A national survey found high awareness of prenatal health guidance but gaps on alcohol avoidance, iron use, and gestational weight gain.
A nationally representative survey of US adults found high awareness of several maternal and infant health recommendations, but persistent gaps in knowledge about alcohol avoidance before pregnancy, iron supplementation, and recommended gestational weight gain—areas that may warrant reinforcement during preconception and prenatal counseling.1
“Pregnancy health decisions are shaped not only by patients and clinicians, but also by family members, partners, and social networks,” Patrick E. Jamieson, PhD, director of the Annenberg Health and Risk Communication Institute, said in the release. “Accurate public understanding of maternal health recommendations – including nutrition and the risks of alcohol use and smoking – is essential to improving outcomes for parents and babies.”1
Key Facts
The findings come from Wave 29 of the Annenberg Science and Public Health survey, conducted April 14-28, 2026, by SSRS for the Annenberg Public Policy Center of the University of Pennsylvania. The probability-based panel included 1639 US adults and had a margin of sampling error of ±3.5 percentage points at the 95% confidence level.1
Overall, 90% of adults reported knowing that health before pregnancy affects infant health, an increase from 86% in 2025. Among women aged 18 to 49 years, awareness increased from 75% to 86% during the same period. Awareness that health during pregnancy affects infant health remained high, at 93% among all adults and 88% among women aged 18 to 49 years.1
Several findings align with routine prenatal counseling targets. Eighty-three percent of adults said pregnant people should be tested for diabetes, up from 80% in 2025. Seventy-seven percent knew untreated hypertension increases the risk of stroke during pregnancy, and 76% knew people who are or may become pregnant should take a daily vitamin containing folic acid.1 The CDC recommends folic acid before and during pregnancy to help prevent major birth defects of the brain and spine.2
Alcohol-related knowledge was mixed. Among women aged 18 to 49 years, 90% correctly identified as false the statement that drinking wine or beer during pregnancy is safe, up from 82% in 2025. However, only 66% of adults and women of childbearing age knew that a person trying to become pregnant should stop drinking alcohol before and during pregnancy. Approximately 1 in 5 women aged 18 to 49 years and 23% of adults incorrectly selected stopping alcohol only after learning of pregnancy as the most accurate recommendation.1 ACOG states that people trying to become pregnant should not drink alcohol.3
For clinicians, the distinction is important because pregnancy recognition often occurs after early embryonic development has begun. The survey results suggest that many patients and members of their support networks may understand alcohol avoidance during a known pregnancy but not the rationale for preconception abstinence.
Other knowledge gaps were seen around nutrition-related recommendations. Only 40% of respondents knew iron supplements are recommended during pregnancy only when a health care professional determines the patient is anemic, while 24% incorrectly believed all pregnant people should take daily iron supplementation, an increase from 19% in 2025.1 About half of all adults and women aged 18 to 49 years correctly identified 25 to 35 lb as recommended gestational weight gain for a person with normal prepregnancy weight.1
Smoking-related risks were more consistently recognized. Eighty-four percent of adults knew smoking during pregnancy increases the risk of birth defects, 81% knew it increases the chance of early delivery, and 80% knew it increases the likelihood of low birth weight. Awareness was lower for secondhand smoke and infant outcomes: 58% of adults knew smoking around a baby increases the risk of sudden infant death syndrome, compared with 67% of women aged 18 to 49 years.1 CDC guidance identifies smoking during and after pregnancy as a risk factor for premature birth, birth defects, low birth weight, and sudden infant death syndrome.4
The survey also found that 76% of adults knew breastfeeding benefits both the infant and breastfeeding parent. Women aged 18 to 49 years were more likely than the overall adult population to know that infants should be placed on their backs for sleep, 77% vs 66%, respectively.1
As an observational survey, the findings measure knowledge rather than clinical behavior or pregnancy outcomes. Responses also may not capture the nuances of individualized counseling, including medical conditions that modify recommendations. Still, the data point to practical opportunities for clinicians: pairing prenatal counseling with preconception guidance, explicitly addressing alcohol avoidance before pregnancy, clarifying when iron is indicated, and reinforcing infant sleep and smoke-exposure counseling beyond the pregnant patient alone.
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