Investigation of factors associated with pediatric intention to vaccinate and vaccine hesitancy and refusal in pregnant women in Turkey

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Lack of confidence in vaccines among pregnant women increases vaccine hesitancy or refusal. Aim This study aims to determine the frequency, causes, and risk factors of pediatric intention to vaccinate and vaccine hesitancy and refusal in pregnant women. Methods Data were collected using a questionnaire designed by the researchers and included items about descriptive characteristics of women and their vaccine hesitancy and refusal. The study was used with the STROBE Statement checklist. Results Pediatric vaccine acceptance in pregnant women was 72.2%, the prevalence of vaccine refusal was 3.4%, and the prevalence of vaccine hesitancy was 24.4%. The vaccine that women were hesitant to get administered to their infants in the first place after birth was the pneumococcal vaccine (17.2%), and Tdab was the vaccine that they intended to have administered to their infants the most(76.3%). According to the multivariate logistic regression model, which was adjusted for age, education, income, and gestational week, vaccine hesitancy was significantly higher in pregnant women (OR = 15.14) who stated that they would not have screening tests such as hearing and heel blood done after birth (p < 0.0001).Vaccine hesitancy was also high in pregnant women who did not use any folic acid during pregnancy (OR = 2.59) and those who had not received two doses of tetanus vaccine during pregnancy or within the last 10 years (OR = 1.75). It was statistically significantly 2.14 times higher in pregnant women who used social media as a source of information about vaccines (OR = 2.14) and those who stated that they did not trust the content of vaccines (OR = 22.08) (p < 0.05). Conclusion The risk of pediatric vaccine hesitancy was higher in pregnant women who did not use preventive interventions during the antenatal period. intention immunization vaccine hesitancy vaccine refusal pregnant women INTRODUCTION Despite the success achieved with immunization in reducing maternal and neonatal mortality and morbidity [ 1 ], pediatric vaccine hesitancy and refusal, which have increased over time, have quickly become a priority public health problem that needs to be addressed and resolved [ 2 ]. Pregnant women have been accepted as an ideal target population in which interventions for the intention to vaccinate infants after birth will be developed since it covers the time when attitudes and beliefs towards childhood vaccinations are first formed.[ 3 ].The antenatal period, with its unique features, is a period in which the mother-to-be decides or starts to think about initiatives and preventive health services, including vaccination, (maternal vaccines, vitamin K, instillation of erythromycin in the eye, double-triple screening test, prophylactic multivitamin use, etc.) to be applied to the newborn at birth or after birth [ 4 – 7 ].It is observed that the anxiety, fear, and hesitancy experienced by pregnant women about preventive health practices during the antenatal period lead to an increased tendency to refusal of birth practices and vaccine hesitancy and refusal against vaccines to be administered to their infants after birth [ 6 , 7 ]. Concerns about vaccine safety, including side effects and long-term effects of vaccines, are the main cause of vaccine hesitancy [ 2 , 4 ].Various socio-contextual variables of expectant mothers affect vaccine acceptance [ 4 ].According to the systematic review by Rosso et al., no relationship was found between sociodemographic characteristics and vaccine acceptance in pregnant women [ 5 ].In studies on the relationship between the obstetrical characteristics of pregnant women, a difference was found between vaccine acceptance and parity. Some studies have shown that hesitancy is higher in primiparous pregnant women, while others have shown that it is higher in multiparous pregnant women [ 5 ].It has been reported that pregnant women's negative attitude toward vaccines is a determining factor in vaccine hesitancy, and that vaccine acceptance is higher in individuals with positive attitudes [ 4 , 5 ].It is known that vaccine acceptance is significantly higher in individuals with a high level of knowledge about vaccines [ 5 ].It has been reported that pregnant women with a high level of knowledge about vaccine-preventable diseases have their children vaccinated more [ 5 , 8 ]. A high level of knowledge about the safety and effectiveness of vaccines and the diseases they prevent are effective in pregnant women’s intention to have their infants receive all or some vaccines (anti-pneumococcal, anti-meningococcal B and C, anti-rotavirus and anti-HPV vaccines) [ 9 ]. There is a significant increase in the number of children who are not vaccinated due to vaccine refusal in Turkey. According to the data of the Ministry of Health, the number of families who refused to have their children vaccinated was estimated to increase from 183 in 2011 to 12,000 in 2016, 23,600 in 2017, and over 40,000 in 2019 [ 10 ].Vaccination is not compulsory in Turkey. According to the National Immunization Program of the Ministry of Health, it is aimed to vaccinate all children free of charge against Tetanus-Diphtheria Acellular Pertussis (Tdap), Measles-mumps-rubella (MMR), Bacillus Calmette-Guerin (BCG) vaccine, poliomyelitis, hepatitis B, pneumococcal and Hemophilus influenza Type b infections, hepatitis A, and chickenpox. Meningococcal and rotavirus vaccines are recommended to families and are administered for a fee [ 11 ].Polio and maternal and neonatal tetanus have been eliminated with an effective vaccination program in our country [ 12 ].Vaccination rates are falling dramatically, with the rate of fully vaccinated 12–23 month-old children in the last 10 years regressing from 74% to 6 [ 13 ].There appears to be a significant problem in Turkey that threatens the desire to achieve the goal of full vaccination of 95% of children. The decrease in vaccination rates and the increase in the incidence of vaccine-preventable infectious diseases in Turkey are important problems in terms of the risk of outbreaks. It is stated that more evidence is needed from non-western, low- and middle-income countries on pediatric vaccine hesitancy [ 14 ].It is thought that the findings of this study will contribute to developing strategies for the causes of vaccine hesitancy in pregnant women in Turkey and similar countries. Countries monitor the frequency of vaccine hesitancy and refusal and try to pinpoint the root of this trend [ 15 – 17 ].When studies on vaccine hesitancy in pregnant women are examined, it is seen that many studies are related to maternal vaccine acceptance (Tdap, tetanus, hepatitis B, influenza) [ 18 – 20 ].In addition, studies on maternal vaccine hesitancy focus on the influenza vaccine in North American countries, while Asian and African countries focus on the tetanus vaccine. Most studies appear to be related to influenza and pertussis [ 21 ].In addition, studies address the risk-benefit of vaccines, the role of health workers, and the level of knowledge about vaccines [ 2 , 4 , 5 , 8 , 9 , 16 , 17 ].It is seen that the literature on vaccination of infants, pediatric vaccine acceptance, and childhood vaccine hesitancy in pregnant women in Turkey is not adequate. The aim of this study is to determine the frequency, causes, and risk factors for intention to vaccinate and vaccine hesitancy and refusal in pregnant women. METHODS Population and sample of the study The study was used with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement checklist. This cross-sectional study was conducted at XXX University Training and Research Hospital, the largest maternal hospital in the province. The study group consisted of pregnant women who presented to XXX University Training and Research Hospital. The population of the study was defined as 16,787 pregnant women who presented to the hospital in 2021. The sample size was calculated on OpenEpi Version 3, which is an open-source calculator.[ 22 ]. Studies conducted in Turkey do not have information about the prevalence of vaccine hesitancy in pregnant women. The prevalence of vaccine hesitancy in parents in a study conducted in the same region (13.8%) was taken into account for sample calculation 17. With the Type-1 error level set at 5%, the prevalence was 13.8%. The design effect was 3, and the sample size was calculated as at least 543 subjects, based on a confidence interval of 95% CI. A total of 687 pregnant women participated in the study. Fifty-three pregnant women were excluded from the study due to missing data. Thus, the study was completed with 634 pregnant women. Inclusion and exclusion criteria Pregnant women who were aged ≥ 18 years, were able to communicate well, were literate, and volunteered to participate in the study were included in the study. Those who did not want to participate in the study, were at risk of miscarriage, were diagnosed with a congenital anomaly, had a risk of preterm birth, had a psychiatric illness, and were diagnosed with a serious risky pregnancy were not included in the study. Data collection tools The data form, which was created by the researchers following a review of the literature [ 3 – 6 , 8 , 9 , 17 ]., consists of two parts. In the first part, there are items about the descriptive characteristics of pregnant women. The second part has items about pregnant women’s vaccine hesitancy and refusal. Within the scope of the face-validity testing, 2 experts in the field of public health were consulted, and the form was piloted on 20 pregnant women. The answers given by these pregnant women to the questionnaire were examined and the questions that were not understood were improved. The questionnaire was finalized accordingly. The descriptive section of the data form It was composed of 28 questions in total, including items about pregnant women’s sociodemographic characteristics (6 items), obstetric characteristics, tests, scans, vaccines, and vitamin drugs used during pregnancy, use of alternative medicine applications (20 items), sources of vaccine information, and evaluation of vaccine information (2 items). The section on vaccine hesitancy and refusal It consisted of a total of 6 questions, including the presence of vaccine-hesitant parents in the circles of pregnant women and their beliefs and opinions about the intention to vaccinate and vaccine acceptance. Main questions about vaccine hesitancy 1) Please indicate your opinion about having your baby get the childhood vaccines included in the national vaccination program of the Ministry of Health after birth. (I'll have it done; I don't think I will; I'm undecided). If the response of the pregnant woman was negative (I don't think I will; I'm undecided), an explanation was asked. 2) Please indicate if there is a vaccine among childhood vaccines that you are hesitant about or refuse (Dabt-Ipa-Hib, Hepatitis A, hepatitis B, Oral Polio, MMR, BCG, KPA). 3) Do you trust the active ingredients in vaccines (yes, no, undecided)? 4) Do you think idiopathic chronic diseases such as Multiple Sclerosis and autism have a relationship with vaccination? 5) Do you know anyone in your close circles such as family/friends who decided not to have their child vaccinated (Yes, No, I don't know)? Data collection The data were collected under the supervision of the researchers using questionnaire forms answered by pregnant women between January-May 2022. It took about 5–8 minutes to fill out the questionnaires. Statistical analysis The data were analyzed on the SPSS 21.0 software package. Descriptive statistics were presented using numbers and percentage distributions, and mean ± standard deviation, median, minimum and maximum values were given. Pregnant women with vaccine hesitancy and refusal were identified according to responses to the following statement: “Please indicate your opinion about having your baby get the childhood vaccines included in the national vaccination program of the Ministry of Health after birth (I'll have it done; I don't think I will; I'm undecided). Those who responded "I don't want to have it done, I'm undecided, I don't know" were coded as subjects who had vaccine hesitancy and refusal. The reasons for childhood vaccine hesitancy of pregnant women who had vaccine hesitancy and refusal and their opinions regarding acceptance specific to vaccine antigens were evaluated with numbers and percentages. Chi-square analysis was used for univariate relationships between sociodemographic, obstetric, and antenatal care characteristics of pregnant women who had vaccine hesitancy and refusal and pregnant women who accepted vaccines. Variables that were significant in univariate analysis were evaluated with logistic regression analysis in multivariate analysis. Enter method was used in logistic regression analysis, and Odds Ratio (OR) values were presented with a confidence interval of 95%. The statistical significance level was accepted as p < 0.05. The data were analyzed on SPSS 24.0 software package. Type 1 error level was taken as α = 0.05. Ethics of the study The study was conducted in accordance with the Declaration of Helsinki. Before the study was initiated, approval of XXX University Medical Faculty Clinical Research Ethics Committee was obtained (date:26 June 2020 no:343). Official permissions were obtained from XXX University Training and Research Hospital. At the beginning of the study, pregnant women were informed about the study, and their written consent was obtained. RESULTS Sample characteristics The mean age of the pregnant women participating in the study was 28.91±5.35 (min: 17; max: 44), 70.1% of them had a high school or above education, 36.3% had a paid job, and 50.7% had a monthly income of the minimum wage or less. The spouses of 96.5% of participants were employed, and 72.7% of them had high school or above education. Of the pregnant women, 12.0% stated that they used alternative medicine applications (treatment with herbs, cupping therapy, hijama). Pregnant women were asked to evaluate their knowledge about vaccines, and 19.6% of them stated that their knowledge was adequate/good. Also, 41.6% of pregnant women stated that they trusted the content of vaccines, and 10.8% stated that they did not. The rate of respondents who used social media as a source of information about vaccines was 28.1% (Table 1). According to the univariate analysis findings of the study, vaccine hesitancy/refusal was significantly higher in pregnant women who graduated from primary education than those with high school or above education (p=0.027). Pregnant women were asked to evaluate their level of knowledge about vaccines, and it was found that as the level of knowledge increased among participants who evaluated their knowledge about vaccines as "moderate" or "high", the number of pregnant