there is a paucity of birth cohort data from low and middle-income countries (LMIC). We describe the rationale for and present baseline findings from the psychosocial component of the Drakenstein Child Health Study (DCHS). Methods We review the psychosocial measures used in the DCHS, a multidisciplinary birth cohort study in a peri-urban area in South Africa, and provide initial data on psychological distress, depression, substance use, and exposure to traumatic stressors and intimate partner violence (IPV). These and other measures will be assessed longitudinally in mothers in order to investigate associations with child neurodevelopmental and health outcomes. Results Baseline psychosocial data is presented for mothers (n = 634) and fathers (n = 75) who have completed antenatal assessments to date. The sample of pregnant mothers is characterized by multiple psychosocial risk factors, including a high prevalence of psychological distress and depression, high levels of substance use, and high exposure to traumatic stressors and IPV. Discussion These data are consistent with prior South African studies which have documented a high prevalence of a multitude of risk factors during pregnancy. Further longitudinal assessment of mothers and children may clarify the underlying psychobiological and psychosocial mechanisms which impact on child health, and so inform clinical and public health interventions appropriate to the South African and other LMIC contexts.

show abstract

Section: Discussionsupporting

confidence: 78%

Investigating the psychosocial determinants of child health in Africa: The Drakenstein Child Health Study

Stein

Koen

Donald

et al. 2015

Journal of Neuroscience Methods

131

217

View full text Add to dashboard Cite

show abstract

“…The tool has been validated for use during pregnancy (Burns et al, 2010) and in a sample of HIV-infected individuals in South Africa specifically (Myer et al, 2008). For the purposes of this research, the prevalence of risky drinking (AUDIT score >6) and alcohol dependence (AUDIT score >20) were described using the scoring system from the original development of the full AUDIT scale (Saunders et al, 1993) and cut-off scores previously used in South Africa (Vythilingum et al, 2012). …”

Section: Methodsmentioning

confidence: 99%

Factors associated with alcohol use prior to and during pregnancy among HIV-infected pregnant women in Cape Town, South Africa

Brittain

Remien

Phillips

et al. 2017

Drug and Alcohol Dependence

View full text Add to dashboard Cite

Introduction Alcohol use during pregnancy is prevalent in South Africa, but there are few prospectively-collected data exploring patterns of consumption among HIV-infected women, which may be important to improve maternal and child health outcomes. We examined patterns of and factors associated with alcohol use prior to and during pregnancy among HIV-infected pregnant women in Cape Town, South Africa. Methods Participants were enrolled when entering antenatal care at a large primary care clinic, and alcohol use was assessed using the AUDIT (Alcohol Use Disorders Identification Test). In analysis, the AUDIT-C scoring was used as a measure of hazardous drinking, and we examined factors associated with patterns of alcohol use in logistic regression models. Results Among 580 women (median age: 28.1 years), 40% reported alcohol use during the 12 months prior to pregnancy, with alcohol use characterised by binge drinking and associated with single relationship status, experience of intimate partner violence (IPV), and lower levels of HIV-related stigma. Of this group, 65% had AUDIT-C scores suggesting hazardous alcohol use, with hazardous alcohol users more likely to report having experienced IPV and having higher levels of education. Among hazardous alcohol users, 70% subsequently reported reduced levels of consumption during pregnancy. Factors independently associated with reduced consumption included earlier gestation when entering antenatal care and report of a better patient-healthcare provider relationship. Conclusions These unique data provide important insights into alcohol use trajectories in this context, and highlight the urgent need for an increased focus on screening and intervention at primary care level.

show abstract

“…Moreover, antenatal mental disorders have been observed to be prevalent in low- and middle-income countries (Fisher et al, 2012), and contribute to a heavy burden of child and maternal consequences in these settings (Patel, DeSouza, & Rodrigues, 2003; Rahman, Bunn, Lovel, & Creed, 2007). South Africa is one such setting where mental disorders, particularly depression, have been detected at high levels among pregnant women (Hartley et al, 2011; Rochat, Tomlinson, Barnighausen, Newell, & Stein, 2011; Vythilingum, Roos, Faure, Geerts, & Stein, 2012). Less is known about the prevalence and predictors of antenatal PTSD among South African women, as well as behavioral opportunities for addressing either of these psychological morbidities during the pregnancy period.…”

Section: Introductionmentioning

confidence: 99%

Maladaptive coping mediates the influence of childhood trauma on depression and PTSD among pregnant women in South Africa

Choi

Sikkema

Velloza

et al. 2015

Arch Womens Ment Health

View full text Add to dashboard Cite

Antenatal mental disorders compromise maternal and child health, and women who have experienced childhood trauma may be at increased risk for such disorders. One hypothesis is that early trauma leads to the development and use of maladaptive coping strategies as an adult, which in turn could predict mental health difficulties during stressful transitions such as pregnancy. To test this hypothesis, this study examined the relationship between childhood trauma and mental health (depression, PTSD) in a sample of 84 pregnant women seeking antenatal care in Cape Town, South Africa, and explored whether maladaptive coping mediated this relationship. The majority of women (62%) met established criteria for antenatal depression and 30% for antenatal PTSD; in addition, 40% reported a history of childhood trauma. Childhood trauma, especially childhood sexual abuse and emotional abuse, was significantly associated with depression and PTSD. The relationships between childhood trauma and depression and PTSD were significantly mediated by maladaptive coping, even when adjusted for the woman’s age, gestational age, and HIV status. Findings highlight the need for coping-based interventions to prevent and treat antenatal mental disorders among women with childhood trauma, particularly in high-trauma settings such as South Africa.

show abstract

Risk factors for substance use in pregnant women in South Africa

Abstract: South Africa has the highest rates of fetal alcohol spectrum disorders (FASD) in the world, with rates of over 70/1 000 in the Western Cape, one of the worst affected areas globally.1 In contrast, rates of 0

Cited by 72 publications

References 21 publications

Investigating the psychosocial determinants of child health in Africa: The Drakenstein Child Health Study

Investigating the psychosocial determinants of child health in Africa: The Drakenstein Child Health Study

Factors associated with alcohol use prior to and during pregnancy among HIV-infected pregnant women in Cape Town, South Africa

Maladaptive coping mediates the influence of childhood trauma on depression and PTSD among pregnant women in South Africa

Contact Info

Product

Resources

About