Assessing maternal knowledge of neonatal danger signs in Egypt: a cross-sectional study

Maternal knowledge regarding the neonatal danger signs (NDSs) plays a fundamental role in early detecting neonatal health conditions, decreasing untreated symptoms, and improving optimal infant development. This study aimed to determine the level of maternal knowledge about NDSs and identify associated socio-demographic factors among Egyptian mothers. A cross-sectional study was conducted in healthcare facilities through face-to-face interviews from January to March 2025. We included mothers older than 18 years with infants aged 1-24 months. Mothers were recruited through a multistage stratified sampling technique from nine Egyptian governments selected from all Egyptian geographical sectors. The Arabic Questionnaire to assess the Knowledge of Neonatal Danger Signs (AQ-KNDS) was used for assessing maternal knowledge with a score ranged from 1 to 16. Multiple linear regression model identified predictors of knowledge score. Of 1831 participating mothers representing 96.3% response rate, 31% were under 25, 97.3% were married, and 58.7% were living in urban areas. The median score of maternal knowledge was 14.0 (IQR: 13.0-16.0). 75.8% of mothers scored above 75.0%. Beheira governorate had the highest median knowledge score while New Valley had the lowest (15.0 (13.3-16.0) vs. 13.0 (12.0-14.0), P < 0.001). Higher-educated mothers had a significantly higher knowledge scores compared to lower education (median (IQR) 15.0 (13.0-16.0) vs. 14.0 (13.0-16.0), P = 0.006). The multivariable linear regression model predicted the higher knowledge score was due to living in rural areas ( β = 0.44; 95% CI 0.23-0.66); P = 0.001), attending antenatal follow-ups ( β = 0.53; 95%CI 0.30-0.76; P = 0.001), and seeking information from healthcare providers (β = 0.93; 95%CI 0.60-1.25; P = 0.001). These findings underscore the urgent need for targeted educational campaigns, particularly in underserved and remote areas. Strengthening antenatal services and leveraging trusted information sources could enhance early recognition of danger signs and timely medical intervention, ultimately contributing to reduced neonatal mortality rates in Egypt.