women who had vaccine hesitancy/refusal decreased statistically significantly (p=0.02). Vaccine hesitancy/refusal was significantly higher in pregnant women who did not trust the content of vaccines than in those who stated that they did (p<0.001). Vaccine hesitancy/refusal was significantly higher in participants who used social media as a source of information on vaccines (p=0.001). The examination of the obstetric and antenatal care characteristics of pregnant women indicated that 67.1% were in the 3rd trimester, 67.9% had 1 or 2 pregnancies, 35.3% were nulliparous, and 57.9% had a planned pregnancy. Regarding screening, testing, and vaccination during pregnancy, 18.8% of the pregnant women had never used folic acid, 12.1% of them in their 16th gestational week and above had never used iron preparation, and 28.7% of those who were over their 28th gestational week had not had an oral glucose tolerance test (OGTT). Also, 66.8% of pregnant women in their 14th gestational week and above had undergone the double screening test. Of the participants, 74.6% stated that they would have their babies receive screening tests such as hearing and heel blood after birth (Table 2). Vaccine hesitancy/refusal was significantly higher in pregnant women who had 3 or more pregnancies, had 3 or more childbirths and children, did not have a planned pregnancy, had not used folic acid in the first three months of pregnancy, did not receive 2 doses of tetanus during pregnancy or in the last 10 years, did not have a double screening test in their 11th – 14th gestational weeks, and stated that they would not have their babies receive screening tests such as hearing and heel blood after birth (P <0.05) (Table 2). Information resources about vaccines When the source of the basic information about vaccines was questioned, 70.6% reported it as health personnel. Other sources of information were television and radio (37.2%), social media (28.1%), and books, magazines, etc (21.5%). Prevalence and causes of vaccine hesitancy/refusal Participants were asked, “Would you have your infant receive the childhood vaccinations included in the national vaccination program of the Ministry of Health after birth?” and 72.2% of them responded that they would. The prevalence of vaccine refusal in pregnant women who stated that they would definitely not have their infants receive vaccines was 3.4% (n=22), and 24.4% reported that they were undecided about vaccination. The primary reason for vaccine hesitancy/refusal was the thought that "vaccines might be harmful to their infant" with 63.5%. This was followed by distrust in vaccines (40.4%), thinking that vaccines have serious side effects (32.9%), and thinking that companies producing vaccines are malicious because they generate huge revenues (19.1%) (Table 3). Intention to vaccinate According to the Turkish Ministry of Health National Extended Immunization Program, the vaccination schedule for 2021 and 2022 for pregnant women, pediatric vaccine acceptance and attitudes were questioned. The pneumococcal vaccine came first among the antigen-specific vaccines that were rejected the most, with 4.7%. This was followed by MMR (4.3%) and varicella vaccines (4.2%). The vaccine they stated that they were undecided about getting their children to receive the most was the pneumococcal vaccine (17.2%) and the most accepted vaccine was Tdab (76.3%) (Table 4). Multivariate regression analysis of factors associated with vaccine hesitancy/refusal in pregnant women is shown in Table 5. Model 1 was adjusted for age, education, income, and gestational week. Vaccine hesitancy was 15.14 times higher (CI 95%: 3.39-67.49) in pregnant women who stated that they would not have screening tests done such as hearing and heel blood after childbirth, and 3.38 times higher (CI 95% 1.99-5.74) in those who responded "I don't know" (p<0.0001). Vaccine hesitancy was 2.59 times (CI 95% 1.32-5.06) higher in pregnant women who had not used folic acid during pregnancy than in those who had used it (p=0.005). Vaccine hesitancy was 1.75 times (CI 95% 1.02-3.02) higher in pregnant women who had received tetanus vaccine than those who had not received two doses of tetanus vaccine during their pregnancy or in the last 10 years (p=0.041). However, in Model 2, which was created by adjusting for income and education, no statistically significant relationship was found between getting vaccinated against tetanus and vaccine hesitancy (p=0.118). Vaccine hesitancy was 22.08 times higher in pregnant women who stated that they did not trust the content of vaccines (CI 95 8.90-54.76), and it was 13.73 times higher in those who responded that they were undecided (CI 95 6.71-28.09) (p <0.001). It was 2.14 times higher in pregnant women who used social media as a source of information about vaccines (CI 95 1.23-3.73) (P = 0.007). According to Model 2, which was created by adjusting for income and education, vaccine hesitancy was 12.07 times higher in pregnant women who stated they would not have their children have screening tests such as hearing and heel blood after birth (CI 95%: 2.83-51.36) and 3.70 times higher in those who stated they did not know anything about vaccines (CI 95% 2.22-6.17%) (p<0.01). It was 2.05 times higher in pregnant women who used folic acid during pregnancy than in those who used it (CI 95% 1.09-3.88%) (p = 0.026). Vaccine hesitancy was 17.92 times higher in pregnant women who stated they did not trust the content of vaccines (CI 95% 7.43-43.23) and 11.81 times higher in those who stated they were undecided (CI 95% 5.86-23.78) (p <0.001). It was 2.31 times higher in those who used social media as a source of information about vaccines (CI 95% 1.34-3.99%) (p = 0.002). DISCUSSION In our study, we aimed to determine the prevalence and related factors of vaccine hesitancy and refusal in pregnant women. Pediatric vaccine acceptance in pregnant women was 72.2%, the prevalence of vaccine refusal was 3.4%, and the prevalence of vaccine hesitancy was 24.4%. The multivariate analysis findings of this study indicated that sociodemographic and obstetric characteristics were not effective in vaccine hesitancy/refusal. According to the multivariate logistic regression model, vaccine hesitancy/refusal was significantly higher in pregnant women who stated that they would not have their children have screening tests such as hearing and heel blood after birth, who had not used any folic acid during pregnancy, who had 2 doses of tetanus vaccine during pregnancy or in the last 10 years, who stated that they did not trust the content of vaccines, and who used social media as an information source about vaccines. In this study, vaccine hesitancy in pregnant women was 24.4%. In studies conducted in Malaysia [ 23 ] and the USA [ 24 ], the prevalence of vaccine hesitancy (8%) was lower than our findings. In studies conducted in different countries and Turkey with families with children under the age of 5, the prevalence of vaccine hesitancy was between 6–14% [ 17 , 25 , 26 ].In general, the measurement tool used for vaccine hesitancy varies according to the socio-cultural characteristics of the research group, country, or research region. There may be differences in prevalence due to social and cultural reasons and self-reports of participants. Henrikson et al., in their randomized controlled trial, found the prevalence of maternal vaccine hesitancy as 12.6% and then 8% after 6 months. Vaccine hesitancy, which is high during pregnancy, may change over time [ 27 ].It has been stated that the vaccine decision-making process can develop over time and that it can continue in the first years of children after birth [ 4 ].The prevalence of vaccine refusal in pregnant women who stated that they would definitely not have their children receive childhood vaccines was 3.4% and it was 4.8% in families with children under the age of 5 in Turkey, which is lower than the finding of this study [ 17 ] In our study, vaccine hesitancy was significantly higher in pregnant women who stated that they would not have their children have tests such as hearing and heel blood after birth. The common feature of the health beliefs of families who reject various preventive practices such as newborn and childhood screenings is that they are worried about the effectiveness of public health programs [ 7 ].In a qualitative study conducted in the United States on the examination of parents' refusal of vitamin K for their infants, it was found that parents also refused or postponed the hepatitis vaccine at birth [ 6 ].In another study on the rejection of vitamin K in the United States, it was reported that parents also refused protective services such as hepatitis B vaccine and erythromycin eye ointment [ 7 ].Similar to vaccines, trust in the content of the vitamin K injection and risk-benefit perception affect decision making in families. If families refuse vitamin K for their newborn, the risk of vaccine refusal and hesitancy increases. The multivariate analysis in our study showed that vaccine hesitancy and refusal were higher in pregnant women who had not used folic acid. If pregnant women do not know the importance of the use of folic acid and are concerned about its content, it is seen that pediatric vaccine hesitancy and refusal are higher. Pregnancy period is very suitable for determining the motivation and health beliefs of pregnant women in the acceptance of screening tests, vaccines, and multivitamin use. It is seen that concerns, fear, hesitancy, and refusal which are related to preventive health practices and experienced during pregnancy have a higher tendency to continue as a refusal of practices at childbirth and vaccine hesitancy and refusal after childbirth. According to the Turkish Ministry of Health National Extended Immunization Program, the vaccination schedule for 2021 and 2022 for pregnant women, pediatric vaccine acceptance and attitudes were questioned. The pneumococcal vaccine came first among the antigen-specific vaccines that were rejected the most, with 4.7%, which was followed by MMR (4.3%) and varicella vaccine (4.2%). The vaccine that pregnant women stated they were most hesitant about was the pneumococcal vaccine (17.2%). In a study conducted in Turkey by İlter et al., families were found to mostly refuse hepatitis A, measles, mumps, and rubella (MMR) combination vaccines, and vaccines that were least refused included chickenpox vaccine, hepatitis B, Bacillus Calmette-Guérin, and Td vaccines [ 28 ].Tdab, KKK, and chickenpox were the most common vaccines that pregnant women intended to have their infants receive. In Italy, it was found that pregnant women mostly intended to have their infants receive Hexavalent (Diphtheria, Tetanus, whole cell pertussis, Hepatitis B, Haemophilus b, and the three IPV serotype antigens) after birth. In a study conducted with pregnant women in Italy, positive attitudes towards the efficacy, safety, and delivery of vaccines were associated with the intention to vaccinate with hexavalent [ 9 ].The national vaccination schedule of each country differs. In our country, unlike in developed countries, oral polio and BCG vaccines are administered, but meningococcal and rotavirus vaccines are not included in the national vaccination scheme. It is thought that awareness about vaccines and health literacy are effective in the intention to vaccinate. The status of being informed by a midwife, physician, or health worker during pregnancy was not questioned in this study. It has been reported that providing information about the practices in antenatal care by health service providers during pregnancy increases this practice and acceptance of vaccines. In addition, previous studies have shown that informing pregnant women about vaccines increases maternal influenza and pertussis vaccine intake and acceptance.[ 29 ].However, the physician-targeted randomized controlled communication intervention study conducted by Henrikson et al. indicated that vaccine conversations did not reduce maternal vaccination [ 27 ].The univariate analysis and multivariate Model 1 showed that vaccine hesitancy was statistically higher in pregnant women who received a tetanus vaccine than those who did not receive two doses of tetanus vaccine during their pregnancy or in the last 10 years. Trust in the content of vaccines and getting information about vaccines is thought to increase vaccine acceptance. The most important reason why individuals and parents decide to vaccinate their children is "confidence" in the efficacy and safety of vaccines [ 2 , 5 ].The perception that vaccines can cause short-term and long-term effects, such as autism and idiopathic diseases, is a cause for concern. In our study, vaccine hesitancy/refusal was significantly lower in pregnant women who had confidence in vaccines. Individuals use many different sources of information about vaccines (social media, health workers, websites of the ministry of health, friends, etc.). The more concerned they are about the safety of vaccines, the more information they seek about vaccines, and thus the more active their communication is. Mothers who perceive the safety of vaccines as a problem and fear its negative effects tend to favor alternative options [ 30 ]. The fact that social media has made it possible for individuals to take a role as a content producer causes personal content about anti-vaccination to circulate in digital environments [ 10 ].Similar to our study, individuals who follow anti-vaccine groups on social media have more vaccine hesitancy and refusal. It was determined that parents who postponed vaccination of their children made this decision under the influence of social media [ 4 ].Anti-vaccine groups on social media affect individuals emotionally and reduce confidence in vaccines by sharing their personal stories about the individual harm of vaccines [ 16 ]. Understanding how pregnant women's views on vaccines, as well as how information and misinformation about vaccines are shared online, are important to guide interventions to increase vaccine trust and coverage [ 31 ].The WHO has conceptualized three key dimensions with a model for identifying causes of vaccine hesitancy: lack of confidence (in effectiveness, safety, the system, or policymakers), complacency (perceived low risk of acquiring VPDs), and lack of convenience (in the availability, accessibility, and appeal of immunization services, including time, place, language, and cultural contexts) [ 32 ].It was observed in our study that the main reasons for vaccine hesitancy primarily included a lack of confidence and complacency. The most important reasons for vaccination hesitancy/refusal among pregnant women included thinking that "it may be harmful to the child"; distrust in vaccines, thinking that vaccines have serious side effects, and thinking that companies producing vaccines are malicious because they make huge incomes. In a study conducted in Malaysia, the most important reason was found as