Comparison of Health Literacy of Mothers with Preterm and Full-term Birth in Exclusive Breastfeeding and Related Factors

Articles in Press

Document Type : Original Article

Authors

1 PhD Student, Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran

2 Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran

3 Assistant Professor, Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran

4 Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

5 PhD in Statistics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

6 Professor, Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background and Objectives: Enhancing women's health literacy leads to a better understanding of health information and can directly influence child nutrition and health throughout the developmental years. This study compared the health literacy of mothers with preterm and full-term births regarding exclusive breastfeeding and related factors among those attending healthcare centers in the Mashhad districts.

Materials and Methods: This cross-sectional study was conducted in 2023 on 648 women with children under two years of age who attended health centers in Mashhad, Iran. Participants were selected using proportional random sampling. Data were collected through validated and reliable questionnaires assessing demographic characteristics, the Labbok breastfeeding levels questionnaire to assess breastfeeding status, and maternal health literacy. Data analysis was performed using SPSS version 25, employing the Kolmogorov-Smirnov test, Chi-square test, independent t-test, one-way ANOVA, Mann–Whitney U test, and Kruskal–Wallis test, with a significance level set at p < 0.05.

Results:  The mean score of total health literacy as well as its domains of auditory comprehension and self-management among mothers with preterm and full-term deliveries was (39.5 ± 9.6, 27.7± 6.8, 11.7 ± 3.4) and (42.1 ± 8.50, 29.7 ± 6.0, 12.3 ± 2.8), respectively. A statistically significant difference was observed between the two groups in terms of health literacy level and exclusive breastfeeding practices (p < 0.05). In addition, maternal occupation, educational level, economic status, family support, number of pregnancies, residence, and infant growth status were significantly associated with maternal health literacy (p < 0.05).

Conclusion: The results indicated that health literacy among mothers of preterm birth was lower than that of mothers with full-term birth, and this group was less likely to practice exclusive breastfeeding. Therefore, developing targeted educational interventions—such as breastfeeding counseling and health literacy training focused on neonatal care—may help improve feeding behaviors and promote the health of preterm birth.

Keywords

Acknowledgments: The authors would like to express their sincere appreciation to the Vice Chancellor for Research of Mashhad University of Medical Sciences and the Comprehensive Health Service Centers of Mashhad for their valuable cooperation in conducting this study.


Availability of Data and Materials: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.


Conflict of Interest: The authors declare that they have no competing interests.


Consent for Publication: Not applicable.


Ethics Approval and Consent to Participate: This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. It was approved by Vice President of Research and Technology in Mashhad University of Medical Sciences (Project Code: 4021149; Ethics Code: IR.MUMS.FHMPM.REC.1402.210), and it has been registered in the university’s research information system. Prior to data collection, the study objectives were fully explained to all participants, and verbal informed consent was obtained from them.


Funding: financial support was received for conducting this study by Vice President of Research and Technology  Mashhad University of Medical Sciences.


Authors’ Contributions: N.P. M.N., N.Z., and A.Ch.Kh. contributed to the study design, data collection, and initial manuscript drafting. Statistical analysis was performed by M.B. N.P. supervised the study design, implementation, and manuscript writing. All authors read and approved the final version of the manuscript.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Journal of Health Literacy

Articles in Press, Accepted Manuscript
Available Online from 14 October 2025

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