Description of the Knowledge and Attitudes of Pregnant Women Related to Prevention of Covid-19 Transmission

Emiona Fransisca A. Tepmul¹, Kristiani Desimina Tauho², Rifatolistia Tampubolon³

Universitas Kristen Satya Wacana, Salatiga, Indonesia^1,2,3

Email: 462023703@student.uksw.edu, enni.tauho@uksw.edu, rifatolistia.tampubolon@uksw.edu

KEYWORDS	ABSTRACT
Covid-19, Pregnant Women, Knowledge, Prevention	Coronavirus disease (COVID-19) is an infectious disease caused by SARSCoV-2, which has a shape and behaviour similar to the severe acute respiratory syndrome (SARS) virus. This disease has become a worldwide pandemic and causes acute respiratory tract disorders. Nationally, Indonesia is in the 19th highest position with total confirmed cases of COVID-19 with 49,578,590 cases and a death toll of 13.8 thousand cases. This research aims to determine the knowledge and attitudes of pregnant women in preventing transmission of Covid-19 during pregnancy. The method used in this research is a quantitative method with a descriptive approach. The population in this study was 39 pregnant women who did not work or were housewives, with the majority having a high school education and an age range of 20 - 35 years who met the inclusion and exclusion criteria. The data collection technique uses a questionnaire. The data analysis used in this research uses parametric statistics, and the scale used is based on interval and ratio measurements. Based on the results and discussion, the level of knowledge and attitudes of pregnant women regarding preventing the transmission of COVID-19 in Salatiga City is good.
DOI: 10.58860/ijsh.v3i10.248

Corresponding Author: Emiona Fransisca A.Tepmul*

Email: 462023703@student.uksw.edu

INTRODUCTION

Coronavirus disease (COVID-19) is an infectious disease caused by SARS-CoV-2, which has a form and behaviour similar to the severe acute respiratory syndrome (SARS) virus (Chairani, 2020). The disease has become a worldwide pandemic and causes acute respiratory disorders (Rohmah, 2020). Covid-19 first occurred in China and was reported on December 31, 2019, by the Chinese government (Beniac et al., 2006). On February 12, 2020, the WHO officially named the disease caused by the coronavirus as COVID-19, which originated from co (coronavirus), vi (virus), d (disease), and 19 was the year when the first case appeared in China. The WHO reported that COVID-19, which is now spreading, is classified as a global pandemic after the number of infections worldwide reached more than 18,406,862 cases. WHO has designated the coronavirus as a Public Health Emergency that Sweeps the World (KKMMD).

Nationally, Indonesia is in the 19th highest position with a total of 412 thousand confirmed cases of COVID-19 and a death toll of 13.8 thousand cases. COVID-19 has been found in 34 provinces (502 districts/cities). However, DKI Jakarta is the province with the highest number of cases, reaching 106 thousand cases as of October 2020, followed by East Java Province with 52 thousand cases, then West Java with 36.5 thousand cases. Meanwhile, Central Java is in 4th place with the highest number of confirmed COVID-19 cases in Indonesia, which is 34 thousand cases (Romdiati & Kusumaningrum, 2021).

Pregnant women are very susceptible to infections, including Coronavirus infection, due to physiological changes in the immune system during pregnancy (Bangsawan, 2022). According to WHO, so far, the symptoms that pregnant women will feel are the same as those of others. In the analysis of 147 pregnant women, only 8% had severe symptoms of the disease, and 1% had critical conditions. Early characteristics when pregnant women are exposed to the coronavirus include fever (78%), cough (44%), muscle pain (33%), general weakness (22%), shortness of breath (11%), and sore throat (22%). It will be more suspicious if there are pregnant women with a history of traveling to the affected area within the last 14 days or have been in contact with a person who is positive for COVID-19 (Organization, 2020).

