Survey reveals persistent knowledge gaps about pregnancy health, vaccination safety

Survey reveals persistent knowledge gaps about pregnancy health, vaccination safety | Image Credit: © Natalya Lys - stock.adobe.com.

A new survey conducted by the Annenberg Public Policy Center (APPC) of the University of Pennsylvania in April 2025 revealed significant gaps in public understanding of pregnancy-related health recommendations, including misconceptions about weight gain, supplement use, and vaccine safety. While many Americans recognize the importance of maternal health before and during pregnancy, awareness of specific medical guidelines remains limited, particularly among women of childbearing age.^1,2

The nationally representative survey included responses from 1,653 US adults and highlighted critical areas where public health education may improve maternal and infant outcomes.

“Because those around us influence our health decisions, persons of childbearing age and their families and friends should know the risks of smoking and alcohol use before, during, and after pregnancy and which vaccines should and should not be taken during pregnancy,” said Patrick E. Jamieson, director of the Annenberg Health and Risk Communication Institute.

Nearly all respondents (91%) agreed that health during pregnancy affects a baby's health, and 86% recognized the importance of preconception health. However, this dropped to 75% among women aged 18 to 49 years, compared to 86% in 2023. Eighty percent of all adults surveyed knew that testing for diabetes during pregnancy is recommended, while 73% acknowledged the stroke risk associated with untreated hypertension.

Knowledge about supplementation was mixed. Seventy-one percent correctly identified the importance of folic acid supplementation, although this marked a decline from 76% in 2023. Regarding iron supplementation, fewer than half (42%) correctly understood that it is recommended only for those with anemia. Nineteen percent believed all pregnant people should take iron daily, while 39% were unsure.

Only 46% of participants knew that a person of normal weight should gain between 25 and 35 pounds during pregnancy, which aligns with CDC guidance. Twenty-five percent incorrectly believed weight gain should be limited to 5 to 10 pounds, and another 25% were uncertain.

The survey also assessed knowledge of health risks associated with smoking and alcohol use. Eighty-two percent recognized the link between smoking during pregnancy and birth defects, and 77% identified its role in increasing the risk of early delivery. Awareness that secondhand smoke exposure raises the risk of sudden infant death syndrome (SIDS) stood at 56%. Meanwhile, 84% knew it is false to claim that wine or beer are safe to drink while pregnant.

However, knowledge of alcohol abstinence recommendations prior to conception showed notable gaps. While 64% of respondents correctly stated that alcohol should be avoided both before and during pregnancy, only 58% of women aged 18 to 49 answered this correctly. Twenty-five percent of this group incorrectly stated that alcohol should only be avoided once pregnancy is confirmed, a significant increase from 17% in 2024.

Vaccine safety and recommendations during pregnancy were another key focus. Awareness has declined across all major recommended vaccines since 2024. Only 37% of US adults knew that the Tdap vaccine is recommended for pregnant people, down from 43% the previous year. Among women aged 18 to 49 years, 52% correctly identified Tdap as recommended, compared to just 31% of adults outside that age group.

Fifty-five percent of adults knew that the flu vaccine is recommended during pregnancy, while 47% were aware of the recommendation for the RSV vaccine. Both figures represented a 5% drop from 2024. Among women of childbearing age, awareness of RSV vaccine recommendations declined from 62% to 52%.

Only 11% of respondents correctly identified that the measles, mumps, and rubella (MMR) vaccine is not recommended during pregnancy due to its live-virus composition. Nearly 30% incorrectly believed it was recommended, and 60% were uncertain. Among women aged 18 to 49, uncertainty was lower at 52%.

The survey findings underscore the ongoing need for targeted public health messaging. According to APPC, these insights are drawn from the 24th wave of the Annenberg Science and Public Health (ASAPH) survey series, which has been tracking American public knowledge of health-related behaviors and beliefs since April 2021.

References:

1. Annenberg Public Policy Center of the University of Pennsylvania. Public knowledge high on smoking and alcohol risks during pregnancy. Eurekalert. July 29, 2025. Accessed August 4, 2025. https://www.eurekalert.org/news-releases/1092803
2. Annenberg Public Policy Center of the University of Pennsylvania. Survey results. Annenberg Public Policy Center of the University of Pennsylvania. July 29, 2025. Accessed August 4, 2025. https://www.annenbergpublicpolicycenter.org/wp-content/uploads/w24-toplines-mathealthFINAL1.pdf