Bridging Knowledge Gaps: Prenatal Education Acquisition and Its Determinants Among Expectant Mothers in Northwestern China

Xiali Yang,1,2 Yanhua Ning,3 Ying He,1 Nadzratulaiman Wan Nordin,4 Xin Wee Chen2 1Department of Maternal and Infant Nursing, School of Nursing, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China; 2Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia; 3Department of Community Nursing, School of Nursing, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China; 4Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Teknologi MARA, Selangor, MalaysiaCorrespondence: Xin Wee Chen, Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia, Tel + 603-6126 7187, Email [email protected]: High-risk pregnancies (HRPs) remain a significant global public health issue, notably increasing maternal and neonatal morbidity and mortality. Prenatal education is crucial in mitigating the risks associated with HRPs by providing expectant mothers with essential health information. This study aims to investigate the factors associated with frequent acquisition of prenatal knowledge.Methods: A multicentre cross-sectional study was conducted between March and October 2023 involving 1211 pregnant women from three hospitals in Northwestern China. Data were collected via a self-administered questionnaire. Frequent prenatal knowledge acquisition was defined as seeking information at least three times per week. Both simple and multivariate logistic regression analyses were performed to identify determinants. Crude odds ratios (ORs) and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated, and model discrimination was assessed using the area under the receiver operating characteristic curve (AUC).Results: Approximately 69.5% of participants reported regularly seeking prenatal information. Healthcare professionals were the most cited information source (64.7%). The multivariate logistic regression model demonstrated good discrimination (AUC = 0.75). Six factors were significantly associated with frequent knowledge acquisition: high-risk pregnancy (AOR=1.49, 95% CI: 1.15– 1.94), higher household income (AOR=1.45, 95% CI: 1.06– 1.98), shorter distance to healthcare facilities (AOR=2.65, 95% CI: 1.80– 3.91 for < 30 min), public sector employment (AOR=2.04, 95% CI: 1.40– 2.99), attending ≥four antenatal visits (AOR=2.49, 95% CI: 1.27– 4.89), and being in a long-distance marriage (AOR=2.21, 95% CI: 1.40– 3.51).Conclusion: The acquisition of prenatal knowledge is influenced by high-risk pregnancy status and multiple sociodemographic factors. Priority interventions should target underserved groups, particularly low-income families, women in remote areas, and those with high-risk pregnancies. Health systems should enhance equitable access by combining digital platforms for urban populations with community-based outreach (e.g, mobile clinics, health workers) for marginalized communities.Plain Language Summary: Some pregnancies carry higher risks, potentially leading to health issues. Prenatal education helps expectant mothers recognise problems early and make informed decisions.This study looked at how often pregnant women learn new information and the factors that affect their learning. 1211 women completed a survey during their first antenatal visit.About 70% regularly sought information on pregnancy health. Factors enabling this included a high-risk pregnancy, higher household income, living closer to healthcare facilities, public-sector employment, attending ≥ 4 antenatal visits, or being in a long-distance marriage. Healthcare professionals were the most trusted information source.The findings highlight the need to improve access to reliable prenatal education, especially for women in underserved settings.Keywords: high-risk pregnancy, prenatal care, health knowledge, attitudes, practice, information-seeking behaviour, sociodemographic factors