Transmission of COVID-19 can occur through direct contact, indirect contact, or close contact with an infected person through secretions such as saliva and respiratory secretions or airway droplets that come out when an infected person coughs, sneezes, talks, or sings (Nugroho et al., 2020). The concentration of aerosols in relatively closed spaces will be higher, which will make transmission easier. Based on current epidemiological investigations, the incubation period for the coronavirus ranges from one to 14 days and will generally occur in three to seven days. Fever, fatigue, and dry cough are considered the main clinical manifestations (Zhao et al., 2020).

Knowledge about COVID-19 is a very important aspect during a pandemic like today, which includes the causes of COVID-19 and its viral characteristics, signs and symptoms, terms related to COVID-19, necessary examinations and transmission processes, as well as efforts to prevent the disease. High public knowledge about Covid-19 will affect the incidence and prevention of Covid-19 disease. Good knowledge can be supported by the proper acceptance of information circulating in the community, and efforts to break the chain of the spread of COVID-19 also require good understanding and knowledge from all elements, including society (Sulistyaningtyas et al., 2020).

Knowledge about pregnancy, childbirth, and postpartum care is obtained by pregnant women when conducting pregnancy examinations with the aim of detecting, preventing, and minimizing complications during pregnancy, childbirth, and undergoing the postpartum period (Mira Rizkia, 2020). In the conditions of the COVID-19 pandemic, the Indonesia Obstetrics and Gynecology Association (Suparni, 2021) recommends conducting fewer pregnancy examination visits than the previous recommendation from the Ministry of Health, which is at least 2 times. In the pregnancy check-up, in addition to checking the health status of pregnant women, education is also provided, especially education related to childbirth preparation, contraceptive use, newborn care, and postpartum maternal care in the late stages of pregnancy (Suparni, 2021).

This study was conducted considering that the pregnancy period, especially in the 3rd trimester, is a critical time when mothers receive vital information related to childbirth and postpartum care (Kamali et al., 2018). Previous studies have indicated that the risk of transmission of COVID-19 from mother to fetus is relatively low compared to transmission after childbirth. However, there remains a significant gap in understanding the knowledge and attitudes of pregnant women regarding the prevention of coronavirus transmission during pregnancy and postpartum. By addressing this gap, the research provides a clearer picture of the preparedness of pregnant women to prevent COVID-19 transmission, thereby offering actionable insights for healthcare providers. The findings will also inform policymakers and healthcare institutions in developing targeted educational programs for pregnant women during pandemics, ensuring that the maternal and neonatal care guidelines are effectively communicated and implemented. Moreover, the study could contribute to enhancing public health strategies, particularly in mitigating the impact of COVID-19 on vulnerable groups such as pregnant women, ultimately improving maternal and neonatal health outcomes.

METHOD

This research method adopts a quantitative approach with a descriptive design. The study was conducted between August 2023 and October 2023 at the Sidorejo Lor Health Center, Salatiga City. The variables in this study include the knowledge and attitudes of pregnant women concerning the prevention of COVID-19 transmission. The population consists of all third-trimester pregnant women in Salatiga City, Sidorejo Lor District, who meet both inclusion and exclusion criteria. The inclusion criteria are as follows: primigravida pregnant women in the third trimester, aged 20-35 years, with at least an elementary school education, residing in Salatiga, Sidorejo Lor District, living with their husbands, willing to participate, and not suffering from physical disabilities or hearing loss. The exclusion criteria include pregnant women who are ill and require treatment, unwilling to participate, lack family consent, or withdraw during the study. The final sample consisted of 39 respondents.

Data collection was carried out using a questionnaire. The primary data were obtained directly from the respondents and included their characteristics, knowledge, and attitudes related to COVID-19 transmission prevention (Rahman et al., 2020). Data analysis employed parametric statistical methods and was presented in percentages. The instrument used in this study was a questionnaire based on a Likert scale designed to assess the level of knowledge and attitudes of pregnant women regarding COVID-19 prevention. The study also underwent an ethical review, with approval number No.021/KOMISISETIK/EC/3/2023.

RESULT AND DISCUSSION

The description of the characteristics of the respondents studied in this study is based on age, education, occupation, as well as the level of knowledge and attitude of pregnant women about the transmission of Covid-19 prevention.