adverse side effects of vaccines (52.1%) [ 23 ].Vaccine hesitant parents are not "thoughtless parents;" they want the best to protect their children's health. Understanding the thoughts and feelings of these parents is important for solving the problem. According to the qualitative study by Dube et al., all mothers who accepted, refused, and were hesitant about vaccines wanted the best to protect their children's health. Mothers' vaccination decision includes different factors such as social norms, past experiences, emotions, values, and social network effects [ 33 ]. In conclusion, no correlation was found between sociodemographic and obstetric characteristics of pregnant women and pediatric vaccine hesitancy and refusal in our study. Vaccine hesitancy and refusal were found to be significantly higher in those who stated that they would not have their baby receive screening tests such as hearing and heel blood after birth, who had not used any folic acid during pregnancy, who stated that they did not trust the content of vaccines, and who used social media as a source of information about vaccines. This study has some strengths. For example, it identified pediatric vaccine hesitancy and refusal and risk factors in pregnant women in a region of Turkey. The main limitation of this study is that as it was a cross-sectional study, it was not strong enough to accurately determine the temporal direction of the cause-effect relationship between factors associated with pediatric vaccine hesitancy and refusal. Data were collected based on a self-report questionnaire. Vaccine hesitancy and refusal may change over time, and expectant mothers may accept vaccines after the birth of the baby. Therefore, the results presented can only reflect the situation at the time when the data had been collected. Since the study was conducted in only one maternal university hospital, the results cannot be generalized to all pregnant women. Larger scale and stronger studies are needed to identify risk factors for vaccine hesitancy and refusal. The results of this study will shed light on future studies on monitoring vaccine hesitancy and refusal in pregnant women and determining strategies to be developed. Abbreviations Tetanus-Diphtheria Acellular Pertussis: Tdap Measles- mumps-rubella: MMR Oral glucose tolerance test: OGTT Bacillus Calmette-Guerin: BC Declarations Acknowledgements We are grateful to all the participants who kindly agreed to participate in our survey. Authors' contributions SY and DG participated in the design of the study, acquisition of data, performed the statistical analysis and drafted the manuscript. All authors read and approved the final manuscript. Funding No funding was received for the study. Data availability Our data is not available for ethical reasons. Ethics approval and consent to participate The study was conducted in accordance with the Declaration of Helsinki. Before the study was initiated, approval of XXX University Medical Faculty Clinical Research Ethics Committee was obtained (date:26 June 2020 no:343). We obtained informed consent from each participant. The research participants were informed of their rights before signing the informed consent, including the right to withdraw from the study at anytime. Any personal identifier was not encoded; identifiers of the women were replaced with identification numbers. Consent for publication Not applicable. 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Hacettepe University Institute of Population Studies. 2018 Turkey demographic and health survey. Ankara: Hacettepe University Institute of Population Studies, T.R. Presidency of Turkey Directorate of Strategy and Budget and TÜBİTAK; 2019. Simas C, Larson HJ. Overcoming vaccine hesitancy in low-income and middle-income regions. Nat Rev Dis Primers. 2021;7(1):41. Stoeckel F, Carter C, Lyons BA, Reifler J. The politics of vaccine hesitancy in Europe. Eur J Public Health. 2022;32(4):636–42. Bianco A, Mascaro V, Zucco R, Pavia M. Parent perspectives on childhood vaccination: How to deal with vaccine hesitancy and refusal? Vaccine. 2019;37(7):984–90. Yörük S, Güler D. Factors associated with pediatric vaccine hesitancy of parents: a cross-sectional study in Turkey. Hum Vaccin Immunother. 2021;17(11):4505–11. Descamps A, Launay O, Bonnet C, Blondel B. Seasonal influenza vaccine uptake and vaccine refusal among pregnant women in France: results from a national survey. Hum Vaccin Immunother. 2020;16(5):1093–100. Van Buynder PG, Van Buynder JL, Menton L, Thompson G, Sun J. Antigen specific vaccine hesitancy in pregnancy. Vaccine. 2019;37(21):2814–20. Wales DP, Khan S, Suresh D, Ata A, Morris B. Factors associated with Tdap vaccination receipt during pregnancy: a cross-sectional study. Public Health. 2020;179:38–44. Wilson RJ, Paterson P, Jarrett C, Larson HJ. Understanding factors influencing vaccination acceptance during pregnancy globally: A literature review. Vaccine. 2015;33(47):6420–9. Dean AG, Sullivan KM, Soe MM, OpenEpi. Open Source Epidemiologic Statistics for Public Health, Version. www.OpenEpi.com, updated 2013/04/06, accessed 2022/09/27. Kalok A, Loh SYE, Chew KT, et al. Vaccine hesitancy towards childhood immunisation amongst urban pregnant mothers in Malaysia. Vaccine. 2020;38(9):2183–9. Cunningham RM, Minard CG, Guffey D, Swaim LS, Opel DJ, Boom JA. Prevalence of Vaccine Hesitancy Among Expectant Mothers in Houston, Texas. Acad Pediatr. 2018;18(2):154–60. Kempe A, Saville AW, Albertin C, Zimet G, Breck A, Helmkamp L, Vangala S, Dickinson LM, Rand C, Humiston S, Szilagyi PG. Parental Hesitancy About Routine Childhood and Influenza Vaccinations: A National Survey. Pediatrics. 2020;146(1):e20193852. Mohd Azizi FS, Kew Y, Moy FM. Vaccine hesitancy among parents in a multi-ethnic country. Malaysia Vaccine. 2017;35(22):2955–61. Henrikson NB, Opel DJ, Grothaus L, et al. Physician Communication Training and Parental Vaccine Hesitancy: A Randomized Trial. Pediatrics. 2015;136(1):70–9. İlter H, Demir SL. Gulhane Med J. 2021;63:96–103. Drezner D, Youngster M, Klainer H, et al. Maternal vaccinations coverage and reasons for non-compliance - a cross-sectional observational study. BMC Pregnancy Childbirth. 2020;20:541. Vrdelja M, Kraigher A, Vercic D, Kropivnik S. The growing vaccine hesitancy: exploring the influence of the internet. Eur J Public Health. 2018;28(5):934–9. Martin S, Kilich E, Dada S, et al. Vaccines for pregnant women… Absurd - Mapping maternal vaccination discourse and stance on social media over six months. Vaccine . 2020;38(42):6627–6637. Greenberg J, Dubé E, Driedger M. Vaccine Hesitancy: In Search of the Risk Communication Comfort Zone. PLoS Curr. 2017;9: ecurrents.outbreaks . Dubé E, Vivion M, Sauvageau C, Gagneur A, Gagnon R, Guay M. Nature Does Things Well, Why Should We Interfere? Vaccine Hesitancy Among Mothers. Qual Health Res. 2016;26(3):411–25. Tables Table 1. The relationship between vaccine acceptance and vaccine hesitancy/refusal according to the sociodemographic characteristics of pregnant women (n=623) Variables Total Vaccine acceptance Refusal/ hesitancy p value Age n(%) n(%) n(%) ≤ 34 518(83.1) 382(73.7) 136(26.3) 0.061 35 ≥ 105(16.9) 68(64.8) 37(35.2) Women’s education Primary education 186(29.9) 123(66.1) 63(33.9) 0.027 High school and above 437(70.1) 327(74.8) 110(25.2) Spouses’ education Primary education 170(27.3) 121(71.2) 49(28.8) 0.719 High school and above 453(72.7) 329(72.6) 124(27.4) Working status No 397(63.7) 285(71.8) 112(28.2) 0.744 Yes 226(36.3) 165(73.0) 61(27.0) Working status of the spouse No 22(3.5) 14(63.6) 8(36.4) 0.359 Yes 601(96.5) 436(72.5) 165(27.5) Income level (n=544) Minimum wage and less 276 (44.3) 192(69.6) 84(30.4) 5501-10000 209 (33.5) 155(74.2) 54(25.8) 0.224 10000 > 138 (22.2) 47(79.7) 12(20.3) Using alternative medicine applications Yes 75(12.0) 48(64.0) 27(36.0) 0.090 No 548(88.0) 402(73.4) 146(26.6) Having knowledge of vaccines Low 178(28.6) 115(64.6) 63(35.4) Moderate 323(51.8) 240(74.3) 83(25.7) 0.020 Adequate/good 122(19.6) 95(77.9) 27(22.1) Trusting the active ingredient in vaccines Yes 259(41.6) 245(94.6) 14(5.4) No 67(10.8) 27(40.3) 40(59.7) <0.001 Undecided 297(47.7) 178(59.9) 119(40.1) Using social media as a vaccine information source Yes 175(28.1) 109(62.3) 66(37.7) 0.001 No 448(71.8) 341(76.1) 107(23.9) Note: statistically significant associations (p < .05) are highlighted in bold. Table 2. The relationship between vaccine acceptance and vaccine hesitancy/refusal according to obstetric and antenatal care characteristics of pregnant women (n=623) Variables Total Vaccine acceptance Refusal/ Hesitancy p value n(%) n(%) n(%) Trimesters 1 st trimester (1.-13 th week) 40(6.4) 32(80.0) 8(20.0) 2 nd trimester (14-26 th week) 165(26.5) 128(77.6) 37(22.4) 0.070 3 rd trimester (27-41 st week) 418(67.1) 289(69.3) 128(30.7) Number of pregnancies 1-2 423(67.9) 325(76.8) 98(23.2) <0.0001 ≥3 200(32.1) 125(62.5) 75(37.5) Number of childbirths Nulliparous 220(35.3) 166(75.5) 54(24.5) 1 217(34.8) 167(77.0) 50(23.0) 0.003 ≥2 186(29.9) 117(62.9) 69(37.1) Number of children None 232(37.2) 172(74.1) 60(25.9) 1 226(36.3) 178(78.8) 48(21.2) <0.0001 ≥2 165(26.5) 100(60.6) 65(39.4) History of miscarriage None 493(79.1) 350(71.0) 143(29.0) 0.179 Yes 130(20.9) 100(76.9) 30(23.1) Planned pregnancy No 262(42.1) 174(66.4) 88(33.6) 0.006 Yes 361(57.9) 276(76.5) 85(23.5) Having used folic acid Regular or irregular use 506(81.2) 385(76.1) 121(23.9) ) Yes 444(71.3) 195(72.8) 73(27.2) 0.268 No 179(28.7) 58(65.9) 30(34.1) Use of iron preparations (>16 weeks of gestation) Yes 487(87.9) 346(71.0) 141(29.0) 0.723 No 67(12.1) 49(73.1) 18(26.9) Double screening (>14 weeks of gestation) Yes 378(66.8) 291(77.0) 87(23.0) <0.0001 No 188(33.2) 113(60.1) 75(39.9) Receiving 2 doses of tetanus during pregnancy or within the last 10 years Yes 296(47.5) 236(79.7) 60(20.3) <0.0001 No 327(52.5) 214(65.4) 113(34.6) Having the baby screened for hearing and heel blood after birth Yes 465(74.6) 383(80.5) 93(19.5) No 17(2.7) 5(26.3) 14(73.7) <0.0001 I do not know/No idea 123(19.7) 62(48.4) 66(51.6) Note: statistically significant associations (p < .05) are highlighted in bold. Table 3. Causes of childhood vaccine hesitancy in pregnant women with vaccine hesitancy and refusal (n=173) n(%) It may be harmful to the child. 110 (63.5) Distrust in vaccines 70 (40.4) Thinking that vaccines have serious side effects 57 (32.9) Think that companies producing vaccines are malicious because they make huge incomes 33 (19.1) Thinking that children do not get vaccine-preventable diseases 30 (17.3) Thinking that children gain natural immunity by getting over diseases such as chickenpox and measles 29 (16.7) Thinking that vaccines do not help 26 (15.1) Believing that the child is not in the risk group needing vaccination 25 (14.4) Believing that complementary and alternative medicine is more effective and has fewer side effects 20 (11.5) Thinking that vaccine-preventable diseases are insignificant 17 (9.8) Being influenced by misinformation in media/communication tools 16 (9.2) Believing that vaccines cause autism 12 (6.9) Being influenced by social media 11 (6.3) Religious reasons 10 (5.7) Being influenced by the anti-vaccine discourses of the media/famous people 8 (4.6) Believing that vaccines cause infertility 7 (4.1) The family refuses vaccination due to complications of previous vaccination 7 (4.1) Believing that vaccines cause homosexuality 6 (3.4) Table 4. Opinions of pregnant women regarding acceptance specific to pediatric vaccine antigens (n=623) I will have it done. I am undecided. I refuse it. I do not know. Tetanus-Diphtheria Acellular Pertussis (Tdap) 475(76.3) 60 (9.6) 22 (3.5) 66 (10.6) Measles-rubella-mumps 459 (73.7) 65 (10.4) 27 (4.3) 72 (11.6) Hepatitis A 427 (68.6) 92(14.8) 22(3.5) 82(13.1) Hepatitis B 436 (69.9) 85(13.7) 22(3.5) 80(12.9) Varicella 463(74.3) 62(9.9) 26(4.2) 72(11.6) BCG 437(70.1) 81(13.1) 24(3.9) 81(13.1) Polio vaccine 432(68.5) 83(13.3) 24(3.9) 89(14.3) Pneumococcal vaccine 379(60.8) 107(17.2) 29(4.7) 108(17.3) Table 5. Univariate analysis and multivariate regression analysis of factors associated with vaccine hesitancy/refusal in pregnant women Univariate analysis Multivariate analysis Model 1 a Model 2 b cOR CI 95% p aOR CI 95% p value aOR CI 95% p value Having screening tests such as hearing and heel blood administered after birth Yes Ref Ref Ref No 11.53 4.05-32.81 <0.0001 15.14 3.39-67.49 <0.0001 12.07 2.83-51.36 0.001 I do not know/No idea 4.38 2.89-6.63 <0.0001 3.38 1.99-5.74 <0.0001 3.70 2.22-6.17 <0.0001 Number of pregnancies 1-2 Ref Ref Ref ≥3 1.99 1.38-2.86 <0.0001 1.66 0.74-3.71 0.21 1.96 0.89-4.32 0.092 Number of childbirths Nulliparous Ref Ref Ref 1 0.92 0.59-1.43 0.712 0.78 0.41-1.49 0.46 0.74 0.40-1.38 0.354 ≥2 1.81 1.18-2.78 0.006 0.95 0.37-2.45 0.92 0.92 0.37-2.29 0.782 Planned pregnancy Yes Ref Ref Ref No 1.64 1.15-2.33 0.006 1.05 0.63-1.75 0.83 1.07 0.65-1.75 0.78 Having used folic acid Yes Ref Ref Ref No 2.54 1.67-3.86 14 weeks of gestation) Yes Ref Ref Ref No 2.20 1.52-3.17 <0.001 0.86 0.49-1.51 0.609 0.82 0.47-1.44 0.495 Receiving 2 doses of tetanus during pregnancy or within the last 10 years Yes Ref Ref Ref No 2.07 1.44-2.98 <0.001 1.75 1.02-3.02 0.041 1.53 0.89-2.26 0.118 Status of knowledge of vaccines Low 1.92 1.13-3.26 0.015 1.53 0.70-3.32 0.282 1.65 0.77-3.55 0.196 Moderate 1.21 0.74-1.99 0.437 1.27 0.60-2.70 0.525 1.44 0.68-3.01 0.332 Adequate/good Ref Ref Ref Trusting the active ingredient in vaccines Yes Ref Ref Ref No 25.92 12.53-53.63 <0.001 22.08 8.90-54.76 <0.001 17.92 7.43-43.23 <0.001 I am undecided. 