SOCIODEMOGRAPHIC DETERMINANTS OF PRENATAL CARE ACCESS AMONG PREGNANT WOMEN IN THE MANGYSTAU REGION: A CROSS-SECTIONAL STUDY.

BACKGROUND: Congenital anomalies (CAs) are a leading cause of infant mortality and disability, accounting for 15-20% of neonatal deaths worldwide. Their etiology is multifactorial, involving genetic, medical, environmental, and socioeconomic determinants. Industrial regions such as Mangystau, Kazakhstan, exhibit particularly elevated rates of birth defects, likely attributable to environmental pollution and limited healthcare access. Given the elevated burden of CAs in this high-risk industrial region, this study aimed to evaluate sociodemographic determinants of prenatal care access and health-seeking behaviors among pregnant women in the Mangystau Region of Kazakhstan.

METHODS: A cross-sectional survey was conducted among 318 pregnant women from urban and rural areas of Mangystau Region. Data were collected via structured questionnaires covering sociodemographic characteristics, health behaviors, medical screening practices, and environmental perceptions. Chi-square tests were applied to identify statistically significant associations (p<0.05).

RESULTS: Higher education and urban residence were significantly associated with greater access to prenatal care services, including ultrasound and genetic testing (p<0.001). Lower education and income levels were correlated with higher rates of pregnancy complications (p<0.01). Rural participants reported poorer food and water quality (p=0.017).

CONCLUSION: Sociodemographic inequalities significantly shape prenatal care access in the Mangystau Region, with rural residence, low education, and low income being key barriers. Targeted public health efforts to improve maternal education and access to diagnostic services, particularly in rural areas, are essential to strengthening prenatal care utilization and ultimately reducing the burden of CAs in the region.