Table 1.

Characteristics of Respondents by age, education and occupation

Characteristic	Number (n=39)	Percentage (%)
Age (Years)
< 20	1	2,5
> 35	3	7,6
20 - 35	35	89,7
Total	39	100
Last Education
Elementary School (SD)	2	5,12
Secondary school First (Junior High School)	5	12,8
High School (High School)	21	53,8
Higher Education (PT)	11	28,2
Total	39	100
Work
Housewives (IRT)	23	58,9
Civil Servants (PNS)	2	5,12
Laborer	13	33,3
Honorary	1	2,5
Total	39	100

Data source: 2023 research data

Based on the data in Table 1, it shows that the age of pregnant women is most in the age range of 20-35 years, which is as many as 35 people (89.7%) compared to the age under 20 years and the age over 35 years. The older a person gets, the more mature a person is in their mindset, including the level of knowledge about the prevention of COVID-19 transmission in pregnant women. Mothers with a more productive age will have a better desire to check their pregnancy and will indirectly receive more health information, including information on COVID-19 prevention transmission (Apriliani et al., 2019).

The characteristics of pregnant women's education in Table 1 show that the majority of pregnant women have a higher level of education with high school (SMA) compared to the other last levels of education. The education level of pregnant women in high school was 21 people (53.8%). The role of a pregnant woman in overcoming the transmission and prevention of COVID-19 is very important; a mother's understanding or knowledge of the prevention of COVID-19 is greatly influenced by the level of the mother's education. The higher a person's education, the more experience it will provide so that it is easy to absorb information (Swandewi et al., 2022).

Table 1, based on job characteristics, shows that of the 39 pregnant women who are housewives (IRT), there are more than 23 people (58.9%) compared to other jobs. Based on this, pregnant women who work and mothers who do not work have the same opportunity to obtain information about health services related to the transmission of COVID-19 prevention. A mother's employment status can affect the opportunities and time used to increase knowledge by increasing knowledge, including knowledge about the transmission of COVID-19 prevention to herself and the fetus she is carrying (Swandewi et al., 2022).

Table 2.

Knowledge Level of Pregnant Women on the Prevention of Covid-19 Transmission

Level of Knowledge	Number (n=39)	Percentage (%)
Low	11	28,2
Tall	28	71,7
Total	39	100

Data source: 2023 research data

Based on the category of knowledge level of pregnant women, it shows that of the 39 people who have a high level of knowledge, more than a low level of knowledge, namely 28 people (71.7%), while 11 people (28.2%) have a low level of knowledge, then, the research conducted illustrates that pregnant women in the city of Salatiga have more high knowledge, so it can be said that pregnant women understand how to transmit and prevent Covid-19 aforementioned.

Knowledge is one of the dominant factors shaping a person's behavior and determining actions or behaviors (Aritonang et al., 2020). The level of education directly and indirectly affects the knowledge of pregnant women on many things, including the transmission and prevention of COVID-19. One of the factors that provides a lot of knowledge to humans in general and pregnant women in particular is education, both formal and non-formal, because the higher the education, the higher the knowledge (Archibald, 2015). "According to a person's assumption about having low knowledge of something, he will also have a bad perspective and activity" (Aritonang et al., 2020).

According to the Task Force for the Acceleration of COVID-19 Handling (2020), pregnant women must learn and practice COVID-19 preventive measures, such as always wearing a mask when leaving the house, avoiding crowds, covering their mouth and nose with their elbows when coughing or sneezing, washing their hands with soap with running water or using alcohol-based hand sanitizers, not shaking hands, and consuming enough nutrients. The COVID-19 virus requires immediate isolation for pregnant women who come into contact with an infected person at an appropriate location. During the COVID-19 pandemic, pregnant women are still required to implement Clean and Healthy Living Behaviors (PHBS) (Pope et al., 2022). Keep a distance when conducting routine checks, approximately 1 meter from other people.

Table 3.