11.69 6.5-21.03 <0.001 13.73 6.71-28.09 <0.001 11.81 5.86-23.78 <0.001 Using social media as a vaccine information source No Ref Ref. Ref Yes 1.93 1.32-2.80 0.001 2.14 1.23-3.73 0.007 2.31 1.34-3.99 0.002 Note: statistically significant associations (p < .05) are highlighted in bold. Abbreviation: cOR, crude odds ratios; aOR, adjusted odds ratios; 95% CIs 95% confidence intervals for the adjusted odds ratios and crude odds ratios a: adjusted for age, education, income, and gestational week b: adjusted for income and education Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 27 May, 2024 Editor assigned by journal 27 May, 2024 Submission checks completed at journal 24 May, 2024 First submitted to journal 23 May, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Yörük","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA90lEQVRIiWNgGAWjYNCCAzYJDOyMzUCWBIhrQIyWtAQGZhQtCQS1HAZqAUIowK9Ffkbysc88Z87n8TczNxt8+GORz8DevE2C8cc9nFoMbqQlz+a5cbtY4jBjc+LMNgnLBp5jZRIMCcW4tUjkGDPzfLid2ADUcpi3QcKAQSLHDKgFt8vkZ4C1nEucD9Ly5w9Qi/wb/FoYboC03DiQuAGoJZmBDWQLD34tBmeeJTPOOZNcbAjUYtjbJmHAxpNWbJGQhsdh7cmHGd4cs8uTO97+WOLHnzoDfvbDG298sMHjMAF0OTYQgUcDAwP/AXyyo2AUjIJRMAqAAACkUFBa9POhMAAAAABJRU5ErkJggg==","orcid":"","institution":"Balıkesir University","correspondingAuthor":true,"prefix":"","firstName":"Selda","middleName":"","lastName":"Yörük","suffix":""},{"id":307111222,"identity":"ea001c9c-4d49-4c21-92a0-e92f8367ad73","order_by":1,"name":"Döndü Güler","email":"","orcid":"","institution":"Sakarya University, Training and Research Hospital","correspondingAuthor":false,"prefix":"","firstName":"Döndü","middleName":"","lastName":"Güler","suffix":""}],"badges":[],"createdAt":"2024-05-23 08:53:22","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4465547/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4465547/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":57812923,"identity":"9d280d86-4d57-4d34-ae08-55fdc87cb915","added_by":"auto","created_at":"2024-06-06 03:29:12","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1297841,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4465547/v1/0cade942-c5fd-4509-8c78-37e2cf61fb0b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Investigation of factors associated with pediatric intention to vaccinate and vaccine hesitancy and refusal in pregnant women in Turkey","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eDespite the success achieved with immunization in reducing maternal and neonatal mortality and morbidity [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], pediatric vaccine hesitancy and refusal, which have increased over time, have quickly become a priority public health problem that needs to be addressed and resolved [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePregnant women have been accepted as an ideal target population in which interventions for the intention to vaccinate infants after birth will be developed since it covers the time when attitudes and beliefs towards childhood vaccinations are first formed.[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].The antenatal period, with its unique features, is a period in which the mother-to-be decides or starts to think about initiatives and preventive health services, including vaccination, (maternal vaccines, vitamin K, instillation of erythromycin in the eye, double-triple screening test, prophylactic multivitamin use, etc.) to be applied to the newborn at birth or after birth [\u003cspan additionalcitationids=\"CR5 CR6\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].It is observed that the anxiety, fear, and hesitancy experienced by pregnant women about preventive health practices during the antenatal period lead to an increased tendency to refusal of birth practices and vaccine hesitancy and refusal against vaccines to be administered to their infants after birth [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eConcerns about vaccine safety, including side effects and long-term effects of vaccines, are the main cause of vaccine hesitancy [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].Various socio-contextual variables of expectant mothers affect vaccine acceptance [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].According to the systematic review by Rosso et al., no relationship was found between sociodemographic characteristics and vaccine acceptance in pregnant women [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].In studies on the relationship between the obstetrical characteristics of pregnant women, a difference was found between vaccine acceptance and parity. Some studies have shown that hesitancy is higher in primiparous pregnant women, while others have shown that it is higher in multiparous pregnant women [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].It has been reported that pregnant women's negative attitude toward vaccines is a determining factor in vaccine hesitancy, and that vaccine acceptance is higher in individuals with positive attitudes [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].It is known that vaccine acceptance is significantly higher in individuals with a high level of knowledge about vaccines [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].It has been reported that pregnant women with a high level of knowledge about vaccine-preventable diseases have their children vaccinated more [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. A high level of knowledge about the safety and effectiveness of vaccines and the diseases they prevent are effective in pregnant women\u0026rsquo;s intention to have their infants receive all or some vaccines (anti-pneumococcal, anti-meningococcal B and C, anti-rotavirus and anti-HPV vaccines) [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThere is a significant increase in the number of children who are not vaccinated due to vaccine refusal in Turkey. According to the data of the Ministry of Health, the number of families who refused to have their children vaccinated was estimated to increase from 183 in 2011 to 12,000 in 2016, 23,600 in 2017, and over 40,000 in 2019 [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].Vaccination is not compulsory in Turkey. According to the National Immunization Program of the Ministry of Health, it is aimed to vaccinate all children free of charge against Tetanus-Diphtheria Acellular Pertussis (Tdap), Measles-mumps-rubella (MMR), Bacillus Calmette-Guerin (BCG) vaccine, poliomyelitis, hepatitis B, pneumococcal and Hemophilus influenza Type b infections, hepatitis A, and chickenpox. Meningococcal and rotavirus vaccines are recommended to families and are administered for a fee [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].Polio and maternal and neonatal tetanus have been eliminated with an effective vaccination program in our country [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].Vaccination rates are falling dramatically, with the rate of fully vaccinated 12\u0026ndash;23 month-old children in the last 10 years regressing from 74% to 6 [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].There appears to be a significant problem in Turkey that threatens the desire to achieve the goal of full vaccination of 95% of children. The decrease in vaccination rates and the increase in the incidence of vaccine-preventable infectious diseases in Turkey are important problems in terms of the risk of outbreaks. It is stated that more evidence is needed from non-western, low- and middle-income countries on pediatric vaccine hesitancy [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].It is thought that the findings of this study will contribute to developing strategies for the causes of vaccine hesitancy in pregnant women in Turkey and similar countries. Countries monitor the frequency of vaccine hesitancy and refusal and try to pinpoint the root of this trend [\u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].When studies on vaccine hesitancy in pregnant women are examined, it is seen that many studies are related to maternal vaccine acceptance (Tdap, tetanus, hepatitis B, influenza) [\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].In addition, studies on maternal vaccine hesitancy focus on the influenza vaccine in North American countries, while Asian and African countries focus on the tetanus vaccine. Most studies appear to be related to influenza and pertussis [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].In addition, studies address the risk-benefit of vaccines, the role of health workers, and the level of knowledge about vaccines [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].It is seen that the literature on vaccination of infants, pediatric vaccine acceptance, and childhood vaccine hesitancy in pregnant women in Turkey is not adequate.\u003c/p\u003e \u003cp\u003eThe aim of this study is to determine the frequency, causes, and risk factors for intention to vaccinate and vaccine hesitancy and refusal in pregnant women.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003ePopulation and sample of the study\u003c/h2\u003e \u003cp\u003eThe study was used with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement checklist. This cross-sectional study was conducted at XXX University Training and Research Hospital, the largest maternal hospital in the province. The study group consisted of pregnant women who presented to XXX University Training and Research Hospital. The population of the study was defined as 16,787 pregnant women who presented to the hospital in 2021. The sample size was calculated on OpenEpi Version 3, which is an open-source calculator.[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Studies conducted in Turkey do not have information about the prevalence of vaccine hesitancy in pregnant women. The prevalence of vaccine hesitancy in parents in a study conducted in the same region (13.8%) was taken into account for sample calculation 17. With the Type-1 error level set at 5%, the prevalence was 13.8%. The design effect was 3, and the sample size was calculated as at least 543 subjects, based on a confidence interval of 95% CI. A total of 687 pregnant women participated in the study. Fifty-three pregnant women were excluded from the study due to missing data. Thus, the study was completed with 634 pregnant women.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eInclusion and exclusion criteria\u003c/h2\u003e \u003cp\u003ePregnant women who were aged\u0026thinsp;\u0026ge;\u0026thinsp;18 years, were able to communicate well, were literate, and volunteered to participate in the study were included in the study. Those who did not want to participate in the study, were at risk of miscarriage, were diagnosed with a congenital anomaly, had a risk of preterm birth, had a psychiatric illness, and were diagnosed with a serious risky pregnancy were not included in the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eData collection tools\u003c/h2\u003e \u003cp\u003eThe data form, which was created by the researchers following a review of the literature [\u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]., consists of two parts. In the first part, there are items about the descriptive characteristics of pregnant women. The second part has items about pregnant women\u0026rsquo;s vaccine hesitancy and refusal. Within the scope of the face-validity testing, 2 experts in the field of public health were consulted, and the form was piloted on 20 pregnant women. The answers given by these pregnant women to the questionnaire were examined and the questions that were not understood were improved. The questionnaire was finalized accordingly.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eThe descriptive section of the data form\u003c/strong\u003e \u003cp\u003eIt was composed of 28 questions in total, including items about pregnant women\u0026rsquo;s sociodemographic characteristics (6 items), obstetric characteristics, tests, scans, vaccines, and vitamin drugs used during pregnancy, use of alternative medicine applications (20 items), sources of vaccine information, and evaluation of vaccine information (2 items).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eThe section on vaccine hesitancy and refusal\u003c/strong\u003e \u003cp\u003eIt consisted of a total of 6 questions, including the presence of vaccine-hesitant parents in the circles of pregnant women and their beliefs and opinions about the intention to vaccinate and vaccine acceptance.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eMain questions about vaccine hesitancy\u003c/strong\u003e \u003cp\u003e1) Please indicate your opinion about having your baby get the childhood vaccines included in the national vaccination program of the Ministry of Health after birth. (I'll have it done; I don't think I will; I'm undecided). If the response of the pregnant woman was negative (I don't think I will; I'm undecided), an explanation was asked. 2) Please indicate if there is a vaccine among childhood vaccines that you are hesitant about or refuse (Dabt-Ipa-Hib, Hepatitis A, hepatitis B, Oral Polio, MMR, BCG, KPA). 3) Do you trust the active ingredients in vaccines (yes, no, undecided)? 4) Do you think idiopathic chronic diseases such as Multiple Sclerosis and autism have a relationship with vaccination? 5) Do you know anyone in your close circles such as family/friends who decided not to have their child vaccinated (Yes, No, I don't know)?\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eData collection\u003c/h2\u003e \u003cp\u003eThe data were collected under the supervision of the researchers using questionnaire forms answered by pregnant women between January-May 2022. It took about 5\u0026ndash;8 minutes to fill out the questionnaires.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eThe data were analyzed on the SPSS 21.0 software package. Descriptive statistics were presented using numbers and percentage distributions, and mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation, median, minimum and maximum values were given. Pregnant women with vaccine hesitancy and refusal were identified according to responses to the following statement: \u0026ldquo;Please indicate your opinion about having your baby get the childhood vaccines included in the national vaccination program of the Ministry of Health after birth (I'll have it done; I don't think I will; I'm undecided). Those who responded \"I don't want to have it done, I'm undecided, I don't know\" were coded as subjects who had vaccine hesitancy and refusal. The reasons for childhood vaccine hesitancy of pregnant women who had vaccine hesitancy and refusal and their opinions regarding acceptance specific to vaccine antigens were evaluated with numbers and percentages. Chi-square analysis was used for univariate relationships between sociodemographic, obstetric, and antenatal care characteristics of pregnant women who had vaccine hesitancy and refusal and pregnant women who accepted vaccines. Variables that were significant in univariate analysis were evaluated with logistic regression analysis in multivariate analysis. Enter method was used in logistic regression analysis, and Odds Ratio (OR) values were presented with a confidence interval of 95%. The statistical significance level was accepted as p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. The data were analyzed on SPSS 24.0 software package. Type 1 error level was taken as α\u0026thinsp;=\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eEthics of the study\u003c/h2\u003e \u003cp\u003e The study was conducted in accordance with the Declaration of Helsinki. Before the study was initiated, approval of XXX University Medical Faculty Clinical Research Ethics Committee was obtained (date:26 June 2020 no:343). Official permissions were obtained from XXX University Training and Research Hospital. At the beginning of the study, pregnant women were informed about the study, and their written consent was obtained.