Risk for Alcohol-Exposed Pregnancies Among Women at Drinking Venues in Cape Town, South Africa.

Abstract

South Africa's Western Cape Province has one of the highest rates of fetal alcohol spectrum disorder globally. Alcohol-serving venues are likely important sites to identify women at high risk of having a child with fetal alcohol spectrum disorder. The goal of this study was to examine the risk for alcohol-exposed pregnancies among women who drink in alcohol-serving venues. Cross-sectional surveys were conducted with 200 women of reproductive age at seven drinking venues in a single Cape Town community. Surveys assessed sexual behavior, contraceptive use, and drinking behavior (both current and during previous pregnancies). Women were defined as being at risk for alcohol-exposed pregnancy if they were currently drinking, sexually active in the previous 60 days, and not consistently using modern contraceptives. Almost all participants (95.5%) met criteria for hazardous drinking. In total, 20.3% of the 152 sexually active women were identified as at risk for alcohol-exposed pregnancy, and 2 women were currently pregnant and drinking. A majority of sexually active participants (79.6%) reported consistent use of a modern contraceptive. Most contraceptives (66.1%) were short-acting methods such as injectables. Of the 176 participants who reported previous pregnancies, 64.8% said they drank alcohol during a previous pregnancy and 51.1% met criteria for hazardous drinking during that pregnancy. Given the high rates of alcohol consumption during pregnancy, alcohol-serving venues should be targeted for fetal alcohol spectrum disorder prevention interventions. Efforts should be made to increase uptake of long-acting contraceptives among women who do not wish to get pregnant and to promote alcohol cessation among women with pregnancy intentions.