Attitudes of Pregnant Women on the Prevention of Covid-19 Transmission

Attitude	Number (n=39)	Percentage (%)
Bad	2	5,12
Good	37	94,8
Total	38	100

Data source: 2023 research data

Table 3 shows the category of attitudes of pregnant women regarding the transmission of COVID-19 prevention; out of 39 people had a good attitude compared to a bad attitude. Pregnant women who had a good attitude were 37 people (94.8%), and those who had a bad attitude were as many as 2 people (5.12%). Based on research conducted on pregnant women in terms of preventing the transmission of the Coronavirus, it is known that more and more individuals have a good mentality, so it can be said that attitudes and ways to prevent the transmission of the Coronavirus are very good by washing hands and isolating families affected by the Coronavirus.

Attitude can be said to be a person's opinion on a certain situation or situation. Individual attitudes are predictors of behavior, although other factors such as environment and self-confidence can influence them. Attitudes can influence a person's behavior in the process of careful decision-making and reasoning. Pregnant women's attitudes toward COVID-19 are also influenced by many things, including education, age, employment, and level of education. Encouragement from the environment and others makes a person have a positive attitude, and a person's personality can also respond to problems (Ariestanti et al., 2020).

The results of the researcher's analysis in this study show that quite a lot of pregnant women have a positive attitude toward preventing the transmission of COVID-19. According to the researcher's analysis, this is influenced by a fairly high level of knowledge about the prevention of COVID-19 transmission, thus encouraging pregnant women to be positive or good and confident in handling COVID-19. Although many pregnant women have a good or positive attitude, there are still some pregnant women who have a bad attitude towards the prevention of COVID-19 transmission, especially as seen from their attitude regarding how to handle and prevent the transmission of the COVID-19 virus. This can happen due to a lack of knowledge or lack of awareness from the individual. Pregnant women are very confident that COVID-19 is a dangerous infectious disease, but one day, this disease will be successfully controlled (Novoa et al., 2021).

CONCLUSION

The level of knowledge of pregnant women in Salatiga City on how to prevent the transmission of COVID-19 has proven to be in the category of high-level knowledge. Likewise, most pregnant women have a good attitude toward preventing COVID-19 in Salatiga City. Further research is needed on the behavior of preventing the transmission of infectious diseases such as COVID-19 and other diseases that have the potential to cause complications in pregnancy and childbirth and are transmitted to newborns.

REFERENCES

Apriliani, S. L., Nikmawati, E. E., & Yulia, C. (2019). Pengetahuan Gizi Ibu Hamil Di Kecamatan Kertasari Kabupaten Bandung. Media Pendidikan, Gizi, Dan Kuliner, 8(2). https://doi.org/10.17509/boga.v8i2.21967

Archibald, T. (2015). “They Just Know”: The epistemological politics of “evidence-based” non-formal education. Evaluation and Program Planning, 48, 137–148. https://doi.org/10.1016/j.evalprogplan.2014.08.001

Ariestanti, Y., Widayati, T., & Sulistyowati, Y. (2020). Determinan Perilaku Ibu Hamil Melakukan Pemeriksaan Kehamilan (Antenatal Care) Pada Masa Pandemi Covid -19. Jurnal Bidang Ilmu Kesehatan, 10(2), 203–216. https://doi.org/10.52643/jbik.v10i2.1107

Aritonang, J., Nugraeny, L., Sumiatik, & Siregar, R. N. (2020). Peningkatan Pemahaman Kesehatan pada Ibu hamil dalam Upaya Pencegahan COVID-19. Jurnal SOLMA, 9(2), 261–269. https://doi.org/10.22236/solma.v9i2.5522

Bangsawan, C. C. (2022). COVID-19 dan Dampak yang Ditimbulkan pada Kehamilan. Jurnal Kesmas Jambi, 6(1), 15–22. https://doi.org/10.22437/jkmj.v6i1.17171

Beniac, D. R., Andonov, A., Grudeski, E., & Booth, T. F. (2006). Architecture of the SARS coronavirus prefusion spike. Nature Structural & Molecular Biology, 13(8), 751–752. https://doi.org/10.1038/nsmb1123

Chairani, I. (2020). Dampak Pandemi Covid-19 Dalam Perspektif Gender Di Indonesia. Jurnal Kependudukan Indonesia, 39. https://doi.org/10.14203/jki.v0i0.571

Kamali, S., Ahmadian, L., Khajouei, R., & Bahaadinbeigy, K. (2018). Health information needs of pregnant women: information sources, motives and barriers. Health Information & Libraries Journal, 35(1), 24–37.

