Central European journal of public health最新文献

{"title":"Epidemiology of ankle fractures: stability and change over two decades.","authors":"Jan Frühauf, Václav Vaněček, Petr Fojtík, Michal Tuček, Anna Horňáková","doi":"10.21101/cejph.a8913","DOIUrl":"https://doi.org/10.21101/cejph.a8913","url":null,"abstract":"<p><strong>Objectives: </strong>Ankle fractures are common lower-limb injuries with substantial effects on mobility and healthcare needs. This study characterised the demographic and morphological distribution of dislocated ankle fractures and compared the findings with a cohort treated approximately two decades earlier.</p><p><strong>Methods: </strong>This retrospective study included 436 adults with dislocated ankle fractures treated at the Military University Hospital Prague between 2018 and 2020. Age, sex, laterality, fracture morphology, medial structure involvement, posterior malleolar and syndesmotic injuries, treatment type, and body mass index (BMI) were analysed. Aggregate results were compared with a historical cohort of 232 patients treated in 1999.</p><p><strong>Results: </strong>Women comprised 52.5% of the cohort. The most frequent age group was 40-49 years overall and among men, whereas women were most frequently affected at 60-69 years. The median age was 51 years and was higher in women than in men (58 vs. 44 years, p < 0.001). Right-sided fractures accounted for 53.2% of cases. Among 413 fibular fractures, 61.5% were Weber B, 20.3% Weber C, and 18.2% Weber A. Medial malleolar fractures occurred in 32.3% of evaluable patients, deltoid ligament lesions in 19.3%, posterior malleolar fractures in 34.6%, and syndesmotic injuries in 19.7%. Overall, 60.1% of patients were overweight or obese, and BMI was associated with several fracture characteristics and surgical treatment. Compared with the historical cohort, sex distribution and posterior malleolar fracture frequency were similar, whereas Weber fracture types and medial structure involvement differed significantly.</p><p><strong>Conclusions: </strong>Selected characteristics, particularly sex distribution and posterior malleolar fracture frequency, were similar between the two cohorts. Differences in Weber fracture types and medial structure involvement should be interpreted in view of changes in imaging, diagnostic criteria, and cohort composition. The observed associations with BMI warrant further investigation in multicentre population-based studies using standardised assessment methods.</p>","PeriodicalId":9823,"journal":{"name":"Central European journal of public health","volume":"34 3","pages":"203-208"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic low back pain: assessment of mental distress, quality of life and pain-related activity patterns.","authors":"Lucie Sikorová, Andrea Polanská, Renáta Zoubková, Jan Divák, Alena Mátlová, Michal Parma","doi":"10.21101/cejph.a8736","DOIUrl":"https://doi.org/10.21101/cejph.a8736","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to assess mental health, quality of life, and patterns of physical activity in patients with chronic low back pain (CLBP), to compare these outcomes across socio-demographic factors, and to evaluate their relationship with subjectively perceived pain.</p><p><strong>Methods: </strong>A quantitative descriptive cross-sectional study was conducted. The research sample included 151 patients with chronic low back pain treated at a Pain Management Centre. Data were collected using the Numeric Rating Scale, Hospital Anxiety and Depression Scale, WHOQOL-BREF questionnaire, Patterns of Activity Measure-Pain scale, and the International Physical Activity Questionnaire.</p><p><strong>Results: </strong>Depression was identified in 48.3% of patients and anxiety in 45.7%. Depression was more prevalent among those receiving disability pensions (p = 0.048), and anxiety was more common in patients treated with pharmacological therapy alone (p = 0.014). Activity avoidance emerged as the dominant activity pattern, and 50.3% of patients reported a moderate level of physical activity. Patients with higher education reported better health satisfaction (p = 0.035). Average pain intensity showed weak negative correlations with overall quality of life (τ = -0.23, p = 0.001), health satisfaction (τ = -0.20, p = 0.004), physical health (τ = -0.21, p = 0.001), and psychological health (τ = -0.18, p = 0.003), and positive correlations with depression (τ = 0.15, p = 0.018) and anxiety (τ = 0.16, p = 0.008). Least pain intensity was negatively associated with physical activity (τ = -0.13, p = 0.034), while average pain intensity was positively associated with activity avoidance (τ = 0.13, p = 0.030).