Relationship between health literacy and pregnancy consequences in women referring to comprehensive health service centers

Document Type : Original Article


1 Department of Nursing, School of Nursing and Midwifery, Dezful University of Medical Sciences, Dezful, Iran

2 Department of Midwifery, School of Nursing and Midwifery, Dezful University of Medical Sciences

3 Student Research Committee, Dezful University of Medical Sciences, Dezful, Iran

4 Department of Nursing, School of Nursing and Midwifery, Dezful University of Medical Sciences, Dezful, Iran.


Background and Objective: Maternal health literacy is a cognitive and social skill that demonstrates women's motivation and ability to properly access, understand, and use the information to maintain the health of themselves and their children. This study aimed to investigate the relationship between health literacy and pregnancy consequences in women referring to comprehensive health service centers in Dezful.

Materials and Methods: This cross-sectional study (descriptive-analytical) was performed in 2020 on 220 pregnant women referring to comprehensive health service centers in Dezful for routine pregnancy care. Subjects were selected by multi-stage cluster random sampling. Data collection tools were Maternal Health Literacy and Pregnancy Consequences Questionnaire (MHLAPQ). Data analysis was performed using SPSS statistical software (version 16).

Results: There was a positive and significant relationship between the average score of health literacy and the mean score of pregnancy consequences including the higher level of health literacy, the lower level of the pregnancy consequences (P <0.0001, r = 0.695), and there was a positive and significant relationship between the mean average of health literacy and the average score of birth weight (<0.002).

Conclusion: The results obtained in the study demonstrated that there was a significant relationship between maternal health literacy and prenatal care, pregnancy consequences, and birth weight, which indicates the need to pay more attention to education and increase maternal health literacy in health promotion programs.


