Alcohol use during pregnancy: prevalence and patterns in selected Buffalo City areas, South Africa

Catriona I Macleod, Charles Young, Katlego Molokoe


The high rate of foetal alcohol spectrum disorders, which results from alcohol consumption during pregnancy, is of concern in South Africa. The aims of this research were to establish the prevalence, patterns and factors associated with alcohol use amongst pregnant women attending antenatal clinics in two former township areas of Buffalo City, South Africa.

A survey was conducted using a structured questionnaire that included socio-demographic questions, and the Alcohol Use Test (AUDIT). The questionnaire was administered in English, Afrikaans or isiXhosa by healthcare providers trained in its administration. Consecutive sampling was used, with all willing women presenting at public clinics offering antenatal care in the two townships being invited to participate. Of the 18 clinics operating in the two townships, 16 were willing to participate, resulting in a sample of 1028 women over a nine-month period.  Data were analysed in Medcalc using descriptive statistics, one-way analysis of variance, independent samples t-test and a multivariable binary logistic regression analysis.

Two-thirds of the sample did not drink alcohol, but results showed high levels of risky alcohol use: 20.1% on the total AUDIT scale, and 16.8% on the AUDIT-C scale. The following variables were found to be significantly associated with risky drinking: age; race; report of intimate partner violence (IPV); and other regular drinker in the home. Employment status, education status, relationship status, parity and gestation were not associated with risky drinking. Interventions aimed at reducing alcohol use during pregnancy should address: drinking youth cultures; drinking norms within the home; and intimate partner violence. Future studies should include additional mental and physical health variables. (Afr J Reprod Health 2021; 25[1]: 114-121).

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