Abstract
BACKGROUND: Venous thromboembolism (VTE) is a critical yet preventable complication during pregnancy. However, evidence on pregnant women’s knowledge, attitudes, and practices (KAP) toward VTE and its influencing factors remains limited. This study aimed to assess the KAP levels of VTE among pregnant women and identify key determinants to inform targeted interventions. METHODS: A hospital-based cross-sectional study was conducted among 1384 pregnant women in a tertiary women’s and children’s hospital in Sichuan Province, China. Data were collected using a structured questionnaire covering sociodemographic characteristics and a validated maternal KAP scale for VTE. Descriptive statistics and multiple linear regression analyses were performed to evaluate KAP scores and their influencing factors. RESULTS: A total of 1,384 women were included with a mean age of 29.4 ± 4.3 years. The mean total KAP score was 113.11 ± 16.82, with knowledge 33.49 ± 5.19(IQRs: 32.00–38.00), attitudes 46.93 ± 5.09(IQRs: 43.75 -75.00), and practices 32.69 ± 6.54(IQRs: 29.00–39.00). Multivariable regression indicated that knowledge was positively associated with second-trimester pregnancy (β = 0.38, 95% CI: 0.32–0.44), higher education (β = 0.15 to 0.26), and proactive learning (β = 0.06, 95% CI: 0.00–0.12), but lower among women without prior VTE education (β = − 0.16, 95% CI: − 0.21 to − 0.10). Attitudes were reduced in late pregnancy and postpartum (β = − 0.12, 95% CI: − 0.18 to − 0.06; β = − 0.09, 95% CI: − 0.16 to − 0.03) and improved with proactive learning (β = 0.11, 95% CI: 0.04–0.17). Preventive practices were lower in late pregnancy (β = − 0.17, 95% CI: − 0.23 to − 0.11) and postpartum (β = − 0.08, 95% CI: − 0.15 to − 0.02), but higher in women with undergraduate or postgraduate education (β = 0.14 to 0.18) and those with proactive learning (β = 0.14, 95% CI: 0.08–0.21). CONCLUSIONS: Pregnant women in Southwest China demonstrated moderate knowledge, generally positive attitudes, but relatively low levels of preventive practices regarding VTE. Tailored interventions should prioritize women in early pregnancy stages, integrate VTE education into routine prenatal care, and leverage family support (e.g., spouse engagement). Healthcare systems should establish standardized VTE training programs and optimize individualized risk communication to reduce pregnancy-related VTE morbidity. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-025-08570-4.