Awareness of danger signs of pregnancy and associated factorsamong pregnant women attending antenatal care at St. Paulhospital millennium medical college, Addis Ababa, Ethiopia

Abstract

Background: Recognition of obstetric danger signs is an important component of timely careseeking and prevention of maternal morbidity and mortality. This study assessed awareness of danger signs of pregnancy and associated factors among pregnant women attending antenatal care at St. Paul Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia. Methods: A facility-based cross-sectional study was conducted among pregnant women attending ANC at SPHMMC from February 1 to March 31, 2020. Participants were selected by systematic random sampling. Data were collected using a structured interviewer-administered questionnaire. Descriptive statistics and bivariate analyses were performed. Because the outcome was highly imbalanced and conventional multivariable logistic regression demonstrated separation/non-convergence, adjusted maximum-likelihood odds ratios were not treated as reliable definitive estimates; a restricted penalized logistic model was considered exploratory. Results: Of 274 eligible questionnaires, 261 were complete (response rate 95.3%). Overall, 227 (87.0%) participants knew at least one obstetric danger sign, while 34 (13.0%) did not. Among those with awareness, 117 (51.5%) reported knowing two or more danger signs. Health personnel were the main reported source of information. In bivariate analysis, 21 variables were associated with the outcome at p<0.05; the strongest associations included education status, perceived possibility of developing danger signs, previous pregnancy/delivery history, experience of danger signs, ANC in the previous pregnancy, and being informed about danger signs. Conventional multivariable logistic regression showed separation and non-convergence, limiting the reliability of standard adjusted estimates. Conclusion: Awareness of at least one obstetric danger sign was relatively high, but a meaningful proportion of women lacked awareness and many knew only a limited range of danger signs. Strengthening standardized, repeated ANC counseling—particularly for women with limited exposure to danger-sign education—may improve recognition and timely careseeking. Future analyses should use se