Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, 760 Westwood Plaza, rm 68-265A, Los Angeles, CA 90024, United States.
Soc Sci Med. 2011 Jan;72(1):83-90. doi: 10.1016/j.socscimed.2010.09.049. Epub 2010 Oct 23.
South Africa has the highest prevalence of Fetal Alcohol Spectrum Disorders (FASDs) in the world. The purpose of this study was to identify high risk factors associated with drinking alcohol prior to pregnancy recognition in 24 neighborhoods in the Cape Flats outside Cape Town, South Africa. An interviewer assessed risk among 619 pregnant Black/African women between the ages of 18 and 41 years. Logistic regression analyses explored factors associated with drinking alcohol post conception but prior to pregnancy recognition. Forced multiple logistic regression analysis revealed that drinking prior to pregnancy recognition was associated with being younger, single, having better living conditions, smoking, having a longer gestation prior to pregnancy recognition, having a greater number of sexual partners, and a higher incidence of intimate partner violence. Depressive symptoms tended to be higher among alcohol users. These risk factors were consistent with other research on the characteristics of South African women having children with a diagnosis of Fetal Alcohol Spectrum Disorders and/or of non pregnant women at high risk for an alcohol-exposed pregnancy. These findings highlight the need for women of child-bearing age to be routinely screened for alcohol use and its associated risk factors. Intervention efforts could be integrated into health initiatives already present in South Africa including the prevention and treatment of HIV/AIDS, tuberculosis, and malnutrition. Preconception care is particularly important since pregnancy recognition often occurs several weeks to months following conception and could be implemented by South African community health workers. These endeavors should facilitate national goals of healthier pregnancies and the elimination of FASDs in South Africa.
南非是世界上胎儿酒精谱系障碍（FASD）发病率最高的国家。本研究的目的是在南非开普敦外的开普弗拉特（Cape Flats）的 24 个街区中，确定与怀孕前意识到怀孕前饮酒相关的高风险因素。一位访谈者对 619 名年龄在 18 至 41 岁之间的怀孕黑人/非洲妇女进行了风险评估。逻辑回归分析探讨了与怀孕后但在意识到怀孕前饮酒相关的因素。强制多逻辑回归分析显示，在意识到怀孕前饮酒与年龄较小、单身、生活条件较好、吸烟、在意识到怀孕前有更长的妊娠时间、有更多性伴侣以及亲密伴侣暴力发生率较高有关。饮酒者的抑郁症状往往较高。这些风险因素与其他关于南非妇女具有胎儿酒精谱系障碍诊断特征的研究以及具有酒精暴露性怀孕高风险的非孕妇的研究结果一致。这些发现强调了需要对育龄妇女进行常规筛查，以了解其饮酒情况及其相关风险因素。干预措施可以整合到南非现有的卫生倡议中，包括预防和治疗艾滋病毒/艾滋病、结核病和营养不良。孕前保健尤为重要，因为意识到怀孕通常发生在受孕后数周至数月，并且可以由南非社区卫生工作者来实施。这些努力应该有助于实现南非更健康怀孕和消除 FASD 的国家目标。