Mira Rizkia, M. (2020). Hubungan Pengetahuan dengan Perilaku Ibu Hamil dalam Menjalani Kehamilan Selama Masa Pandemi Covid-19. Jurnal Keperawatan Malang, 5(2), 80–86. https://doi.org/10.36916/jkm.v5i2.110

Novoa, R. H., Quintana, W., Llancarí, P., Urbina-Quispe, K., Guevara-Ríos, E., & Ventura, W. (2021). Maternal clinical characteristics and perinatal outcomes among pregnant women with coronavirus disease 2019. A systematic review. Travel Medicine and Infectious Disease, 39, 101919. https://doi.org/10.1016/j.tmaid.2020.101919

Nugroho, W. D., Cahyani, W. I., Tobing, A. S., Istiqomah, N., Cahyasari, I., Indrastuti, M., Sugondo, P., & Isworo, A. (2020). Literature Review: transmisi COVID-19 dari manusia ke manusia di Asia. Journal of Bionursing, 2(2), 101–112.

Organization, W. H. (2020). Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations: scientific brief, 29 March 2020. World Health Organization.

Pope, J., Olander, E. K., Leitao, S., Meaney, S., & Matvienko-Sikar, K. (2022). Prenatal stress, health, and health behaviours during the COVID-19 pandemic: An international survey. Women and Birth, 35(3), 272–279. https://doi.org/10.1016/j.wombi.2021.03.007

Rahman, S. M. M., Akter, A., Mostary, K. F., Ferdousi, S., Ummon, I. J., Mubdi-Un-Naafi, S., Rahman, M. M., Uddin, M. G. M. N., Tasmin, S., & Uddin, M. A. (2020). Assessment of knowledge, attitudes and practices towards prevention of coronavirus disease (COVID-19) among Bangladeshi population. Bangladesh Medical Research Council Bulletin, 46(2), 73–82.

Rohmah, M. K. (2020). Corona virus disease 2019 (Covid-19) pada wanita hamil dan bayi: Sebuah tinjauan literatur. Medica Hospitalia Journal of Clinical Medicine RSUP Dr. Kariadi, 7(1A), 1–8.

Romdiati, H., & Kusumaningrum, D. (2021). Poverty during Covid-19 Pandemic in Indonesia: A Case Study in Java-Bali Region. Jurnal Kawistara, 11(3), 239–251.

Sulistyaningtyas, T., Jaelani, J., & Suryani, Y. (2020). Power of knowledge and community social class above Covid-19 pandemic information on social media. Jurnal Komunikasi Ikatan Sarjana Komunikasi Indonesia, 5(1), 52–62.

Suparni, I. E. (2021). Literature Review: Covid 19 & Pregnancy. The 3rd Joint International Conference, 3(1), 120–126.

Swandewi, L. M. M., Hartati, N. N., Suratiah, S., Runiari, N., & Ruspawan, D. M. (2022). Hubungan Tingkat Pengetahuan dengan Sikap Ibu Hamil tentang Pandemi COVID-19 di Wilayah Kerja UPT. Kesmas Ubud I. Jurnal Gema Keperawatan, 15(1), 40–53.

Zhao, J., Zhao, S., Ou, J., Zhang, J., Lan, W., Guan, W., Wu, X., Yan, Y., Zhao, W., & Wu, J. (2020). COVID-19: coronavirus vaccine development updates. Frontiers in Immunology, 11, 602256.

© 2024 by the authors. It was submitted for possible open-access publication under the terms and conditions of the Creative Commons Attribution (CC BY SA) license (https://creativecommons.org/licenses/by-sa/4.0/).