Pregnant women’s knowledge, attitudes, and practices on food safety: a cross-sectional study

Abstract

Background: Pregnant women are physiologically more vulnerable to foodborne diseases because immune, hormonal, and metabolic changes reduce resistance to pathogens and increase the severity of dehydration and its fetal consequences. This study assessed the knowledge, attitudes and practices (KAP) of pregnant women regarding food safety. Methods: A cross-sectional study was conducted among 216 pregnant women attending Family Health Centers in Bitlis, Türkiye. Data were collected using a structured and validated questionnaire consisting of sections on socio-demographic characteristics, pregnancy-related factors, food safety knowledge (20 items), attitudes (18 items), and practices (11 items). Statistical analyses included descriptive statistics, chi-square tests and non-parametric group comparisons. Results: While general hygiene awareness was high (e.g., washing fruits/vegetables: 98.6%), knowledge of specific pathogens Salmonella (15.1%), Listeria (3.4%), Toxoplasma gondii (3.9%) was limited, which is expected as these pathogens are typically unfamiliar to the general public. Risky behaviors such as thawing frozen foods at room temperature (39.5%) and consuming unpasteurized milk were common. Misconceptions about packaged foods and food additives were striking (Approximately 95% perceived them as harmful), despite evidence showing that risks depend on additive type and dose rather than their mere presence. The mean attitude score was high (50.36 ± 4.63), and Higher educational level was significantly associated with safer practices such as checking expiry dates, refrigerating foods promptly, and using paper towels for hand drying (p = 0.002; p < 0.001; p < 0.001). Conclusion: Although pregnant women demonstrated positive attitudes and adequate general hygiene knowledge, gaps in pathogen-specific knowledge and several unsafe household practices persist. Antenatal education should prioritize clarifying true risk factors, correcting widespread misinformation, and reinforcing practical skills to promote safer food behaviors during pregnancy.