The Relationship between Health Literacy and Adequacy of Prenatal Care Utilization Index with Pregnancy and Postpartum Outcomes

Document Type : Original Article


1 Bsc, Msc Nursing Student, Department of Nursing, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

2 Associate Professor of Health Education and Promotion, Department of Health Education and Promotion, School of public health, Ahvaz Jundishapur University of Medical Sciences Ahvaz, Iran

3 Assistant Professor of Biostatistics, Department of Biostatistics and Epidemioligy, School of public health, Ahvaz Jundishapur University of Medical Sciences Ahvaz, Iran

4 Assistant Professor of Nursing, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences Ahvaz, Iran.


Background and Objective: Health literacy of pregnant mothers along with prenatal care is effective in preventing the adverse outcomes of pregnancy. We aimed to assess the relationship between health literacy and adequacy of prenatal care utilization index with pregnancy and adverse postpartum outcomes.

Materials and Methods: The present study was a descriptive-analytical study done in health centers affiliated to Jundishapur University of Medical Sciences, Ahvaz, Iran. Cluster sampling is used and 20 centers were selected from 55 center randomatically.The data collection tools were demographic characteristics questionnaire, maternal health literacy and pregnancy outcome questionnaire (MHLAPQ), standard Adequacy of Prenatal Care Utilization Index (APNCUI), fetal-maternal outcomes checklist, and neonatal-maternal outcomes checklist designed by the researcher. Data were analyzed at a significance level of 0.05.

Results: The health literacy score was 55.65±11.53 (range: 14-70). 176 (44%) women had adequate prenatal care index. 64% of the women had adverse pregnancy outcomes, and neonatal outcomes were seen in 49% of the participants. 16% of the women and 64.3% of the neonates had postpartum outcomes. Health literacy was significantly associated with fetal outcomes during pregnancy (P=0.023) but not with maternal outcomes during pregnancy (P=0.652), maternal postpartum outcomes (P=0.084), and neonatal postpartum outcomes (P=0.391). The pregnancy care adequacy index had a significant relationship with maternal and fetal outcomes during pregnancy and infancy (P<0.001). But it had no significant relationship with maternal outcomes after delivery (P=0.224).

Conclusion: Promoting health literacy and receiving prenatal care in pregnant mothers requires health care providers to be aware of these indicators to design educational and care programs to promote and maintain a safe pregnancy and create a pleasant experience of pregnancy and postpartum for the mother and her family.


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