The effects of maternal education on pregnancy knowledge and behaviors using the Pregnancy Risk Assessment Monitoring System data

Background: It is estimated that 90 million Americans have trouble understanding and using health information. Specific Aims: Examine the: (1) association between education and the health knowledge and behaviors of maternal women in two different time periods (1997-1999 and 2006, 2008, & 2009) and (2) trends in maternal health knowledge and behaviors, separately, stratified by education. Study Design: A retrospective design was conducted, using the North Carolina PRAMS data. Analyses: Multiple logistic regression models estimated the likelihood that (1) education would affect behavior and knowledge in the areas of the folic acid consumption, breastfeeding, and infant sleep position and (2) there would be a positive trend in these three areas. Results: Women with <12th grade education were less likely to (1) have knowledge of folic acid (OR=0.64, 95% CI=0.48- 0.84) and (2) use the correct infant sleep position (OR=0.54, 95% CI=0.34-0.85) when compared with high school graduates. The trend found that women with <12 th grade education in the latter time period were more likely to have knowledge about folic acid. Women of all educational backgrounds were more likely to breastfeed in the latter phase compared to earlier phase and women with between 9th and 15th grades education were more likely to place their infant to sleep on his/her back. Significance: The results suggest that improvements over time are occurring in some key maternal health areas, such as folic acid knowledge, breastfeeding, and correct infant sleep position