Factors Associated with Self-Reported Treatment Adherence During Pregnancy and Preliminary Psychometric Assessment of the PMAM in Primary Care

Background/Objectives: Medication-taking behaviour during pregnancy may be associated with treatment-related beliefs, emotional concerns, information sources, and clinician–patient communication. We examined these cross-sectional associations and the preliminary measurement properties of the Pregnancy Medication Adherence Model (PMAM). Methods: This cross-sectional study included 355 pregnant women with prescribed treatment recruited from nine general practices in Dolj County, Romania. Q25 was analysed on its five-category scale and using an operational threshold of ≥4. Internal consistency, principal component analysis, an ordinal exploratory factor analysis based on polychoric correlations, regression modelling, and review-stage sensitivity analyses addressing criterion overlap were performed. Results: Overall, 255 participants (71.8%) scored ≥4 on Q25. The four multi-item domains had Cronbach’s α values of 0.897–0.935. Parallel analysis and principal-axis factoring with oblique rotation supported four factors; salient loadings were 0.797–0.925 and no secondary loading reached 0.30. In the original adjusted binary model, cognitive understanding, emotional reassurance, clinician–patient communication, and lower endorsement of information-seeking and social-influence items were associated with Q25 ≥ 4. After Q23 was removed from the communication score and Q19 and Q24 were omitted, these four associations persisted (adjusted ORs 1.90–2.55). Conclusions: The findings identify concurrent associations between medication-related perceptions and a single self-reported treatment-behaviour item. PMAM remains an exploratory framework; external psychometric evaluation and prospective assessment against defined medication-specific adherence and clinical outcomes are required before clinical use.