Knowledge, attitudes, practices, and barriers regarding oral healthcare during pregnancy: a cross-sectional study among obstetricians in Guangxi, China

Maternal oral health is closely linked to pregnancy outcomes, yet its integration into prenatal care remains inadequate, particularly in resource-limited regions like Guangxi, China. Obstetricians, as primary caregivers for pregnant women, play a critical role in bridging this gap. This study aimed to evaluate their knowledge, attitudes, and practices regarding oral healthcare during pregnancy, identify service barriers, and analyze the interrelationships among these factors. A cross-sectional, online questionnaire-based study was conducted from Nov 2024 to Jan 2025 among licensed obstetricians in Guangxi.The questionnaire assessed demographic characteristics and four key dimensions: knowledge, attitudes, practices, and barriers related to oral healthcare during pregnancy. Data were analyzed using multivariable descriptive statistics (frequencies, percentages) and inferential methods (Mann-Whitney U test, Kruskal-Wallis test, Spearman correlation, and multiple linear regression). Among 532 participants, 526 returned valid surveys (98.9% response rate). Only 179 (34.0%) had received oral health training. Mean scores were: knowledge 9.68/16, attitude 32.18/40, practice 18.61/30, and barriers 28.09/40. Knowledge strongly correlated with attitude (r = 0.668, P <0.001), weakly with practice (r = 0.116, P <0.001), and positively with barriers (r = 0.341, P <0.001). Due to the cross-sectional design, causality cannot be inferred; notably, knowledge alone poorly predicts practice. The weak knowledge-practice association further indicates that knowledge alone is insufficient to predict service utilization. Obstetricians in Guangxi demonstrated moderate knowledge and positive attitudes toward perinatal oral healthcare; however, their clinical engagement remained limited and substantial service barriers were reported. These findings underscore the urgent need for developing interdisciplinary clinical guidelines between obstetrics and dentistry, establishing specialized oral health training programs tailored for obstetricians, and systematically integrating oral health screening into routine antenatal care protocols to bridge the knowledge-practice gap and enhance the quality of perinatal oral health services.