</p><p><strong>Conclusions: </strong>The findings support the importance of a comprehensive approach to CLBP management that considers psychological distress, physical activity, and pain-related activity patterns alongside pain intensity. Individually tailored management strategies addressing these dimensions may contribute to more comprehensive care for patients with CLBP.</p>","PeriodicalId":9823,"journal":{"name":"Central European journal of public health","volume":"34 3","pages":"196-202"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult HPV vaccination (27-45 years): who benefits, when to offer, and how to counsel.","authors":"Marek Broul, Pavel Dlouhý, Aneta Hujová, Michaela Liegertová","doi":"10.21101/cejph.a8941","DOIUrl":"https://doi.org/10.21101/cejph.a8941","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the study was to translate major international recommendations and the current evidence base into a practical approach for counselling adults aged 27-45 years about human papillomavirus (HPV) vaccination.</p><p><strong>Methods: </strong>We conducted a targeted narrative review of guidance from the World Health Organization, the European Centre for Disease Prevention and Control and US public health sources that frame HPV vaccination in mid-adults as shared clinical decision-making. We prioritised systematic reviews, randomised trials and recent evidence syntheses relevant to mid-adult vaccination and vaccination after cervical excisional treatment.</p><p><strong>Results: </strong>Global and European guidance emphasises that the greatest population impact is achieved by high vaccination coverage before sexual debut and therefore does not support routine population-wide vaccination programmes for mid-adults. In contrast, US guidance supports shared clinical decision-making for adults aged 27-45 years because some individuals may still derive meaningful personal benefit, particularly those not adequately vaccinated who anticipate new sexual partners or belong to higher-exposure networks (e.g., men who have sex with men) or who are immunocompromised. Vaccine effectiveness is highest in individuals not previously exposed to vaccine HPV types; vaccination prevents new infections but does not treat established infection or existing HPV-related disease. Evidence on vaccination after cervical conisation is mixed: observational studies often suggest reduced recurrence, whereas randomised-trial-only syntheses do not show a consistent overall reduction in recurrence of high-grade lesions (high-grade squamous intraepithelial lesion) or cervical intraepithelial neoplasia.</p><p><strong>Conclusions: </strong>Adult HPV vaccination should be considered selectively and framed as prevention of future infections. A brief shared decision-making conversation focusing on anticipated future exposure, realistic benefits, dosing, and ongoing screening can support consistent practice. We provide a decision algorithm and practice scenarios to facilitate implementation.</p>","PeriodicalId":9823,"journal":{"name":"Central European journal of public health","volume":"34 3","pages":"155-159"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spirometry and end-tidal carbon dioxide changes during chest compressions with PPE: a simulation randomized crossover study.","authors":"Patrik Cmorej, Petr Bureš, Ondřej Kounovský, Alena Kohlová, Danka Boguská, Dana Rebeka Ralbovská, Karel Hrach, Robin Šín, Jaroslav Pekara","doi":"10.21101/cejph.a8785","DOIUrl":"10.21101/cejph.a8785","url":null,"abstract":"<p><strong>Objectives: </strong>Personal protective equipment (PPE) use in prehospital emergency care has increased significantly since the coronavirus pandemic onset in 2019. Few studies have been published on the PPE effects on spirometry parameters and end-tidal carbon dioxide (Et-CO2). This study aimed to determine whether PPE use affects spirometric parameters and Et-CO2 during chest compressions.</p><p><strong>Methods: </strong>This was a randomized crossover simulation study with 35 emergency medical service providers who performed 20 minutes of intermittent chest compressions on a mannikin (five 2 min cycles alternated by 2 min of rest). Two iterations were completed in randomized order: without PPE and with PPE. Spirometry parameters (forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow, and Tiffeneau index) and end-tidal carbon dioxide were measured.</p><p><strong>Results: </strong>No spirometry parameter differences were noted between the two groups (p > 0.05). When using PPE with an FFP2 mask, Et-CO2 was higher at the end of the first and fifth chest compression cycles (p ≤ 0.001).