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003e\u003cstrong\u003eSample characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe mean age of the pregnant women participating in the study was 28.91\u0026plusmn;5.35 (min: 17; max: 44), 70.1% of them had a high school or above education, 36.3% had a paid job, and 50.7% had a monthly income of the minimum wage or less. \u0026nbsp;The spouses of 96.5% of participants were employed, and 72.7% of them had high school or above education. Of the pregnant women, 12.0% stated that they used alternative medicine applications (treatment with herbs, cupping therapy, hijama). Pregnant women were asked to evaluate their knowledge about vaccines, and 19.6% of them stated that their knowledge was adequate/good. Also, 41.6% of pregnant women stated that they trusted the content of vaccines, and 10.8% stated that they did not. The rate of respondents who used social media as a source of information about vaccines was 28.1% (Table 1). According to the univariate analysis findings of the study, vaccine hesitancy/refusal was significantly higher in pregnant women who graduated from primary education than those with high school or above education (p=0.027). Pregnant women were asked to evaluate their level of knowledge about vaccines, and it was found that as the level of knowledge increased among participants who evaluated their knowledge about vaccines as \u0026quot;moderate\u0026quot; or \u0026quot;high\u0026quot;, the number of pregnant women who had vaccine hesitancy/refusal decreased statistically significantly (p=0.02). Vaccine hesitancy/refusal was significantly higher in pregnant women who did not trust the content of vaccines than in those who stated that they did (p\u0026lt;0.001). Vaccine hesitancy/refusal was significantly higher in participants who used social media as a source of information on vaccines (p=0.001). The examination of the obstetric and antenatal care characteristics of pregnant women indicated that 67.1% were in the 3rd trimester, 67.9% had 1 or 2 pregnancies, 35.3% were nulliparous, and 57.9% had a planned pregnancy. Regarding screening, testing, and vaccination during pregnancy, 18.8% of the pregnant women had never used folic acid, 12.1% of them in their 16th gestational week and above had never used iron preparation, and 28.7% of those who were over their 28th gestational week had not had an oral glucose tolerance test (OGTT). Also, 66.8% of pregnant women in their 14th gestational week and above had undergone the double screening test. Of the participants, 74.6% stated that they would have their babies receive screening tests such as hearing and heel blood after birth (Table 2).\u003c/p\u003e\n\u003cp\u003eVaccine hesitancy/refusal was significantly higher in pregnant women who had 3 or more pregnancies, had 3 or more childbirths and children, did not have a planned pregnancy, had not used folic acid in the first three months of pregnancy, did not receive 2 doses of tetanus during pregnancy or in the last 10 years, did not have a double screening test in their 11th \u0026ndash; 14th gestational weeks, and stated that they would not have their babies receive screening tests such as hearing and heel blood after birth (P \u0026lt;0.05) (Table 2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformation resources about vaccines\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWhen the source of the basic information about vaccines was questioned, 70.6% reported it as health personnel. Other sources of information were television and radio (37.2%), social media (28.1%), and books, magazines, etc (21.5%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePrevalence and causes of vaccine hesitancy/refusal\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants were asked, \u0026ldquo;Would you have your infant receive the childhood vaccinations included in the national vaccination program of the Ministry of Health after birth?\u0026rdquo; and 72.2% of them responded that they would. The prevalence of vaccine refusal in pregnant women who stated that they would definitely not have their infants receive vaccines was 3.4% (n=22), and 24.4% reported that they were undecided about vaccination. The primary reason for vaccine hesitancy/refusal was the thought that \u0026quot;vaccines might be harmful to their infant\u0026quot; with 63.5%. This was followed by distrust in vaccines (40.4%), thinking that vaccines have serious side effects (32.9%), and thinking that companies producing vaccines are malicious because they generate huge revenues (19.1%) (Table 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIntention to vaccinate\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAccording to the Turkish Ministry of Health National Extended Immunization Program, the vaccination schedule for 2021 and 2022 for pregnant women, pediatric vaccine acceptance and attitudes were questioned. The pneumococcal vaccine came first among the antigen-specific vaccines that were rejected the most, with 4.7%. This was followed by MMR (4.3%) and varicella vaccines (4.2%). The vaccine they stated that they were undecided about getting their children to receive the most was the pneumococcal vaccine (17.2%) and the most accepted vaccine was Tdab (76.3%) (Table 4).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMultivariate regression analysis of factors associated with vaccine hesitancy/refusal in pregnant women is shown in Table 5. Model 1 was adjusted for age, education, income, and gestational week. Vaccine hesitancy was 15.14 times higher (CI 95%: 3.39-67.49) in pregnant women who stated that they would not have screening tests done such as hearing and heel blood after childbirth, and 3.38 times higher (CI 95% 1.99-5.74) in those who responded \u0026quot;I don\u0026apos;t know\u0026quot; (p\u0026lt;0.0001). Vaccine hesitancy was 2.59 times (CI 95% 1.32-5.06) higher in pregnant women who had not used folic acid during pregnancy than in those who had used it (p=0.005). Vaccine hesitancy was 1.75 times (CI 95% 1.02-3.02) higher in pregnant women who had received tetanus vaccine than those who had not received two doses of tetanus vaccine during their pregnancy or in the last 10 years (p=0.041). However, in Model 2, which was created by adjusting for income and education, no statistically significant relationship was found between getting vaccinated against tetanus and vaccine hesitancy (p=0.118).\u003c/p\u003e\n\u003cp\u003eVaccine hesitancy was 22.08 times higher in pregnant women who stated that they did not trust the content of vaccines (CI 95 8.90-54.76), and it was 13.73 times higher in those who responded that they were undecided (CI 95 6.71-28.09) (p \u0026lt;0.001). It was 2.14 times higher in pregnant women who used social media as a source of information about vaccines (CI 95 1.23-3.73) (P = 0.007).\u003c/p\u003e\n\u003cp\u003eAccording to Model 2, which was created by adjusting for income and education, vaccine hesitancy was 12.07 times higher in pregnant women who stated they would not have their children have screening tests such as hearing and heel blood after birth (CI 95%: 2.83-51.36) and 3.70 times higher in those who stated they did not know anything about vaccines (CI 95% 2.22-6.17%) (p\u0026lt;0.01). It was 2.05 times higher in pregnant women who used folic acid during pregnancy than in those who used it (CI 95% 1.09-3.88%) (p = 0.026). Vaccine hesitancy was 17.92 times higher in pregnant women who stated they did not trust the content of vaccines (CI 95% 7.43-43.23) and 11.81 times higher in those who stated they were undecided (CI 95% 5.86-23.78) (p \u0026lt;0.001). It was 2.31 times higher in those who used social media as a source of information about vaccines (CI 95% 1.34-3.99%) (p = 0.002).\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eIn our study, we aimed to determine the prevalence and related factors of vaccine hesitancy and refusal in pregnant women. Pediatric vaccine acceptance in pregnant women was 72.2%, the prevalence of vaccine refusal was 3.4%, and the prevalence of vaccine hesitancy was 24.4%. The multivariate analysis findings of this study indicated that sociodemographic and obstetric characteristics were not effective in vaccine hesitancy/refusal. According to the multivariate logistic regression model, vaccine hesitancy/refusal was significantly higher in pregnant women who stated that they would not have their children have screening tests such as hearing and heel blood after birth, who had not used any folic acid during pregnancy, who had 2 doses of tetanus vaccine during pregnancy or in the last 10 years, who stated that they did not trust the content of vaccines, and who used social media as an information source about vaccines.\u003c/p\u003e \u003cp\u003eIn this study, vaccine hesitancy in pregnant women was 24.4%. In studies conducted in Malaysia [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] and the USA [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], the prevalence of vaccine hesitancy (8%) was lower than our findings. In studies conducted in different countries and Turkey with families with children under the age of 5, the prevalence of vaccine hesitancy was between 6\u0026ndash;14% [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].In general, the measurement tool used for vaccine hesitancy varies according to the socio-cultural characteristics of the research group, country, or research region. There may be differences in prevalence due to social and cultural reasons and self-reports of participants. Henrikson et al., in their randomized controlled trial, found the prevalence of maternal vaccine hesitancy as 12.6% and then 8% after 6 months. Vaccine hesitancy, which is high during pregnancy, may change over time [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].It has been stated that the vaccine decision-making process can develop over time and that it can continue in the first years of children after birth [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].The prevalence of vaccine refusal in pregnant women who stated that they would definitely not have their children receive childhood vaccines was 3.4% and it was 4.8% in families with children under the age of 5 in Turkey, which is lower than the finding of this study [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eIn our study, vaccine hesitancy was significantly higher in pregnant women who stated that they would not have their children have tests such as hearing and heel blood after birth. The common feature of the health beliefs of families who reject various preventive practices such as newborn and childhood screenings is that they are worried about the effectiveness of public health programs [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].In a qualitative study conducted in the United States on the examination of parents' refusal of vitamin K for their infants, it was found that parents also refused or postponed the hepatitis vaccine at birth [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].In another study on the rejection of vitamin K in the United States, it was reported that parents also refused protective services such as hepatitis B vaccine and erythromycin eye ointment [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].Similar to vaccines, trust in the content of the vitamin K injection and risk-benefit perception affect decision making in families. If families refuse vitamin K for their newborn, the risk of vaccine refusal and hesitancy increases. The multivariate analysis in our study showed that vaccine hesitancy and refusal were higher in pregnant women who had not used folic acid. If pregnant women do not know the importance of the use of folic acid and are concerned about its content, it is seen that pediatric vaccine hesitancy and refusal are higher. Pregnancy period is very suitable for determining the motivation and health beliefs of pregnant women in the acceptance of screening tests, vaccines, and multivitamin use. It is seen that concerns, fear, hesitancy, and refusal which are related to preventive health practices and experienced during pregnancy have a higher tendency to continue as a refusal of practices at childbirth and vaccine hesitancy and refusal after childbirth.\u003c/p\u003e \u003cp\u003eAccording to the Turkish Ministry of Health National Extended Immunization Program, the vaccination schedule for 2021 and 2022 for pregnant women, pediatric vaccine acceptance and attitudes were questioned. The pneumococcal vaccine came first among the antigen-specific vaccines that were rejected the most, with 4.7%, which was followed by MMR (4.3%) and varicella vaccine (4.2%). The vaccine that pregnant women stated they were most hesitant about was the pneumococcal vaccine (17.2%). In a study conducted in Turkey by İlter et al., families were found to mostly refuse hepatitis A, measles, mumps, and rubella (MMR) combination vaccines, and vaccines that were least refused included chickenpox vaccine, hepatitis B, Bacillus Calmette-Gu\u0026eacute;rin, and Td vaccines [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].Tdab, KKK, and chickenpox were the most common vaccines that pregnant women intended to have their infants receive. In Italy, it was found that pregnant women mostly intended to have their infants receive Hexavalent (Diphtheria, Tetanus, whole cell pertussis, Hepatitis B, Haemophilus b, and the three IPV serotype antigens) after birth. In a study conducted with pregnant women in Italy, positive attitudes towards the efficacy, safety, and delivery of vaccines were associated with the intention to vaccinate with hexavalent [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].The national vaccination schedule of each country differs. In our country, unlike in developed countries, oral polio and BCG vaccines are administered, but meningococcal and rotavirus vaccines are not included in the national vaccination scheme. It is thought that awareness about vaccines and health literacy are effective in the intention to vaccinate.\u003c/p\u003e \u003cp\u003eThe status of being informed by a midwife, physician, or health worker during pregnancy was not questioned in this study. It has been reported that providing information about the practices in antenatal care by health service providers during pregnancy increases this practice and acceptance of vaccines. In addition, previous studies have shown that informing pregnant women about vaccines increases maternal influenza and pertussis vaccine intake and acceptance.