ArticleSouth African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde2022
The tragedy of smoking, alcohol, and multiple substance use during pregnancy.
Article in South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 19 citations in OpenAlex.
- Prevalence and determinants of preterm birth at University Teaching Hospital of Kigali: a retrospective study.BMC pregnancy and childbirth · 2026Article
- A systematic review investigating prenatal cannabis and tobacco co-exposure: Impacts on neonatal, behavioral, cognitive and physiological outcomes.Drug and alcohol dependence reports · 2025Review
- Substance and alcohol use in pregnant women attending antenatal care at a tertiary hospital in Johannesburg, South Africa.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2025Article
- Associations of maternal alcohol and non-prescribed substance use with early child growth.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2025Article
- Selecting a birth weight standard for an indigenous population in a LMIC: A prospective comparative study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2024Article
- Risk factors for small for gestational age as defined by a birthweight z-score below minus one: A prospective observational study.Medical research archives · 2024Article
- Alcohol exposure before and during pregnancy is associated with reduced fetal growth: the Safe Passage Study.BMC medicine · 2023Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAntenatal substance use is a significant public health concern in South Africa (SA). Information on smoking, drinking and drug use during pregnancy was collected prospectively for the Safe Passage Study of the PASS (Prenatal Alcohol in Sudden infant death syndrome and Stillbirth) Network.
objectivesData from 4 926 pregnant women in a community near Tygerberg Academic Hospital, Cape Town, were examined to determine whether associations between different substance use groups and postnatal infant outcomes at birth and 1 year were significant.
methodsGestational age (GA) was determined by earliest ultrasound. Maternal data were collected at enrolment or first antenatal visit. Substance use data were obtained at up to four occasions. Birthweight data were derived from medical records, and birthweight z-scores (BWZs) were specifically calculated using INTERGROWTH-21st study data. Statistical analyses were done with Statistica version 13. Results. Women who used more substances enrolled later, were younger, and had smaller mid-upper arm circumferences (MUACs), less education and lower monthly income than women who used no substances (control group). Infants born to women who used more substances had lower GA at delivery, birthweight and BWZ than infants from the control group. At 1 year, infants born to women who used more substances had a lower weight, shorter length and smaller head circumference. Education was positively associated with all infant outcomes at birth and 1 year. MUAC was positively associated with infant BWZ, and weight and length at 1 year. Income was negatively associated with BWZ, but positively associated with all 1-year outcomes.
conclusionSubstance use during pregnancy affects infant outcomes at birth and 1 year of age. The addictive properties of substance use make cessation difficult, so prevention strategies should be implemented long before pregnancy. Higher maternal education, associated with better infant outcomes at birth and 1 year and acting as a countermeasure to substance use, is of paramount importance.
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