{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:44:35Z","timestamp":1792161875048,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Health literacy is an important determinant of maternal health and may influence improving pregnancy outcomes. This study aimed to assess the health literacy levels of pregnant women and explore their relationship with empowerment and self\u2010care practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This cross\u2010sectional study included 350 pregnant women receiving prenatal care at 12 health service centers in Langroud, northern Iran. Participants were recruited through convenience sampling and provided written informed consent. Data were collected from March to September 2024 using the Health Literacy for Iranian Adults Questionnaire (HELIA), the Pregnancy Empowerment Questionnaire (PEQ), and the Pregnancy Self\u2010Care Questionnaire (PSCQ). Stepwise multiple linear regression analyses were conducted to identify independent predictors of pregnancy self\u2010care. The mediating effect of pregnancy empowerment on the association between health literacy and self\u2010care was examined using PROCESS macro (Model 4) with bootstrap confidence intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean scores of health literacy, pregnancy empowerment, and self\u2010care were 66.67\u2009\u00b1\u200913.56, 76.26\u2009\u00b1\u20099.83, and 118.45\u2009\u00b1\u200924.54, respectively. Higher health literacy was significantly associated with greater pregnancy empowerment (B\u2009=\u20090.344,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and better self\u2010care behaviors (B\u2009=\u20091.15,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Family income and planned pregnancy were identified as significant correlates of both empowerment and self\u2010care. Mediation analysis demonstrated a significant indirect effect of health literacy on self\u2010care through pregnancy empowerment, indicating partial mediation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study highlights the critical role of health literacy as an independent predictor of both women's empowerment and self\u2010care during pregnancy. Higher levels of health literacy not only directly contribute to better self\u2010care practices but also indirectly promotes empowerment. Pregnancy empowerment partially mediated the association between health literacy and self\u2010care among pregnant women. These findings emphasize the potential value of integrating health literacy and empowerment strategies into prenatal care programs to support maternal self\u2010care and well\u2010being.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73329","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:03:47Z","timestamp":1791183827000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Can Health Literacy Empower Pregnant Women? Examining Its Role in Self\u2010Care Practices: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"9","author":[{"given":"Zahra","family":"Rezaee","sequence":"first","affiliation":[{"name":"Student Research Committee Babol University of Medical Sciences Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3653-4210","authenticated-orcid":false,"given":"Fatemeh","family":"Bakouei","sequence":"additional","affiliation":[{"name":"Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9813-8141","authenticated-orcid":false,"given":"Hajar","family":"Adib\u2010Rad","sequence":"additional","affiliation":[{"name":"Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soraya","family":"Khafri","sequence":"additional","affiliation":[{"name":"Social Determinants of Health Research Center, Health Research Institute Babol University of Medical Sciences Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzaneh","family":"Khorsand","sequence":"additional","affiliation":[{"name":"Guilan University of Medical Sciences Guilan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.22038\/jhl.2017.10934"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.48305\/him.2022.26202"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.srhc.2022.100796"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.22038\/jhl.2021.61245.1232"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2020.01.010"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.13291"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/4576352"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.70136"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-11954-3"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.5812\/semj.70685"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-017-1490-6"},{"issue":"2","key":"e_1_2_12_13_1","first-page":"229","article-title":"The Impact of Group Prenatal Care on Pregnant Women Empowerment","volume":"13","author":"Jahdi F.","year":"2014","journal-title":"Payesh"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.22037\/ch.v6i1.21855"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-04701-4"},{"issue":"4","key":"e_1_2_12_16_1","first-page":"59","article-title":"Assessment of the Relationship Between Health Literacy and Self\u2010Care in Afghan Pregnant Mothers With Chronic Diseases","volume":"6","author":"Rahimi M.","year":"2022","journal-title":"J Health Lit"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-09738-y"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/jehp.jehp_1005_21"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.32592\/ajnmc.33.1.59"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17082910"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/17455057231224179"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.4103\/jehp.jehp_746_22"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.52547\/jech.8.4.253"},{"issue":"3","key":"e_1_2_12_24_1","first-page":"16","article-title":"Empowerment of Pregnant Women","volume":"26","author":"HajiPour L.","year":"2016","journal-title":"Journal of Holistic Nursing and Midwifery"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.22038\/JMRH.2016.7980"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.21608\/asalexu.2020.206110"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.enfcli.2019.07.046"},{"issue":"5","key":"e_1_2_12_28_1","first-page":"860","article-title":"Health Literacy in Iranian Women: A Systematic Review and Meta\u2010Analysis","volume":"49","author":"Khorasani E. 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