The current study investigated the feelings of worry and perceived reliability of online health information among expectant women and the associated factors in Qatar. It was found that a large portion of pregnant women denied being worried when accessing the internet for pregnancy information (68.8%) and considered this information to be reliable or highly reliable (79.2%). Accessing the internet during pregnancy has become a source of relief and worry simultaneously. It offers expecting women the opportunity to share fears and worries with their peers; however, it can trigger or amplify anxiety due to the vast amount of generic information with little or no clarification being offered (9).
Given that most of the population in Qatar, especially women (78.7%), use the internet for health information (11), it was vital to assess their feelings of worry towards this issue. In our study, a large portion (68.8%) of pregnant women denied being worried after the use of the internet for health information. On the other hand, a study among Swedish pregnant women revealed that many participants (65.6%) reported feelings of worry after reading online pregnancy-related information (3). This difference can be explained by the higher educational level (76.4% vs 54.9% college level) among our sample. Nevertheless, cyberchondria is a phenomenon that can be defined as ‘the unfounded escalation of concerns about common symptomatology, based on the review of search results and literature on the web’ (12).
Among expecting women, pregnancy can be a stressful phase of their life and might represent their first major contact with the healthcare system. It involves several clinical visits, laboratory investigations, and radiological exams (13). As a result, many women would like to seek reassurance through online resources. However, online search algorithms were not developed to accommodate an individual’s threshold for fear, worry, and anxiety (12). Also, the search results might not be prioritized to reflect each receiver’s level of comprehension, clinical judgement, and health literacy. Although a large portion of participants in this study denied feeling worried when accessing online health information, health care professionals have a vital role of signposting expecting women to valid online resources that promote reassurance during pregnancy (14).
Furthermore, social media accounts (47%) and websites (38%) were the two most common triggers of worry among our participants. Similarly, websites (43.7%) and social media (25.7%) were among the most frequently identified sources of worry when browsing online health information among pregnant women in Sweden (3). This can be attributable to the fact that internet users, including pregnant women, might not be inclined to share as much positive experiences as negative ones through virtual platforms. Subsequently, the negative aspect of pregnancy, including common symptoms and pathological ones, will be inflated. To manage these feelings of worry, almost half of the participants in the present study sought advice from their healthcare providers (51%) or family and friends (47%). Similarly, an earlier survey of Turkish pregnant women found that nearly half (51%) had shared online health information with their healthcare providers (6). On the other hand, an earlier systematic review on internet use among pregnant women revealed that the majority refrained from discussing any information they retrieved online with their health care providers (15). Thus, there is a need to empower antenatal care providers with the adequate skills and tools to foresee and prevent such situations or identify them early through clinical guidelines and workshops.
Regarding the perceived reliability of online health information, our results (79.2%) conform with an earlier Chinese study in which most pregnant women (90.9%) found such information to be of medium-high reliability (16). Also, a cross-sectional study among Italian pregnant women discovered that the majority (96.4%) had moderate-high confidence in online health information (17). In addition, the two most frequently reported factors for judging the reliability of online health resources by our study participants were the recommendation of a healthcare professional (48.1%) and that of a family member or friend (32.7%). In contrast, Turkish pregnant women attributed their perceived reliability of online health information to it being given by an expert (29.3%) and its frequency of usage (18.5%) (6). Moreover, Chinese pregnant women judged the reliability of online health resources through cross-checking with other sources (67%), presence of references (42.1%), and being validated by experts (34%) (16). To assess the reliability of web-related health information, there are seven general criteria, known as Mitretek criteria, and include Credibility, Content, Disclosure, Links, Design, Interactivity, and Caveats (18). Currently, several guidelines and online tools have been developed to assist internet users in assessing the reliability of any information online. Nevertheless, these instruments have several drawbacks such as placing a burden on internet users and providers, lack maintenance and update, and require funding (19). Thus, public health officials must pursue a locally adapted tool for the community in Qatar through input from pregnant women and health care professionals.
Regarding the perceived reliability of online health information among our participants, the level of education (college/university), gravidity (primi), and having no children were significantly associated with this phenomenon. As a result, it could be inferred that a higher level of education is associated with better critical thinking and reasoning skills. This might mislead educated pregnant women to consider themselves as experts on judging the reliability of online health information (15). Furthermore, primigravid women are more likely to perceive online health information as reliable because they are usually younger and have less fear of any age-related pregnancy or postpartum complications and congenital defects (20). In addition, pregnant women with no children were less likely to have gained a comprehensive spectrum of experiences from conception till birth and parenthood. Thus, they rely on the internet to learn about what to anticipate during the current pregnancy and might consider themselves to be capable of independently judging the reliability of online health resources. These findings reinforce the importance of equipping perinatal healthcare professionals with the knowledge and skills to provide tailored counselling for pregnant women in Qatar based on their characteristics, health literacy level, and information technology savviness.
The present study was not without limitations. First, it was conducted among expectant mothers visiting the ANC clinics in publicly funded primary care settings. Hence, the results might not be generalizable to other pregnant women seeking ANC services in the private health sector. Secondly, the cross-sectional design of our study was not enough to establish a causal relationship between perceived reliability and the participants’ characteristics. Thirdly, this study relied on self-report, which may be subject to recall and social desirability biases. However, this study possesses many strengths. It was the first cross-sectional study to evaluate the feelings of worry and perceived reliability towards online pregnancy-related information among pregnant women in Qatar. The study achieved a high response rate (86%) and a probability sampling technique was used to recruit participants from PHC centres, which despite not being a population-based study, it offers a good representation of the different ethnic, cultural and social backgrounds in Qatar.