Knowledge of Danger Signs in Pregnancy Among Women Attending Primary Healthcare Centres in Osun State

Recognition of obstetric danger signs by pregnant women is a critical determinant of timely care-seeking behaviour and emergency obstetric care utilisation, yet knowledge gaps remain substantial in rural and semi-urban Nigerian communities. This study assesses knowledge of danger signs in pregnancy among women attending primary healthcare centres in Osun State, South West Nigeria. A descriptive cross-sectional design enrolled 220 pregnant women across five primary healthcare centres in Osogbo, Ede, and Ikirun. A structured interviewer-administered questionnaire measured spontaneous and prompted recall of nine WHO-listed obstetric danger signs, sources of obstetric information, and sociodemographic characteristics. Fewer than 30 percent of respondents could spontaneously name three or more danger signs. Vaginal bleeding was the most commonly recognised sign (62 percent), while convulsions (38 percent), severe headache (29 percent), and blurred vision (24 percent) were less frequently identified. Prompted recall improved recognition substantially, with 74 percent acknowledging convulsions as dangerous when listed. Educational level (OR 2.9), attendance at antenatal health education sessions (OR 3.6), and multiparity (OR 1.8) were significant predictors of adequate knowledge. The study identifies the antenatal health talk as an underutilised knowledge transfer opportunity in Osun State PHCs. Recommendations include standardised danger signs education at every antenatal contact, visual aid distribution, and community health worker reinforcement of danger sign messaging between visits. Keywords: danger signs in pregnancy, knowledge, primary healthcare, Osun State, obstetric emergencies