PREPARE: Pregnancy Research on European Women's Preterm Birth Awareness, Risk, and Education

Preterm birth (PTB) is the leading cause of neonatal death and a major contributor to under-five mortality. Women's awareness, knowledge, and ability to recall PTB-related themes are essential for prevention and care but remain understudied in Europe.

To describe self-appraised awareness of PTB, PTB themes recalled from discussions with health care professionals (HCPs), perception of personal PTB risk, and recognition-based knowledge score.

We conducted a cross-sectional, web-based survey of pregnant women at 12-32 weeks' gestation in five European countries. Analyses were stratified by country and by PTB risk.

The analytic sample comprised 247 women, of whom 111 (44.9%; 95% confidence interval [CI], 38.9-51.2) were classified as at higher PTB risk. Among these, 35.1% (95% CI, 26.9-44.4) did not recognize their higher PTB risk in the current pregnancy despite a previous PTB. Differences in awareness were observed between countries, with no differences across PTB risk strata. Recall of PTB themes discussed with HCPs and the recognition-based knowledge score were low and did not differ across PTB risk strata. Topic-specific shortfalls in recall and recognition were identified.

A disconnect emerged between feeling informed and retaining actionable knowledge. HCPs should reserve time with women to deliver education using evidence-based techniques (e.g., teach-back) to build, maintain, and reinforce recall of PTB knowledge so that women are not only aware but also active participants in prevention, monitoring, and care.