Susa Ana, Zekovic Milica, Davidovic Dragana, Paunovic Katarina, Kujundzic Vera, Mihajlovic Sladjana, Bogdanovic Ljiljana
Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Institute of Hygiene and Medical Ecology, 11000 Belgrade, Serbia.
Healthcare (Basel). 2025 Jun 19;13(12):1475. doi: 10.3390/healthcare13121475.
In regions with sustained air pollution, the adoption of protective health behaviors is critical, particularly among pregnant women-a population marked by physiological vulnerability and heightened receptivity to preventive guidance. Understanding and supporting patient-driven behavioral change requires attention to individual perception and awareness, which are shaped by socio-economic and spatial factors, as well as access to credible information. : This study investigates how pregnant women in Serbia perceive air quality, identifies determinants that influence these perceptions, and evaluates the extent and nature of behavioral adaptations undertaken to mitigate exposure-related risks. : A cross-sectional survey was conducted among 279 pregnant women using a structured, researcher-administered questionnaire. Collected data included demographic and psychosocial variables, air quality perceptions, self-reported health effects, and behavioral responses. Residential proximity to land-use attributes was assessed using GIS-based spatial analysis. : Most participants perceived air quality as poor (68.8%), primarily informed by unofficial sources such as mobile applications and social media. Living close to continuous urban fabric (OR = 0.180, 95% CI: 0.059-0.558, = 0.003) and water (OR = 0.306, 95% CI: 0.127-0.738, = 0.008) was associated with poorer perceptions, while proximity to forests (OR = 2.938, 95% CI: 1.323-6.525, = 0.008) correlated with more favorable assessments. Despite prevalent concern, around half of respondents (50.2%) reported no behavioral modifications. Importantly, none had received guidance from healthcare professionals on the topic. : These findings highlight critical gaps in environmental health literacy and provider engagement. Integrating tailored communication and behavioral support in existing prenatal counseling could advance health-related quality of life in this vulnerable population.
在空气污染持续存在的地区，采取保护性健康行为至关重要，尤其是在孕妇中——这一人群生理上较为脆弱，对预防性指导的接受度更高。理解并支持患者驱动的行为改变需要关注个体认知和意识，这些受社会经济和空间因素以及获取可靠信息的影响。本研究调查了塞尔维亚孕妇对空气质量的认知，确定影响这些认知的决定因素，并评估为降低与接触相关风险而采取的行为适应的程度和性质。采用结构化、由研究人员管理的问卷对279名孕妇进行了横断面调查。收集的数据包括人口统计学和心理社会变量、空气质量认知、自我报告的健康影响以及行为反应。使用基于地理信息系统的空间分析评估住宅与土地利用属性的距离。大多数参与者认为空气质量差（68.8%），主要依据移动应用程序和社交媒体等非官方来源。居住在连续城市区域附近（比值比=0.180，95%置信区间：0.059 - 0.558，P = 0.003）和水体附近（比值比=0.306，95%置信区间：0.127 - 0.738，P = 0.008）与较差的认知相关，而靠近森林（比值比=2.938，95%置信区间：1.323 - 6.525，P = 0.008）则与更积极的评估相关。尽管普遍担忧，但约一半的受访者（50.2%）报告没有行为改变。重要的是，没有人就该主题接受过医疗保健专业人员的指导。这些发现凸显了环境健康素养和医疗服务提供者参与方面的关键差距。将量身定制的沟通和行为支持纳入现有的产前咨询中，可提高这一脆弱人群与健康相关的生活质量。