[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].However, the physician-targeted randomized controlled communication intervention study conducted by Henrikson et al. indicated that vaccine conversations did not reduce maternal vaccination [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].The univariate analysis and multivariate Model 1 showed that vaccine hesitancy was statistically higher in pregnant women who received a tetanus vaccine than those who did not receive two doses of tetanus vaccine during their pregnancy or in the last 10 years. Trust in the content of vaccines and getting information about vaccines is thought to increase vaccine acceptance. The most important reason why individuals and parents decide to vaccinate their children is \"confidence\" in the efficacy and safety of vaccines [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].The perception that vaccines can cause short-term and long-term effects, such as autism and idiopathic diseases, is a cause for concern. In our study, vaccine hesitancy/refusal was significantly lower in pregnant women who had confidence in vaccines. Individuals use many different sources of information about vaccines (social media, health workers, websites of the ministry of health, friends, etc.). The more concerned they are about the safety of vaccines, the more information they seek about vaccines, and thus the more active their communication is. Mothers who perceive the safety of vaccines as a problem and fear its negative effects tend to favor alternative options [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe fact that social media has made it possible for individuals to take a role as a content producer causes personal content about anti-vaccination to circulate in digital environments [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].Similar to our study, individuals who follow anti-vaccine groups on social media have more vaccine hesitancy and refusal. It was determined that parents who postponed vaccination of their children made this decision under the influence of social media [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].Anti-vaccine groups on social media affect individuals emotionally and reduce confidence in vaccines by sharing their personal stories about the individual harm of vaccines [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Understanding how pregnant women's views on vaccines, as well as how information and misinformation about vaccines are shared online, are important to guide interventions to increase vaccine trust and coverage [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e].The WHO has conceptualized three key dimensions with a model for identifying causes of vaccine hesitancy: lack of confidence (in effectiveness, safety, the system, or policymakers), complacency (perceived low risk of acquiring VPDs), and lack of convenience (in the availability, accessibility, and appeal of immunization services, including time, place, language, and cultural contexts) [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].It was observed in our study that the main reasons for vaccine hesitancy primarily included a lack of confidence and complacency. The most important reasons for vaccination hesitancy/refusal among pregnant women included thinking that \"it may be harmful to the child\"; distrust in vaccines, thinking that vaccines have serious side effects, and thinking that companies producing vaccines are malicious because they make huge incomes. In a study conducted in Malaysia, the most important reason was found as adverse side effects of vaccines (52.1%) [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].Vaccine hesitant parents are not \"thoughtless parents;\" they want the best to protect their children's health. Understanding the thoughts and feelings of these parents is important for solving the problem. According to the qualitative study by Dube et al., all mothers who accepted, refused, and were hesitant about vaccines wanted the best to protect their children's health. Mothers' vaccination decision includes different factors such as social norms, past experiences, emotions, values, and social network effects [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn conclusion, no correlation was found between sociodemographic and obstetric characteristics of pregnant women and pediatric vaccine hesitancy and refusal in our study. Vaccine hesitancy and refusal were found to be significantly higher in those who stated that they would not have their baby receive screening tests such as hearing and heel blood after birth, who had not used any folic acid during pregnancy, who stated that they did not trust the content of vaccines, and who used social media as a source of information about vaccines.\u003c/p\u003e \u003cp\u003eThis study has some strengths. For example, it identified pediatric vaccine hesitancy and refusal and risk factors in pregnant women in a region of Turkey. The main limitation of this study is that as it was a cross-sectional study, it was not strong enough to accurately determine the temporal direction of the cause-effect relationship between factors associated with pediatric vaccine hesitancy and refusal. Data were collected based on a self-report questionnaire. Vaccine hesitancy and refusal may change over time, and expectant mothers may accept vaccines after the birth of the baby. Therefore, the results presented can only reflect the situation at the time when the data had been collected. Since the study was conducted in only one maternal university hospital, the results cannot be generalized to all pregnant women. Larger scale and stronger studies are needed to identify risk factors for vaccine hesitancy and refusal. The results of this study will shed light on future studies on monitoring vaccine hesitancy and refusal in pregnant women and determining strategies to be developed.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eTetanus-Diphtheria Acellular Pertussis: Tdap\u003c/p\u003e\n\u003cp\u003eMeasles- mumps-rubella: MMR\u003c/p\u003e\n\u003cp\u003eOral glucose tolerance test: OGTT\u003c/p\u003e\n\u003cp\u003eBacillus Calmette-Guerin: BC\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe are grateful to all the participants who kindly agreed to participate in our survey.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSY and DG participated in the design of the study, acquisition of data, performed the statistical analysis and drafted the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was received for the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur data is not available for ethical reasons.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted in accordance with the Declaration of Helsinki. Before the study was initiated, approval of XXX University Medical Faculty Clinical Research Ethics Committee was obtained (date:26 June 2020 no:343).\u0026nbsp;We obtained informed consent from\u003c/p\u003e\n\u003cp\u003eeach participant. The research participants were informed of their rights before signing the\u003c/p\u003e\n\u003cp\u003einformed consent, including the right to withdraw from the study at anytime. Any personal\u003c/p\u003e\n\u003cp\u003eidentifier was not encoded; identifiers of the women were replaced with identification numbers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eMarchant A, Sadarangani M, Garand M, et al. Maternal immunisation: collaborating with mother nature. Lancet Infect Dis. 2017;17(7):e197\u0026ndash;208.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDub\u0026eacute; \u0026Egrave;, Ward JK, Verger P, MacDonald NE. Vaccine Hesitancy, Acceptance, and Anti-Vaccination: Trends and Future Prospects for Public Health. Annu Rev Public Health. 2021;42:175\u0026ndash;91.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSalmon DA, Dudley MZ, Glanz JM, Omer SB. Vaccine hesitancy: causes, consequences, and a call to action. Am J Prev Med. 2015;49:S391\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSmith SE, Sivertsen N, Lines L, De Bellis A. Weighing up the risks - Vaccine decision-making in pregnancy and parenting. Women Birth. 2022;S1871-5192(22)00032\u0026thinsp;\u0026ndash;\u0026thinsp;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRosso A, Massimi A, Pitini E, et al. Factors affecting the vaccination choices of pregnant women for their children: a systematic review of the literature. Hum Vaccin Immunother. 2020;16(8):1969\u0026ndash;80.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLoyal J, Weiss TR, Cheng JH, Kair LR, Colson E. Refusal of Vitamin K by Parents of Newborns: A Qualitative Study. 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Ankara:Nobel; 2022. pp. 220\u0026ndash;1.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://asi.saglik.gov.tr/asi-takvimi2\u003c/span\u003e\u003cspan address=\"https://asi.saglik.gov.tr/asi-takvimi2\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e Accessed September 13, 0.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://covid19asi.saglik.gov.tr/EN-80229/turkeys-national-immunization-program--.html\u003c/span\u003e\u003cspan address=\"https://covid19asi.saglik.gov.tr/EN-80229/turkeys-national-immunization-program--.html\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e Accessed September 13, 2022.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHacettepe University Institute of Population Studies. 2018 Turkey demographic and health survey. 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Vaccine. 2015;33(47):6420\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDean AG, Sullivan KM, Soe MM, OpenEpi. Open Source Epidemiologic Statistics for Public Health, Version. www.OpenEpi.com, updated 2013/04/06, accessed 2022/09/27.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKalok A, Loh SYE, Chew KT, et al. Vaccine hesitancy towards childhood immunisation amongst urban pregnant mothers in Malaysia. Vaccine. 2020;38(9):2183\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCunningham RM, Minard CG, Guffey D, Swaim LS, Opel DJ, Boom JA. Prevalence of Vaccine Hesitancy Among Expectant Mothers in Houston, Texas. Acad Pediatr. 2018;18(2):154\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKempe A, Saville AW, Albertin C, Zimet G, Breck A, Helmkamp L, Vangala S, Dickinson LM, Rand C, Humiston S, Szilagyi PG. Parental Hesitancy About Routine Childhood and Influenza Vaccinations: A National Survey. Pediatrics. 2020;146(1):e20193852.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMohd Azizi FS, Kew Y, Moy FM. Vaccine hesitancy among parents in a multi-ethnic country. Malaysia Vaccine. 2017;35(22):2955\u0026ndash;61.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHenrikson NB, Opel DJ, Grothaus L, et al. Physician Communication Training and Parental Vaccine Hesitancy: A Randomized Trial. Pediatrics. 2015;136(1):70\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eİlter H, Demir SL. Gulhane Med J. 2021;63:96\u0026ndash;103.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDrezner D, Youngster M, Klainer H, et al. Maternal vaccinations coverage and reasons for non-compliance - a cross-sectional observational study. BMC Pregnancy Childbirth. 2020;20:541.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVrdelja M, Kraigher A, Vercic D, Kropivnik S. The growing vaccine hesitancy: exploring the influence of the internet. Eur J Public Health. 2018;28(5):934\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMartin S, Kilich E, Dada S, et al. Vaccines for pregnant women\u0026hellip; Absurd - Mapping maternal vaccination discourse and stance on social media over six months. \u003cem\u003eVaccine\u003c/em\u003e. 2020;38(42):6627\u0026ndash;6637.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGreenberg J, Dub\u0026eacute; E, Driedger M. Vaccine Hesitancy: In Search of the Risk Communication Comfort Zone. PLoS Curr. 2017;9:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003eecurrents.outbreaks\u003c/span\u003e\u003cspan address=\"http://ecurrents.outbreaks\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDub\u0026eacute; E, Vivion M, Sauvageau C, Gagneur A, Gagnon R, Guay M. Nature Does Things Well, Why Should We Interfere? Vaccine Hesitancy Among Mothers. Qual Health Res. 2016;26(3):411\u0026ndash;25.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1. The relationship between vaccine acceptance and vaccine hesitancy/refusal according to the sociodemographic characteristics of pregnant women (n=623)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"603\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003eVaccine acceptance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003eRefusal/ hesitancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003ep value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAge\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026le; 34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e518(83.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e382(73.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e136(26.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e0.061\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003e35 \u0026ge;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e105(16.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e68(64.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e37(35.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eWomen\u0026rsquo;s education\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003ePrimary education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e186(29.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e123(66.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e63(33.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.027\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eHigh school and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e437(70.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e327(74.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e110(25.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eSpouses\u0026rsquo; education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003ePrimary education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e170(27.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e121(71.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e49(28.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e0.719\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eHigh school and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e453(72.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e329(72.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e124(27.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eWorking status\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e397(63.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e285(71.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e112(28.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e0.744\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e226(36.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e165(73.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e61(27.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eWorking status of the spouse\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e22(3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e14(63.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e8(36.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e0.359\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e601(96.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e436(72.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e165(27.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eIncome level (n=544)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eMinimum wage and less\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e276 (44.