Gaps in knowledge and awareness of microplastic exposure among pregnant women in South India: implications for maternal and fetal health

Microplastic pollution has emerged as a significant environmental and public health concern, with increasing detection in human tissues and growing concern about potential risks during pregnancy and early development. Despite this, little is known about awareness and self-reported preventive behaviours among pregnant women in India. This study aimed to evaluate knowledge, awareness, and self-reported practices regarding microplastic exposure among pregnant women attending a tertiary care centre in South India. A cross-sectional, questionnaire-based survey was conducted among 600 pregnant women between January and May 2025. Participants completed a structured, validated questionnaire assessing, sociodemographic characteristics, awareness and knowledge of microplastics, perceived health risks, and self-reported preventive behaviors. Data were analysed using descriptive statistics and chi-square tests to examine associations between educational status and awareness. Among all 600 participants, 486(81.0%) were unfamiliar with the term “microplastics,” while 114 (19.0%) reported having heard of them. Of the total sample, 96 participants (16.0%) correctly identified microplastics as plastic particles smaller than 5 mm. Awareness that microplastics may be present in drinking water and seafood was reported by 172 participants (28.66%) and 164 participants (27.33%), respectively. Knowledge of microplastic detection in placenta and breast milk was low, with 13 participants (2.16%) and 8 participants (1.33%) indicating awareness. Higher educational attainment was significantly associated with greater awareness ( p = 0.001). Although 228 participants (38.0%) expressed concern about microplastic exposure, self-reported preventive behaviours were limited. These findings reveal substantial knowledge deficits and limited self-reported preventive behaviours related to microplastic exposure among pregnant women in South India. Integrating targeted, culturally appropriate educational interventions into antenatal care may enhance awareness and encourage lower-plastic-use behaviours, their effects on actual exposure and maternal or fetal health outcomes require further study.