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Research Article: Maternal health literacy status and associated factors among pregnant women: a cross-sectional study in Chongqing, China

Date Published: 2026-07-16

Abstract:
Maternal health literacy (MHL) plays a critical role in improving perinatal outcomes. This study aimed to investigate MHL status and its associated factors among pregnant women in Chongqing, China. This multi-center cross-sectional study included 1025 low-risk pregnant women between September 1 and December 31,2023, at 6 hospitals in Chongqing, and the participants were enrolled with equal distribution across trimesters (1:1:1). Data were collected using medical records, sociodemographic questionnaire and MHL questionnaire. Logistic regression was used to examine factors associated with MHL. The adequate MHL rate was 7.9% among pregnant women in this study, with a higher rate (9.66%) in the dimension of basic knowledge. However, there was no significant difference in the three subscales of MHL ( P = 0.070). Furthermore, there was no significant difference in the rate of MHL across different trimesters ( P = 0.058), although the rate was higher in the first trimester (9.94%) and lower in the second trimester (5.19%). Higher educational level (OR = 2.584, 95% CI = 1.045–6.391), worries about the effect of pregnancy on work (OR = 2.287, 95% CI = 1.386–3.772), and attendance at pregnancy school (OR = 2.917, 95% CI = 1.434–5.934) were positively associated with the rate of MHL. Participants from rural areas (OR = 0.365, 95% CI = 0.218–0.610), ethnic minorities (OR = 0.297, 95% CI = 0.103–0.859), and abnormal results of prenatal screening (OR = 0.259, 95% CI = 0.078–0.861) were negatively associated with the rate of MHL. The adequate MHL rate in Chongqing was relatively low, and it was positively associated with higher educational level, worries about the effect of pregnancy on work, and attendance at pregnancy school, but was negatively associated with living in rural areas, ethnic minorities, and abnormal results of prenatal screening. Based on this evidence, future research could improve the rate of MHL.

Introduction:
Maternal health literacy (MHL) plays a critical role in improving perinatal outcomes. This study aimed to investigate MHL status and its associated factors among pregnant women in Chongqing, China.

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