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e192(69.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e84(30.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003e5501-10000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e209 (33.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e155(74.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e54(25.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e0.224\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003e10000 \u0026gt;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e138 (22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e47(79.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e12(20.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eUsing alternative medicine applications\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e75(12.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e48(64.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e27(36.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e0.090\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e548(88.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e402(73.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e146(26.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eHaving knowledge of vaccines\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e178(28.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e115(64.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e63(35.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eModerate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e323(51.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e240(74.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e83(25.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.020\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eAdequate/good\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e122(19.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e95(77.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e27(22.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eTrusting the active ingredient in vaccines\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e259(41.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e245(94.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e14(5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e67(10.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e27(40.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e40(59.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eUndecided\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e297(47.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e178(59.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e119(40.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eUsing social media as a vaccine information source\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e175(28.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e109(62.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e66(37.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.192371475953564%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.422885572139304%\" valign=\"top\"\u003e\n \u003cp\u003e448(71.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.739635157545607%\" valign=\"top\"\u003e\n \u003cp\u003e341(76.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.398009950248756%\" valign=\"top\"\u003e\n \u003cp\u003e107(23.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.24709784411277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: statistically significant associations (p \u0026lt; .05) are highlighted in bold.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2. The relationship between vaccine acceptance and vaccine hesitancy/refusal according to obstetric and antenatal care characteristics of pregnant women (n=623)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"593\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003eVaccine acceptance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003eRefusal/ Hesitancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003ep value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eTrimesters\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003csup\u003est\u003c/sup\u003e trimester (1.-13\u003csup\u003eth\u003c/sup\u003e week)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e40(6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e32(80.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e8(20.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003csup\u003end\u003c/sup\u003e trimester (14-26\u003csup\u003eth\u003c/sup\u003e week)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e165(26.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e128(77.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e37(22.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e0.070\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003csup\u003erd\u003c/sup\u003e trimester (27-41\u003csup\u003est\u003c/sup\u003e week)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e418(67.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e289(69.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e128(30.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eNumber of pregnancies\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e1-2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e423(67.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e325(76.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e98(23.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026ge;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e200(32.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e125(62.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e75(37.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eNumber of childbirths\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eNulliparous\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e220(35.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e166(75.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e54(24.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e217(34.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e167(77.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e50(23.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026ge;2\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e186(29.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e117(62.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e69(37.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eNumber of children\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e232(37.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e172(74.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e60(25.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e1\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e226(36.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e178(78.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e48(21.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026ge;2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e165(26.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e100(60.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e65(39.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eHistory of miscarriage\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e493(79.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e350(71.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e143(29.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e0.179\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e130(20.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e100(76.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e30(23.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ePlanned pregnancy\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e262(42.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e174(66.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e88(33.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.006\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e361(57.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e276(76.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e85(23.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eHaving used folic acid\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eRegular or irregular use\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e506(81.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e385(76.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e121(23.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e117(18.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e65(55.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e52(44.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eOGTT (only 28 week\u0026gt;)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e444(71.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e195(72.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e73(27.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e0.268\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e179(28.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e58(65.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e30(34.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eUse of iron preparations (\u0026gt;16 weeks of gestation)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e487(87.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e346(71.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e141(29.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e0.723\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e67(12.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e49(73.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e18(26.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eDouble screening (\u0026gt;14 weeks of gestation)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e378(66.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e291(77.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e87(23.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e188(33.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e113(60.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e75(39.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eReceiving 2 doses of tetanus during pregnancy or within the last 10 years\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e296(47.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e236(79.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e60(20.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e327(52.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e214(65.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e113(34.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eHaving the baby screened for hearing and heel blood after birth\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e465(74.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e383(80.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e93(19.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e17(2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e5(26.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e14(73.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.61952861952862%\" valign=\"top\"\u003e\n \u003cp\u003eI do not know/No idea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.37037037037037%\" valign=\"top\"\u003e\n \u003cp\u003e123(19.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e62(48.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.993265993265993%\" valign=\"top\"\u003e\n \u003cp\u003e66(51.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.50841750841751%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: statistically significant associations (p \u0026lt; .05) are highlighted in bold.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3. Causes of childhood vaccine hesitancy in pregnant women with vaccine hesitancy and refusal (n=173)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eIt may be harmful to the child.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e110 (63.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eDistrust in vaccines\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e70 (40.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eThinking that vaccines have serious side effects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e57 (32.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eThink that companies producing vaccines are malicious because they make huge incomes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e33 (19.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eThinking that children do not get vaccine-preventable diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e30 (17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eThinking that children gain natural immunity by getting over diseases such as chickenpox and measles\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e29 (16.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eThinking that vaccines do not help\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e26 (15.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eBelieving that the child is not in the risk group needing vaccination\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e25 (14.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eBelieving that complementary and alternative medicine is more effective and has fewer side effects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e20 (11.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eThinking that vaccine-preventable diseases are insignificant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e17 (9.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eBeing influenced by misinformation in media/communication tools\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e16 (9.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eBelieving that vaccines cause autism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e12 (6.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eBeing influenced by social media\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e11 (6.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eReligious reasons\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e10 (5.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eBeing influenced by the anti-vaccine discourses of the media/famous people\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e8 (4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eBelieving that vaccines cause infertility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e7 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eThe family refuses vaccination due to complications of previous vaccination\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e7 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"84.22764227642277%\" valign=\"top\"\u003e\n \u003cp\u003eBelieving that vaccines cause homosexuality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.772357723577235%\" valign=\"top\"\u003e\n \u003cp\u003e6 (3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Table 4. Opinions of pregnant women regarding acceptance specific to pediatric vaccine antigens (n=623)\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"631\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.521394611727416%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003eI will have it done.