Knowledge, Attitudes, and Self-Care Practices of Pregnant Women for COVID-19 Prevention: Implications for Sustainable Development Goals (SDG 3 & SDG 5)

Background: The COVID-19 pandemic has placed an unprecedented burden on global health systems, disproportionately affecting maternal and child health outcomes, particularly in low- and middle-income countries. Pregnant women are biologically and socially vulnerable to both the direct consequences of infection and the indirect effects of disrupted health services. Understanding the knowledge, attitudes, and self-care practices (KAP) of pregnant women is crucial for informing antenatal counseling, shaping community health interventions, and addressing inequities. In alignment with the Sustainable Development Goals (SDG 3: Good Health and Well-being; SDG 5: Gender Equality), evidence-based insights can guide the development of gender-sensitive and context-specific preventive strategies to strengthen maternal and child health resilience. Objective: This study aimed to examine the levels of knowledge, attitudes, and self-care practices of pregnant women regarding COVID-19 prevention, and to identify significant predictors of preventive behaviors within antenatal care settings. Methods: A cross-sectional analytical study was conducted among 219 pregnant women attending antenatal clinics in public hospitals across Health Region 8, Thailand (Udon Thani, Nong Khai, Nong Bua Lamphu, and Sakon Nakhon Provinces), between June and December 2024. Data were collected using a structured and validated questionnaire covering three domains: knowledge, attitudes, and practices. Instrument validity and reliability were established through expert review and pilot testing. Data were analyzed using descriptive statistics, Pearson correlation, and multiple regression to identify factors associated with preventive self-care practices. Results: Participants demonstrated moderate (51.15%) to high (49.77%) levels of knowledge. Attitudes toward prevention were predominantly positive (M = 3.70, SD = 0.54), and self-care practices were frequently performed (M = 4.28, SD = 0.54). Attitudes were positively correlated with practices (r = 0.457, p < 0.01). Predictors of preventive practices included having a family member infected with COVID-19 (β = .15, p = .014), receiving information from health professionals (β = –.12, p = .046), receiving information from the internet (β = –.13, p = .036), and positive attitudes (β = .45, p < .001). Collectively, these predictors explained 26.3% of the variance in self-care practices (p < 0.001). Conclusion: The findings underscore the importance of strengthening maternal health systems by promoting positive attitudes, enhancing access to credible health information, and integrating family experiences into health education. Policy implications include the need for gender-sensitive, community-based, and digitally supported interventions that address inequalities in access to information and services. This study contributes to the global evidence base by highlighting the role of psychosocial and contextual factors in shaping preventive practices among pregnant women. Strengthening antenatal education and community linkages in line with SDG 3 and SDG 5 can enhance resilience and improve maternal and child health outcomes in the ongoing and post-pandemic era.