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

J Stud Alcohol Drugs. 2017 Sep;78(5):795-800. doi: 10.15288/jsad.2017.78.795.


Objective: 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.

Method: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Alcohol Drinking / epidemiology*
  • Cross-Sectional Studies
  • Ethanol / administration & dosage*
  • Female
  • Fetal Alcohol Spectrum Disorders / epidemiology*
  • Humans
  • Pregnancy
  • Risk Factors
  • Sexual Behavior
  • South Africa / epidemiology
  • Surveys and Questionnaires
  • Young Adult


  • Ethanol