Relationship Between Reproductive Health Literacy And Adverse Pregnancy Outcomes Among Pre-pregnant Women In Tongling City

Objective The correlation between the level of reproductive health literacy and adverse pregnancy outcomes was clarified to provide evidence for improving the level of reproductive health literacy and reducing the incidence of adverse pregnancy.Methods Prospective follow-up study design was used in this study.From April 2017to August 2018,women who participated in free pre-pregnancy examination in tongling city were recruited into the follow-up cohort,and general demographic characteristics and reproductive health literacy related information were collected by using the self-made questionnaire on reproductive health literacy of pre-pregnancy women.A total of4181 cases of pre-pregnancy women were included in the pre-pregnancy cohort,79 of whom were lost to follow-up,3,500 of whom had no pregnancy outcome,and 500 of whom were finally included in the analysis.The general demographic characteristics and health literacy level of pre-pregnancy women were statistically described,and the correlation between the health literacy level of pre-pregnancy women and poor pregnancy outcome was investigated using the multi-factor binary logistic regression model.Results The total percentage of 500 pre-pregnancy women with pregnancy outcomes was 45.4%,with the highest rate of life style and behavior 78.8%and the lowest rate of basic skills 13.0%in the three dimensions of health literacy.Among the five types of reproductive health knowledge,the knowledge of sexually transmitted diseases is the highest,with an availability rate of 68.0%,followed by reproductive tract infection knowledge,with an availability rate of 54.2%,family planning knowledge and pre-pregnancy knowledge are relatively low,and the knowledge of menstruation,with the lowest,is 26.8%.Women aged 25 to 34 years,with bachelor’s degree or above,public institutions,professional technicians,high level of economic income,high degree of education of their spouses,and no adverse pregnancy history,have a higher level of total quality of reproductive health and higher level of reproductive health related knowledge.A total of 108 adverse pregnancy outcomes,with an incidence of 21.6%,were followed up to 500 pregnancy outcomes.The incidence of adverse pregnancy was34.07%in the low group with poor reproductive health literacy,higher than 6.61%in the high group(χ~2=55.181,P<0.05).Negative pregnancy was 6.67%in the higher reproductive health knowledge dimension and 28.00%in the lower one(χ~2=28.219,P<0.05).The incidence of adverse pregnancy was 18.02%,34.91%in the high and low score of lifestyle and behavior(χ~2=14.063%,P<0.05).The incidence of adverse pregnancy was 13.85%,22.76%,respectively in the higher and lower dimensions of basic skills(χ~2=1.704,P>0.05).The incidence rate of natural abortion was higher than that in the lower dimensions of total reproductive health literacy,reproductive health knowledge literacy,reproductive health way and behavioral literacy.The incidence of premature birth was lower in total reproductive health literacy than higher.In the dimensions of total reproductive health literacy,reproductive health knowledge literacy,reproductive health mode and behavioral literacy,the incidence rate of giant children was lower than higher.The incidence rate of low birth weight group was higher than high group in the total quality dimension of reproductive health,and the difference between groups was statistically significant(P<0.005).Univariate analysis of factors influencing adverse pregnancy outcome showed that adverse pregnancy outcome was statistically significant for pre-pregnant women with different age,occupation,education level,spouse culture,personal monthly income and adverse pregnancy history(P<0.05).Logistic regression analysis showed that before pregnancy,women had total reproductive health literacy,reproductive tract infection knowledge,and venereal disease knowledge,which were the influencing factors of adverse pregnancy outcomes.OR values were total reproductive health literacy(OR=0.279),reproductive tract infection knowledge(OR=0.431),and venereal disease knowledge(OR=0.511).Conclusion At present,the level of reproductive health literacy of women in tongling city is generally low.Pre-pregnancy health literacy is affected by different demographic characteristics;Reproductive health literacy and related knowledge are the protective factors for the adverse pregnancy outcomes of women before pregnancy.