</p><p><strong>Conclusion: </strong>PPE use during simulated resuscitation was not associated with deterioration of spirometric parameters. Although Et-CO2 increased slightly during selected CPR cycles, these changes were unlikely to represent clinically relevant respiratory impairment.</p>","PeriodicalId":9823,"journal":{"name":"Central European journal of public health","volume":"34 3","pages":"185-190"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood heavy metal levels and bone turnover markers in Korean elementary school children.","authors":"Kiook Baek, Chulyong Park","doi":"10.21101/cejph.a8682","DOIUrl":"https://doi.org/10.21101/cejph.a8682","url":null,"abstract":"<p><strong>Objectives: </strong>Although the health effects of heavy metal exposure in children are well documented, their impact on bone metabolism is less understood. Bone turnover markers such as serum C-terminal telopeptide of type I collagen (CTX) and serum Procollagen type I N-terminal propeptide (P1NP) can help assess skeletal effects. This study aimed to evaluate the relationship between blood concentrations of mercury (Hg), lead (Pb), and cadmium (Cd) and bone turnover markers in children.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 221 elementary school children aged 11-13 years attending four schools around a municipal incinerator, one of which served as a control area. Blood Hg, Pb, and Cd and serum CTX and P1NP were measured. All exposure and outcome variables were natural log-transformed, a choice supported by Box-Cox analysis. A single primary model, including all three metals and adjusted for age, sex, body mass index, and residential area, was specified in advance and fitted with heteroscedasticity-consistent standard errors.</p><p><strong>Results: </strong>Blood Pb was positively associated with both markers: each 2-fold increase in blood Pb corresponded to an 18.6% higher CTX (95% CI: 7.4-31.0, p < 0.001) and an 18.4% higher P1NP (95% CI: 3.6-35.4, p = 0.014). Both associations persisted after correction for multiple testing and across all sensitivity analyses, including adjustment for proxies of pubertal growth. Hg and Cd were not associated with either marker.</p><p><strong>Conclusion: </strong>Blood Pb was associated with higher bone turnover in children at concentrations lower than those previously reported for Korean children of similar age, involving both bone resorption and formation. Because the design was cross-sectional and increased bone remodelling may itself mobilise skeletal Pb, the direction of this relationship cannot be determined, and longitudinal research is warranted.</p>","PeriodicalId":9823,"journal":{"name":"Central European journal of public health","volume":"34 3","pages":"177-184"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 on breast cancer screening: time series analysis of pre-pandemic, pandemic and post-pandemic periods.","authors":"Gökhan Mert Özyurt, Sarhun Zirek, Duygu Kolukisa, Cemil Yüksel, Mutlay Keskin","doi":"10.21101/cejph.a8451","DOIUrl":"https://doi.org/10.21101/cejph.a8451","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the impact of the COVID-19 pandemic on breast cancer screening activity, cancer detection rates, and stage at diagnosis by comparing pre-pandemic, pandemic, and post-pandemic periods.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included women who underwent breast cancer screening between March 2018 and February 2024. The study period was divided into three phases: pre-pandemic (March 2018 - February 2020), pandemic (March 2020 - February 2022), and post-pandemic (March 2022 - February 2024). Screening activity, including mammography and breast ultrasonography examinations, cancer detection rates, age at diagnosis, tumour size, and stage distributions were evaluated.</p><p><strong>Results: </strong>A total of 102,833 women underwent breast cancer screening during the study period. Significant differences were observed in the numbers of screened women, mammography examinations, ultrasound examinations, and breast cancers detected across the study periods (all p < 0.001). The cancer detection rate increased from 10.64 per 1,000 screened women in the pre-pandemic period to 12.68 during the pandemic and 16.32 in the post-pandemic period (p < 0.001). Early-stage diagnoses decreased from 84% to 72%, whereas advanced-stage diagnoses increased from 16% to 28% (p = 0.002). The proportion of metastatic disease increased from 5.6% to 22% (p = 0.028). No significant differences were observed in age at diagnosis (p = 0.896), tumour size (p = 0.201), or T stage distribution (p = 0.519).