Sociodemographic factors associated with health literacy in a large sample of mothers of newborn children: cross-sectional findings from the KUNO-Kids birth cohort study

  • Susanne BrandstetterEmail author
  • Josefine Atzendorf
  • Birgit Seelbach-Göbel
  • Michael Melter
  • Michael Kabesch
  • Christian Apfelbacher
  • the KUNO-Kids study group
Short Communication


Health literacy is an important public health goal and of particular relevance when people are starting a family. Health literacy is thought to be crucial for the management of the manifold demands relating to child health which are imposed on parents. The aim of this study was to investigate health literacy in a large sample of mothers of newborn children in Germany. Sociodemographic factors and health literacy (as assessed by the HLS-EU health care scale) were analyzed using data from 2403 mothers of newborns who take part in an ongoing birth cohort study (KUNO-Kids health study). Almost 40% of mothers had a limited health literacy level. Being primiparous was significantly associated with lower health literacy, while having a high level of education compared with a medium level of education was significantly associated with higher health literacy.

Conclusion: The finding of a substantial amount of mothers experiencing problems in dealing with and navigating through the healthcare system is important for the design of pediatric health services.

What is Known:

New parents are confronted with many recommendations about child health.

Health literacy of parents is considered crucial for child health outcomes.

What is New:

Many mothers of newborns have a limited health literacy level.

First-time mothers and mothers with lower education are particularly at risk for low health literacy.


Health literacy Mothers Newborns Sociodemographic factors 



Health literacy



We would like to thank all families who participate in the KUNO-Kids birth cohort study as well as all medical students, nurses, midwives, physicians, and researchers who facilitated the recruitment of participants and data assessment.

Further, we thank all members of the KUNO-Kids study group:

Petra Arndt (ZNL Transfercenter of Neuroscience and Learning, University of Ulm, Ulm, Germany), Andrea Baessler (Department of Internal Medicine II, Regensburg University Medical Center, Regensburg, Germany), Mark Berneburg (Department of Dermatology, University Medical Centre Regensburg, Regensburg, Germany), Wolfgang Buchalla (Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, University of Regensburg, Regensburg, Germany), André Gessner (Department of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany), Iris Heid (Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany), Sebastian Kerzel (Department of Pediatric Pneumology and Allergy, University Children’s Hospital Regensburg, St. Hedwig Campus, Regensburg, Germany), Michael Koller (Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany), Michael Leitzmann (Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany), David Rothfuss (City of Regensburg, Coordinating Center for Early Interventions, Regensburg, Germany), Wolfgang Rösch (Department of Pediatric Urology, University Medical Center, Regensburg, Germany), Hugo Segerer (Children’s Hospital St. Hedwig, University of Regensburg, Regensburg, Germany), Berhard Weber (Institute of Human Genetics, University of Regensburg, Regensburg, Germany), and Stephan Weidinger (Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany).

Authors’ contribution

Susanne Brandstetter designed the study, performed data analysis, interpreted the study findings, drafted the manuscript, critically evaluated the manuscript, and approved the final manuscript as submitted. Josefine Atzendorf contributed to data analysis, manuscript writing, and revision of the manuscript. She critically evaluated the manuscript and approved the final manuscript as submitted. Birgit Seelbach-Göbel contributed to data collection, critically evaluated the manuscript, and approved the final manuscript as submitted. Michael Melter contributed to data collection, critically evaluated the manuscript, and approved the final manuscript as submitted. Michael Kabesch contributed to data collection, data interpretation, and drafting of the manuscript. He critically evaluated the manuscript and approved the final manuscript as submitted. Christian Apfelbacher designed the study, interpreted study findings, and drafted the manuscript. He contributed to data collection, critically evaluated the manuscript, and approved the final manuscript as submitted.

Funding information

The KUNO-Kids study is funded by research grants of the EU (HEALS: 603946) and the German Federal Ministry for Education and Research (SYSINFLAME: 01ZX1306E). Further financial support was provided by the University Children’s Hospital of the University of Regensburg (KUNO-Clinics) and the clinic “St. Hedwig” (Hospital “Barmherzige Brüder Regensburg”).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Ethics Committee of the University of Regensburg, reference number: 14-101-0347) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.University Children’s Hospital Regensburg (KUNO-Clinics)University of RegensburgRegensburgGermany
  2. 2.Medical Sociology, Institute of Epidemiology and Preventive MedicineUniversity of RegensburgRegensburgGermany
  3. 3.Clinic of Gynecology and Obstetrics St. HedwigUniversity of RegensburgRegensburgGermany
  4. 4.Institute of Social Medicine and Health EconomicsOtto von Guericke University MagdeburgMagdeburgGermany

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