Knowledge, Attitude and Practice Regarding Thyroid Disorders in Pregnant Women: A Cross-Sectional Study in Guangdong, China

中国广东省孕妇甲状腺疾病知识、态度和行为的横断面研究

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Abstract

BACKGROUND: Thyroid disorders are diseases that can harm both the fetus and the pregnant woman. This study aimed to investigate the knowledge, attitudes, and practices (KAP) of pregnant women regarding thyroid disorders during pregnancy. METHODS: A cross-sectional study was conducted from May 20, 2024, to June 30, 2024, in the Obstetrics and Gynecology Department of Zhujiang Hospital, Southern Medical University to pregnant women. Online questionnaires were distributed to collect demographic data and KAP scores. The KAP questionnaire was developed based on the 2017 American Thyroid Association Guidelines and relevant literature. Content validity was reviewed by three experts, and a pilot test involving 30 participants was conducted. The questionnaire demonstrated excellent internal consistency with a Cronbach's alpha of 0.957. RESULTS: A total of 568 valid questionnaires were included in the study and the effective rate was 93.11%. Of the respondents, 272 (47.89%) had a normal Body Mass Index (BMI), and 263 (46.3%) were experiencing their first pregnancy. The mean ± SD scores for knowledge, attitude, and practice were 34.04 ± 7.87 (possible range: 10-50), 28.82 ± 4.39 (possible range: 7-35), and 26.43 ± 5.59 (possible range: 8-40), respectively. Multivariate logistic regression analysis indicated that practice score (OR = 1.212, 95% CI: [1.136-1.294], P < 0.001) and age (OR = 1.069, 95% CI: [1.007-1.135], P = 0.029) were protective factors directly associated with thyroid disease complicating pregnancy. The structural equation model (SEM) results showed a direct effect of knowledge on attitude (β = 0.434, P = 0.021) and of attitude on practice (β = 0.604, P = 0.012). Moreover, knowledge indirectly influenced practice through attitude (β = 0.262, P = 0.009). CONCLUSION: Pregnant women demonstrated suboptimal knowledge, positive attitudes, and inactive practices regarding thyroid disorders during pregnancy. These findings underscore the need for targeted educational interventions to enhance knowledge and promote proactive practices among pregnant women, which may help mitigate the risk of thyroid-related complications during pregnancy.

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