Alcohol Use, Partner Violence, and Depression
Open accessAbstract
INTRODUCTION: Pregnant South African women with histories of drinking alcohol, abuse by violent partners, depression, and living with HIV are likely to have their post-birth trajectories over 36 months significantly influenced by these risks. DESIGN: All pregnant women in 24 Cape Town neighborhoods were recruited into a cluster RCT by neighborhood to either: (1) a standard care condition (n=12 neighborhoods, n=594 mothers); or (2) a home-visiting intervention condition (n=12 neighborhoods, n=644 mothers). SETTING/PARTICIPANTS: Pregnant women residing in urban, low-income neighborhoods in Cape Town, South Africa. INTERVENTION: Home visiting included prenatal and postnatal visits by community health workers (Mentor Mothers) focusing on general maternal and child health, HIV/tuberculosis, alcohol use, and nutrition. MAIN OUTCOME MEASURES: Mothers were assessed in pregnancy and at 18 and 36 months post birth: 80.6% of mothers completed all assessments between 2009 and 2014 and were included in these analyses performed in 2014. Longitudinal structural equation modeling examined alcohol use, partner violence, and depression at the baseline and 18-month interviews as predictors of maternal outcomes at 36 months post birth. RESULTS: Relative to standard care, intervention mothers were significantly less likely to report depressive symptoms and more positive quality of life at 36 months. Alcohol use was significantly related to use over time, but was also related to depression and HIV status at each assessment and partner violence at 36 months. CONCLUSIONS: Alcohol, partner violence, and depression are significantly related over time. A home-visiting intervention improved the emotional health of low-income mothers even when depression was not initially targeted.
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Of the health promotion and education RCTs, 2 were based in the workplace, 5 in the community, 6 in schools, and 7 in clinics, of which 1 focused on women sex workers.
“Of these, 2 were based in the workplace [26,38], 5 in the community [23,37,43,84], 6 in schools [33,40,65,85,86], and 7 in clinics [39,55–57], of which 1 was focused on women sex workers [95].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [84]
Rotheram-Borus found that home visits for pre- and postnatal women were associated with a reduction in the use of alcohol during pregnancy, but this drinking resumed postpartum.
“Similarly, Rotheram-Borus found that home visits for pre- and postnatal women were associated with a reduction in the use of alcohol during pregnancy, but this drinking resumed postpartum [84].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [84]
About half (8 of 17) of the health promotion and education interventions were found to have positive results.
“About half (8 of 17) of the health promotion and education interventions were found to have positive results [25,26,38,39,54,56,57,65,66,84].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [84]
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“…with spiritual and traditional healers (Agyapong et al. 2015a); disconnect between providers and decision makers (Agyapong et al. 2015a, 2016; Rotheram-Borus et al. 2015); existing heavy workload of lay providers (Petersen et al. 2011; Hung et al. 2014); gender differences in responding to…”
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“There was also heterogeneity in the target population across RCTs; eg, Patel et al (2017) [12] focused solely on depressed women while Rotheram-Borus et al (2015) [25] focused on pregnant women with history of IPV.”
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“Consistent with previous research (Rotheram-Borus et al., 2015; le Roux et al., 2014), we hypothesize that maternal alcohol use is associated with more negative child outcomes and that the intervention will reduce both maternal alcohol use and the associated negative child outcomes.”
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- Authors
- Rotheram-Borus, M. J., Tomlinson, M., Roux, I. L., & Stein, J. A.
- Affiliations
- Stellenbosch University (ZA)
- University of California, Los Angeles (US)
- Venue
- American Journal of Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2015-11
- Volume
- 49
- Issue
- 5
- Pages
- 715-725
- ISSN
- 0749-3797 (ISSN-L)
- PMC
- PMC4615286
- OpenAlex
- W958894477
- Cited by
- 71
- References
- 46
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 5 · 2023: 4 · 2022: 10 · 2021: 7 · 2020: 8 · 2019: 10 · 2018: 8 · 2017: 8 · 2016: 5
- FWCI
- 8.78
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- American Journal of Preventive Medicine (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (1R01AA017104)
- NIH (MH58107, 5P30AI028697, 1R24AA022919, UL1TR000124)
- Topics
- Social Sciences › Health › Intimate Partner and Family Violence
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- alcohol use in pregnancy, intimate partner violence, maternal depression, postpartum depression, home visiting intervention, community health workers, maternal mental health, HIV status, quality of life, low-income mothers, Cape Town
- MeSH terms
- Maternal Health, Adolescent, Adult, Alcohol Drinking, Depression, Female, House Calls, Humans, Longitudinal Studies, Mothers, Poverty, Pregnancy, Psychiatric Status Rating Scales, Quality of Life, South Africa, Spouse Abuse, Urban Population, HIV Infections, Young Adult
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