</p><p><strong>Conclusions: </strong>The COVID-19 pandemic substantially affected breast cancer screening and diagnosis. Although screening activity declined during the pandemic, cancer detection rates increased and a significant shift toward advanced-stage and metastatic disease was observed in the post-pandemic period. Maintaining resilient and accessible breast cancer screening services during future healthcare crises is essential to minimize diagnostic delays and improve patient outcomes.</p>","PeriodicalId":9823,"journal":{"name":"Central European journal of public health","volume":"34 3","pages":"171-176"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paracetamol overdose: systematic review of case reports and national toxicological data (2018-2023).","authors":"Jana Mlíchová, Ondřej Šimandl, Kateřina Kotíková, Karolína Šimůnková, Carla Torre, Zoltán Paluch, Eva Kmoníčková","doi":"10.21101/cejph.a8897","DOIUrl":"https://doi.org/10.21101/cejph.a8897","url":null,"abstract":"<p><strong>Objectives: </strong>Paracetamol is widely used as an analgesic and antipyretic, but its accessibility also makes it a frequent drug in overdose cases. Increasing rates of intentional paracetamol poisoning, particularly among adolescents, raise public health concerns. This study aimed to examine recent patterns of paracetamol overdose and identify risk groups for intentional self-poisoning.</p><p><strong>Methods: </strong>A systematic review of published case reports (2018-2023) describing paracetamol overdose was conducted using PubMed, Scopus, Web of Science, and the Cochrane Library. Additionally, a retrospective analysis of telephone inquiries to the Czech Toxicological Information Centre (TIC) during the same period was performed.</p><p><strong>Results: </strong>Sixty-eight published case reports met inclusion criteria, with reported doses ranging from 6.5 to 250 g. Intentional overdose occurred in 50 cases (74%), including 11 teenage girls (22% of intentional cases). No deaths were reported in this subgroup. TIC recorded 3,318 inquiries related to paracetamol exposure between 2018 and 2023, of which 2,032 (61%) involved intentional overdose. Females predominated among intentional cases, particularly in children and adolescents, and the number of intentional overdoses among girls aged 0-19 years increased after 2020. The data indicate a growing number of suicide attempts involving paracetamol, particularly among teenage girls.</p><p><strong>Conclusion: </strong>The majority of paracetamol intoxications reported in the literature and in national toxicological data were intentional, with adolescent females representing a key risk group. Increased attention to the safe use and communication of paracetamol-related risks is needed.</p>","PeriodicalId":9823,"journal":{"name":"Central European journal of public health","volume":"34 3","pages":"191-195"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital dementia in adults: an assessment of digital generations.","authors":"İnci Arikan, Buse Turan, Muammer Yilmaz, Ömer Faruk Tekin","doi":"10.21101/cejph.a8850","DOIUrl":"https://doi.org/10.21101/cejph.a8850","url":null,"abstract":"<p><strong>Objectives: </strong>This study was conducted to examine the level of digital dementia (DD) in adults and related socio-demographic and smartphone addiction factors.</p><p><strong>Methods: </strong>The study was conducted between June and September 2025 in western Türkiye and included individuals who applied to selected family health centres. Data were collected using a researcher-developed questionnaire consisting of socio-demographic information, behaviour-related items, the Digital Dementia Scale Adult Form (DDAF) and Smartphone Addiction Scale (SAS). This study evaluated participants according to digital generations.</p><p><strong>Results: </strong>The mean DDAF score was 40.56 ± 21.18 among digital natives (18-29 years), 34.93 ± 21.88 among the digital transition generation (30-44 years), and 25.17 ± 18.59 among digital immigrants (45-70 years) (p < 0.001). DDAF scores were significantly higher among participants without children (40.59 ± 21.47), unmarried individuals (40.86 ± 21.40), university graduates (36.65 ± 20.63), students (43.15 ± 20.17), and those living in low socioeconomic regions (41.72 ± 20.50), with sleep onset latency > 30 minutes (44.61 ± 24.05), those who used smartphones within 30 minutes after waking (37.77 ± 21.53), those who always used smartphones before sleep (40.80 ± 21.02), those who relied on smartphones for simple tasks and definitions (52.50 ± 17.03), and those who experienced phone-related health problems (43.38 ± 20.55) (p < 0.001). In the final linear regression model, being a digital native, unmarried status, prolonged sleep onset latency, using smartphones for simple tasks and definitions, experiencing phone-related health problems, smartphone use before sleep, and smartphone addiction were identified as independent predictors of higher DD levels (adjusted R² = 0.681, p < 0.001).