Knowledge of obstetric danger signs and health-seeking practices among pregnant women with and without previous pregnancy complications in the Jeddah first health cluster, Saudi Arabia

Objective To assess knowledge of obstetric danger signs and self-reported intended health-seeking practices among pregnant women attending Althagher Hospital and affiliated primary healthcare centers in Jeddah, Saudi Arabia, and to compare these outcomes between women with and without a history of previous pregnancy complications. Methods A cross-sectional study was conducted among 200 pregnant women attending antenatal and obstetric services at Althagher Hospital and affiliated primary healthcare centers between July and December 2024. Data were collected using a self-administered questionnaire adapted from a previously published instrument assessing sociodemographic characteristics, obstetric history, knowledge of obstetric danger signs, and intended responses to five hypothetical danger-sign scenarios. Unadjusted comparisons used Mann–Whitney U, Kruskal–Wallis (with Dunn–Bonferroni post-hoc tests), and Spearman correlation, with Benjamini–Hochberg control of the false discovery rate; multivariable linear regression with robust standard errors identified factors independently associated with knowledge and practice scores. Results The mean knowledge score was 2.92 ± 2.20 out of 11; 88.0% of participants had poor knowledge and only 1.5% had good knowledge. In contrast, 73.0% reported adequate health-seeking practices (mean 3.35 ± 1.69 out of 5). Women with previous pregnancy complications had higher knowledge scores than those without (median 3.5 vs. 2.0; p = 0.004), and this association persisted after adjustment (B = 0.90, 95% CI 0.23–1.57; p = 0.009) and when the analysis was restricted to women with at least one previous pregnancy ( p = 0.006). Practice scores did not differ by complication history ( p = 0.636). In the adjusted model, being in the third trimester (B = 1.33, 95% CI 0.67–2.00) and having heard about danger signs (B = 1.06, 95% CI 0.44–1.67) were also associated with higher knowledge, whereas age ≥ 30 years (B = 0.67, 95% CI 0.18–1.16) and having heard about danger signs (B = 0.67, 95% CI 0.17–1.17) were associated with higher practice scores. The correlation between knowledge and practice scores was weak (rho = 0.146, p = 0.040) and did not remain significant after false-discovery-rate correction. Conclusion Pregnant women showed poor knowledge of obstetric danger signs despite relatively favorable intended health-seeking responses. Previous pregnancy complications, later gestational age and prior exposure to danger-sign information were independently associated with higher knowledge. These findings support structured danger-sign education early in antenatal care, particularly for women without a previous complicated pregnancy.