1. Peyman N, Ezzati Rastegar K, Tehrani H, Zarei F. Explanation of unwanted pregnancy from the perspective of family planning service providers: An exploratory study. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2016;19(12):18-26.
2. Zalvand R, Tajvar M, Pourreza A, Asheghi H. Determinants and causes of maternal mortality in Iran based on ICD-MM: a systematic review. Reproductive health. 2019;16(1):1-15.
PMid:30736803 PMCid:PMC6368742  
3. Vila-Candel R, Navarro-Illana E, Mena-Tudela D, Pérez-Ros P, Castro-Sánchez E, Soriano-Vidal FJ, et al. Influence of Puerperal Health Literacy on Tobacco Use during Pregnancy among Spanish Women: A Transversal Study. International journal of environmental research and public health. 2020;17(8):2910.
PMid:32340128 PMCid:PMC7216153  
4. Izadi rad H, Nohtani V, Aliahmadi M, Pourhaji F, Niknami S. The effect of educational intervention based on the integrated model of health belief with the structure of social support on self-care behaviors during pregnancy. Iranian Journal of Health Education and Health Promotion. 2020;8(4):324-35.  
5. Pirzadeh A, Nodooshan T, Nasirian M. Association between maternal health literacy level and prenatal care in Iran. Journal of Health Literacy. 2024;4(1):60-7.  
6. Salem OA, Sulami A, Al-Ammar KA. Evaluation of health literacy among females in outpatient clinics. Annals of Medical and Health Sciences Research. 2018.  
7. Zaree F, Karimi F, Mohseni S, Mdani S, Dadipoor S, Mdani AH. Health literacy of pregnant women and some related factors in pregnant women referred to Minab health centers. Journal of Preventive Medicine. 2017;4(2):40-6.  
8. Mirzaei R, Sayehmiri K, Mousavi M, Direkvand Moghadam A, Asadollahi K. Evaluation of the prevalence rate and risk factors associated with intrauterine growth retardation in Ilam province during 2014. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2017;20(10):95-104.  
9. Barnes LAJ, Barclay L, McCaffery K, Aslani P. Complementary medicine products used in pregnancy and lactation and an examination of the information sources accessed pertaining to maternal health literacy: a systematic review of qualitative studies. BMC complementary and alternative medicine. 2018;18(1):229.
PMid:30064415 PMCid:PMC6069845  
10. Briese V, Voigt M, Hermanussen M, Wittwer-Backofen U. Morbid obesity: pregnancy risks, birth risks and status of the newborn. Homo. 2010;61(1):64-72.
11. Jafari Y, Vahedian-Shahroodi M, Tehrani H, Haresabadi M, Shariati M. The relationship between caregivers' health literacy and the behavior of women with multiple sclerosis. Iranian Journal of Obstetrics, Gynecology and Infertility. 2018;21(7):71-64.  
12. Safari Morad Abadi A, Agha Molaei T, Ramezankhani A, Dadipoor S. The Health Literacy of Pregnant Women in Bandar Abbas, Iran. Journal of School of Public Health and Institute of Public Health Research. 2017;15(2):121-32.  
13. Khorasani EC, Sany SBT, Orooji A, Ferns G, Peyman N. Health literacy in Iranian women: a systematic review and meta-analysis. Iranian Journal of Public Health. 2020;49(5):860.  
14. Khosravi A, Ahmadzadeh K. Investigating health literacy Level of patients referred to Bushehr hospitals and recognizing its effective factors. 2016.  
15. Carollo S. Low health literacy in older women: The influence of patient-clinician relationships. Geriatric Nursing. 2015;36(2):S38-S42.
16. Nejatian M, Tehrani H, Momeniyan V, Jafari A. A modified version of the mental health literacy scale (MHLS) in Iranian people. BMC psychiatry. 2021;21(1):1-11.
PMid:33485306 PMCid:PMC7824912  
17. Izadirad H, Niknami S, Zareban I, Hidarnia A, Masoudy G. Relationship between health literacy and prenatal care in young pregnant women. Journal of Health Literacy. 2017;2(3):141-7.  
18. Nodooshan T, Pirzadeh A, Nasirian M. The Relationship between Maternal Health Literacy and Pregnancy Status in New Mothers who Referred to Health Centers of Yazd. Tolooebehdasht. 2020;18(6):22-33.  
19. Sajjadi H, Hosseinpour N, Sharifian Sani M, Mahmoodi Z. Association between health literacy and life style in married rural women in Izeh, Iran. Journal of health. 2016;7(4):479-89.  
20. -Kharazi SS, Peyman N, Esmaily H. ěž. An evaluation of the validity and reliability of the maternal health literacy and pregnancy consequences questionnaire. Journal of Health System Research. 2017;12(4):512-9.  
21. Eshghizadeh M, Akbari S, Majidi F, Khalili F. Relationship between health literacy and lifestyle in patients at risk and with chronic obstructive pulmonary disease. Journal of Health Literacy. 2020;5(1):61-8.  
22. Forghani T, Ahmadian M, Rezaeisharif F, Ahadi M. Survey of Health Literacy during pregnancy and Its Relationship with Prenatal Care. Journal of Health Literacy. 2021;6(1):20-30.  
23. Tugut N, Yesildag Celik B, Yılmaz A. Health Literacy and Its Association with Health Perception in Pregnant Women. Journal of Health Literacy. 2021;6(2):9-20.  
24. Wilhelmova R, Hruba D, Vesela L. Key determinants influencing the health literacy of pregnant women in the Czech Republic. Slovenian Journal of Public Health. 2015;54(1):27.
PMid:27646619 PMCid:PMC4820146  
25. Arabin B, Timmesfeld N, Noever K, Behnam S, Ellermann C, Jenny MA. How to improve health literacy to reduce short-and long-term consequences of maternal obesity? The Journal of Maternal-Fetal & Neonatal Medicine. 2019;32(17):2935-42.
26. Dadipoor S, Mehraban M, Ziapour A, Safari Moradabadi A. Causes of maternal mortality in Iran: a systematic review. International journal of pediatrics. 2017.  
27. Rahmani N, Mostafavian Z, Nasiri R, Farajpour A. Comparison of health literacy between the pregnant women referring to health care centers and those referring to private offices. Journal of Health Literacy. 2019;4(2):35-43.  
28. França AS, Pirkle CM, Sentell T, Velez MP, Domingues MR, Bassani DG, et al. Evaluating Health Literacy among Adolescent and Young Adult Pregnant Women from a Low-Income Area of Northeast Brazil. International Journal of Environmental Research and Public Health. 2020;17(23):8806.
PMid:33260807 PMCid:PMC7730350