</p><p><strong>Conclusions: </strong>These results reveal that digital risks are linked not only to demographic characteristics but more to digital behaviour patterns. Increasing digital awareness across all segments of society, especially among young individuals, promoting digital detox approaches, and developing behavioural intervention programmes are crucial for reducing digital addiction and the risk of digital dementia.</p>","PeriodicalId":9823,"journal":{"name":"Central European journal of public health","volume":"34 3","pages":"209-215"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety profile of the COVID-19 vaccine in chronic vs. non-chronic populations: evidence from a retrospective cohort study.","authors":"Fitim Alidema, Arieta Hasani Alidema","doi":"10.21101/cejph.a8953","DOIUrl":"https://doi.org/10.21101/cejph.a8953","url":null,"abstract":"<p><p>This retrospective cohort study evaluated the safety profile of COVID-19 vaccination after the administration of three doses among 1,000 participants in Kosovo, including 600 individuals with chronic diseases and 400 without chronic conditions. Data were collected from medical records and standardized questionnaires on post-vaccination adverse events. Overall, 68.5% of participants reported at least one adverse effect, with a higher incidence among those with chronic diseases (74.3%) compared with non-chronic individuals (59.7%, p = 0.01). The most common reactions were mild and transient, including local injection site pain (39.2%), fatigue (27.6%), headache (21.4%), and mild fever (18.9%), while severe effects such as allergic or cardiac reactions were rare (1.2%). No significant differences were found among vaccine types. The findings indicate that COVID-19 vaccines were generally safe and well tolerated in both chronic and non-chronic populations, emphasizing the importance of continued pharmacovigilance and public health efforts to maintain vaccine confidence.</p>","PeriodicalId":9823,"journal":{"name":"Central European journal of public health","volume":"34 3","pages":"167-170"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician's recommendation as a key determinant of influenza vaccination uptake during pregnancy: a prospective observational study.","authors":"Asiye Uzun, Saliha Büşra Aksu, Güneş Topçu, Seda Özmen Sever, Güzin Zeren Öztürk","doi":"10.21101/cejph.a9024","DOIUrl":"10.21101/cejph.a9024","url":null,"abstract":"<p><strong>Objectives: </strong>Influenza infection is associated with substantial maternal morbidity and mortality during pregnancy; however, influenza vaccination uptake remains low. Physician's recommendations have been identified as one of the key determinants of vaccination rates. This study was conducted to evaluate the effect of physician's recommendation on influenza vaccination rates among pregnant women and to examine factors associated with vaccination behaviour.</p><p><strong>Methods: </strong>This prospective observational study included 356 pregnant women aged 18-50 years with a gestational age of ≥12 weeks who were receiving prenatal care at a tertiary-care hospital in Istanbul, Türkiye. Participants completed a structured questionnaire assessing their knowledge and attitudes toward the influenza vaccine. Standard information about the influenza vaccine was provided as part of routine prenatal care. Vaccination status was confirmed via telephone follow-up at the end of the influenza season.</p><p><strong>Results: </strong>The overall influenza vaccination rate during pregnancy was 7.6%. A prior 's recommendation was strongly associated with higher vaccination uptake (15.2% vs. 1.5%, RR = 10.0, 95% CI: 3.07-32.69, p < 0.001). In multivariable analysis, physician's recommendation remained an independent predictor of vaccination (aOR = 10.39, 95% CI: 3.00-35.97, p < 0.001). The most common reasons for vaccine refusal were a lack of trust (42.2%) and perceived lack of necessity (36.2%).</p><p><strong>Conclusion: </strong>Influenza vaccination uptake during pregnancy remains low in this Turkish cohort. Physician's recommendation is a strong independent determinant of vaccination behaviour. Strengthening physician-led counselling and improving patient awareness may play a critical role in increasing vaccination rates and reducing preventable maternal and neonatal complications.</p>","PeriodicalId":9823,"journal":{"name":"Central European journal of public health","volume":"34 3","pages":"160-166"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}