G-2630

Investigating the Relationship Between Health Literacy and Reproductive and Newborn Health

 Mehrnoosh Sanadgol ¹ ℗, Soleyman Saravani ² ©, Ehsan Bastami ¹, Omolbanin Sargazi Aval ³   

 
Abstract

Introduction: Maternal health literacy critically influences decisions during pregnancy, childbirth, and neonatal care, affecting both maternal and newborn outcomes. Low health literacy is associated with delayed care and poor neonatal practices. Despite its importance, few studies have examined its combined impact on reproductive and neonatal health. This study uniquely addresses this gap, offering novel, context-specific insights to enhance maternal and neonatal health strategies. Materials and Methods: This cross-sectional study was conducted in 2025 among 357 women in … to evaluate the relationship between maternal health literacy, reproductive health, and neonatal outcomes. Participants included postpartum women and recently pregnant women with at least one live birth. Convenience sampling was conducted in hospitals and maternal health centers. Inclusion criteria were age 10–54 years, minimum one prenatal visit, basic literacy (or a literate assistant), and complete health records. Data were collected using four validated tools: a demographic-obstetric questionnaire, the Health Literacy for Iranian Adults (HELIA), the Reproductive Health Assessment Questionnaire for Women of Reproductive Age (RHAQ-WRA), and a neonatal health checklist. Statistical analysis was performed using SPSS version 27 and neonatal outcomes were analyzed only for postpartum women. Ethical approval was obtained, and informed consent was secured from all participants. Results: Of 357 participants, the mean health literacy score was 53.84 ± 18.78; only 20.2% had adequate or excellent literacy. Health literacy was significantly correlated with reproductive health total score (ρ = 0.540, p 0.001) and subdomains such as family planning (ρ = 0.510, p 0.001). No significant association was found between health literacy and place of residence (p = 0.212) or number of living children (p = 0.098). Mothers with higher literacy had fewer pregnancies (p 0.001) and significantly better scores in risk avoidance and domestic violence protection (p 0.01). Among postpartum women, higher literacy was associated with improved neonatal outcomes: birth weight (p = 0.001), 1-minute Apgar (p = 0.004), and breastfeeding initiation (p = 0.02). However, maternal literacy was not significantly related to neonatal vaccination status (p = 0.127). In regression models, health literacy (β = 0.322, p = 0.047) and pregnancy count were independent predictors of reproductive health (adjusted R² = 0.252). These results confirm both the strengths and limits of literacy’s role in maternal-child health. Discussion and Conclusion: Maternal health literacy significantly improves reproductive behaviors and neonatal outcomes, including birth weight and Apgar scores. Although some factors showed no significant association, literacy remains a key determinant. Integrating health literacy into maternal health programs can enhance informed decision-making and reduce preventable risks in reproductive and newborn health among vulnerable populations.

Keywords: Health Literacy, Pregnancy, Reproductive Health, Neonatal Care