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003eI am undecided.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.48177496038035%\" valign=\"top\"\u003e\n \u003cp\u003eI refuse it.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.055467511885896%\" valign=\"top\"\u003e\n \u003cp\u003eI do not know.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.521394611727416%\" valign=\"top\"\u003e\n \u003cp\u003eTetanus-Diphtheria Acellular Pertussis (Tdap)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003e475(76.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003e60 (9.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.48177496038035%\" valign=\"top\"\u003e\n \u003cp\u003e22 (3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.055467511885896%\" valign=\"top\"\u003e\n \u003cp\u003e66 (10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.521394611727416%\" valign=\"top\"\u003e\n \u003cp\u003eMeasles-rubella-mumps\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003e459 (73.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003e65 (10.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.48177496038035%\" valign=\"top\"\u003e\n \u003cp\u003e27 (4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.055467511885896%\" valign=\"top\"\u003e\n \u003cp\u003e72 (11.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.521394611727416%\" valign=\"top\"\u003e\n \u003cp\u003eHepatitis A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003e427 (68.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003e92(14.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.48177496038035%\" valign=\"top\"\u003e\n \u003cp\u003e22(3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.055467511885896%\" valign=\"top\"\u003e\n \u003cp\u003e82(13.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.521394611727416%\" valign=\"top\"\u003e\n \u003cp\u003eHepatitis B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003e436 (69.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003e85(13.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.48177496038035%\" valign=\"top\"\u003e\n \u003cp\u003e22(3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.055467511885896%\" valign=\"top\"\u003e\n \u003cp\u003e80(12.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.521394611727416%\" valign=\"top\"\u003e\n \u003cp\u003eVaricella\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003e463(74.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003e62(9.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.48177496038035%\" valign=\"top\"\u003e\n \u003cp\u003e26(4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.055467511885896%\" valign=\"top\"\u003e\n \u003cp\u003e72(11.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.521394611727416%\" valign=\"top\"\u003e\n \u003cp\u003eBCG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003e437(70.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003e81(13.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.48177496038035%\" valign=\"top\"\u003e\n \u003cp\u003e24(3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.055467511885896%\" valign=\"top\"\u003e\n \u003cp\u003e81(13.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.521394611727416%\" valign=\"top\"\u003e\n \u003cp\u003ePolio vaccine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003e432(68.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003e83(13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.48177496038035%\" valign=\"top\"\u003e\n \u003cp\u003e24(3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.055467511885896%\" valign=\"top\"\u003e\n \u003cp\u003e89(14.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.521394611727416%\" valign=\"top\"\u003e\n \u003cp\u003ePneumococcal vaccine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003e379(60.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.47068145800317%\" valign=\"top\"\u003e\n \u003cp\u003e107(17.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.48177496038035%\" valign=\"top\"\u003e\n \u003cp\u003e29(4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.055467511885896%\" valign=\"top\"\u003e\n \u003cp\u003e108(17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5.\u0026nbsp;\u003c/strong\u003eUnivariate analysis and multivariate regression analysis of factors associated with vaccine hesitancy/refusal in pregnant women\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnivariate analysis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMultivariate analysis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eModel 1\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eModel 2\u003csup\u003eb\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ecOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCI 95%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eaOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCI 95%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep value\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eaOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCI 95%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep value\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHaving screening tests such as hearing and heel blood administered after birth\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e4.05-32.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.39-67.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.83-51.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eI do not know/No idea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e2.89-6.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.99-5.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.22-6.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of pregnancies\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1-2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ge;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1.38-2.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.0001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.74-3.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.89-4.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.092\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of childbirths\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNulliparous\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.59-1.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.712\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.41-1.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.40-1.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.354\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ge;2\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1.18-2.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.006\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.37-2.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.37-2.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.782\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlanned pregnancy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1.15-2.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.006\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.63-1.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.65-1.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHaving used folic acid\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1.67-3.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.32-5.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.09-3.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.026\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDouble screening (\u0026gt;14 weeks of gestation)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1.52-3.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.49-1.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.609\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.47-1.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.495\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eReceiving 2 doses of tetanus during pregnancy or within the last 10 years\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1.44-2.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.02-3.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.041\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.89-2.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.118\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eStatus of knowledge of vaccines\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1.13-3.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.015\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.70-3.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.282\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.77-3.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.196\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eModerate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.74-1.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.437\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.60-2.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.525\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.68-3.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.332\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAdequate/good\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTrusting the active ingredient in vaccines\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12.53-53.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e22.08\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e8.90-54.76\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.43-43.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eI am undecided.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.5-21.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e13.73\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e6.71-28.09\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.86-23.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUsing social media as a vaccine information source\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eRef.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRef\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1.32-2.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.14\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.23-3.73\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.007\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.34-3.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: statistically significant associations (p \u0026lt; .05) are highlighted in bold. Abbreviation: cOR, crude odds ratios; \u0026nbsp;aOR, adjusted odds ratios; 95% CIs 95% confidence intervals for the adjusted odds ratios and crude odds ratios\u003c/p\u003e\n\u003cp\u003ea: adjusted for age, education, income, and gestational week\u003c/p\u003e\n\u003cp\u003eb: adjusted for income and education\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"intention, immunization, vaccine hesitancy, vaccine refusal, pregnant women","lastPublishedDoi":"10.21203/rs.3.rs-4465547/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4465547/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003ePregnant women are an ideal target population for interventions intended to immunize infants after birth. Lack of confidence in vaccines among pregnant women increases vaccine hesitancy or refusal.\u003c/p\u003e\u003ch2\u003eAim\u003c/h2\u003e \u003cp\u003eThis study aims to determine the frequency, causes, and risk factors of pediatric intention to vaccinate and vaccine hesitancy and refusal in pregnant women.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eData were collected using a questionnaire designed by the researchers and included items about descriptive characteristics of women and their vaccine hesitancy and refusal. The study was used with the STROBE Statement checklist.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003ePediatric vaccine acceptance in pregnant women was 72.2%, the prevalence of vaccine refusal was 3.4%, and the prevalence of vaccine hesitancy was 24.4%. The vaccine that women were hesitant to get administered to their infants in the first place after birth was the pneumococcal vaccine (17.2%), and Tdab was the vaccine that they intended to have administered to their infants the most(76.3%). According to the multivariate logistic regression model, which was adjusted for age, education, income, and gestational week, vaccine hesitancy was significantly higher in pregnant women (OR\u0026thinsp;=\u0026thinsp;15.14) who stated that they would not have screening tests such as hearing and heel blood done after birth (p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001).Vaccine hesitancy was also high in pregnant women who did not use any folic acid during pregnancy (OR\u0026thinsp;=\u0026thinsp;2.59) and those who had not received two doses of tetanus vaccine during pregnancy or within the last 10 years (OR\u0026thinsp;=\u0026thinsp;1.75). It was statistically significantly 2.14 times higher in pregnant women who used social media as a source of information about vaccines (OR\u0026thinsp;=\u0026thinsp;2.14) and those who stated that they did not trust the content of vaccines (OR\u0026thinsp;=\u0026thinsp;22.08) (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe risk of pediatric vaccine hesitancy was higher in pregnant women who did not use preventive interventions during the antenatal period.\u003c/p\u003e","manuscriptTitle":"Investigation of factors associated with pediatric intention to vaccinate and vaccine hesitancy and refusal in pregnant women in Turkey","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-06 03:21:05","doi":"10.21203/rs.3.rs-4465547/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-05-27T07:20:59+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-05-27T07:05:25+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-05-24T14:00:44+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2024-05-23T08:51:43+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c03ed41a-cc8c-43fe-aa18-235a5fbdd7f6","owner":[],"postedDate":"June 6th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-01-13T15:08:27+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-06 03:21:05","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4465547","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4465547","identity":"rs-4465547","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}