Knowledge, perceptions, and health education needs regarding hepatitis B virus among HBsAg-positive pregnant women in Taiyuan, China: a cross-sectional study

BACKGROUND: Hepatitis B virus (HBV) infection remains a major global public health challenge, with China bearing a high burden of disease. Mother-to-child transmission (MTCT) is the primary pathway leading to chronic HBV infection. Insufficient awareness among pregnant women continues to impede effective MTCT prevention. This study aimed to assess HBV-related knowledge, perceptions, and health education needs among HBsAg-positive pregnant women in Taiyuan, China, a key population for interrupting MTCT. METHODS: From March 2020 to October 2022, we conducted a hospital-based, cross-sectional survey using a structured questionnaire among 203 HBsAg-positive pregnant women recruited from five tertiary hospitals in Taiyuan. Descriptive statistics were used to summarize knowledge and perceptions. Multiple linear regression was performed to identify sociodemographic factors associated with knowledge scores. RESULTS: Nearly half (45.3%) were first diagnosed during the current pregnancy, and the majority (84.7%) were unaware of their hepatitis B e antigen (HBeAg) status. Misconceptions were common; 41.9% incorrectly believed that HBV could be transmitted through food. Hospitals/doctors (90.1%) and the internet (85.7%) were the main information sources. Multiple linear regression identified occupation (β = − 0.215, p = 0.002) and urban–rural residence (β = 0.184, p = 0.011) as significant predictors of HBV knowledge, whereas educational level showed no significant association. CONCLUSION: Substantial knowledge gaps and persistent misconceptions regarding HBV transmission and prevention remain among HBsAg-positive pregnant women in Taiyuan. The stronger influence of occupation and place of residence, compared with formal education, underscores the need for tailored and context-specific health education programs. Therefore, interventions should be tailored to occupational settings and rural–urban contexts, and antenatal counseling must be strengthened to address specific misconceptions. These targeted efforts are essential to improve maternal awareness and support China’s efforts to eliminate MTCT of HBV.