Frontiers in public health · 2026
Pregnant women's perceived understanding and antenatal information needs regarding newborn screening for inherited metabolic diseases in southwestern China: a cross-sectional study.
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Yang Hao, He Fenghua, Xia Dan, Wang Xihong, Liu Hongqian
Аннотация
BACKGROUND: Newborn screening (NBS) can reduce morbidity from some inherited metabolic diseases (IMDs) through early detection and timely treatment. Clear antenatal communication can support informed participation and timely follow-up by helping parents understand the purpose and pathway of screening. Evidence on pregnant women's perceived understanding, attitudes, antenatal information engagement, and screening- and follow-up-related intentions regarding newborn IMD screening in China remains limited. This study described these four domains and examined their associations with sociodemographic and reproductive-history characteristics in southwestern China.
METHODS: This hospital-based cross-sectional survey used a purposive sample recruited at a tertiary women's and children's hospital (National Regional Medical Center in China) from January 2024 to December 2024. After data-quality review, 1,320 eligible records were analyzed. All 21 questionnaire items were retained and analyzed as four domains: perceived understanding, attitudes, antenatal information engagement, and screening/follow-up intentions. Internal consistency, post hoc exploratory factor analysis, Pearson correlations, and four fully adjusted linear models with HC3 robust standard errors were evaluated. Benjamini-Hochberg false-discovery-rate (FDR) correction was applied across 92 non-intercept coefficients.
RESULTS: Parallel analysis supported four factors (Kaiser-Meyer-Olkin = 0.912; Bartlett χ2 = 21,719.21, p < 0.001), explaining 67.5% of variance. Mean (SD) scores were 15.15 (4.54)/35 for perceived understanding, 25.43 (3.77)/30 for attitudes, 9.34 (2.31)/15 for antenatal information engagement, and 20.09 (3.16)/25 for intentions; Cronbach's α values were 0.918, 0.950, 0.745, and 0.914. Fifteen coefficients had nominal p < 0.05, but none remained significant after FDR correction (all q ≥ 0.051); adjusted R2 values were 0.010-0.039.
CONCLUSION: Participants reported limited self-perceived understanding alongside favorable attitudes, moderate antenatal information engagement, and strong stated intentions. Adjusted R2 values of 0.010-0.039 and the absence of FDR-significant predictors indicate that the measured sociodemographic and reproductive-history variables had negligible explanatory value and should not be used for subgroup prediction or targeting. The domain pattern supports universal, nursing-led antenatal communication focused on screening procedures, abnormal-result interpretation, recall, confirmation, and follow-up, while future work should refine the questionnaire and test whether education improves observed participation and follow-up.
METHODS: This hospital-based cross-sectional survey used a purposive sample recruited at a tertiary women's and children's hospital (National Regional Medical Center in China) from January 2024 to December 2024. After data-quality review, 1,320 eligible records were analyzed. All 21 questionnaire items were retained and analyzed as four domains: perceived understanding, attitudes, antenatal information engagement, and screening/follow-up intentions. Internal consistency, post hoc exploratory factor analysis, Pearson correlations, and four fully adjusted linear models with HC3 robust standard errors were evaluated. Benjamini-Hochberg false-discovery-rate (FDR) correction was applied across 92 non-intercept coefficients.
RESULTS: Parallel analysis supported four factors (Kaiser-Meyer-Olkin = 0.912; Bartlett χ2 = 21,719.21, p < 0.001), explaining 67.5% of variance. Mean (SD) scores were 15.15 (4.54)/35 for perceived understanding, 25.43 (3.77)/30 for attitudes, 9.34 (2.31)/15 for antenatal information engagement, and 20.09 (3.16)/25 for intentions; Cronbach's α values were 0.918, 0.950, 0.745, and 0.914. Fifteen coefficients had nominal p < 0.05, but none remained significant after FDR correction (all q ≥ 0.051); adjusted R2 values were 0.010-0.039.
CONCLUSION: Participants reported limited self-perceived understanding alongside favorable attitudes, moderate antenatal information engagement, and strong stated intentions. Adjusted R2 values of 0.010-0.039 and the absence of FDR-significant predictors indicate that the measured sociodemographic and reproductive-history variables had negligible explanatory value and should not be used for subgroup prediction or targeting. The domain pattern supports universal, nursing-led antenatal communication focused on screening procedures, abnormal-result interpretation, recall, confirmation, and follow-up, while future work should refine the questionnaire and test whether education improves observed participation and follow-up.