Introduction Zika, when transmitted during pregnancy, can be associated with significant infant morbidity. Little is known about pregnant women’s knowledge and attitudes regarding the Zika virus.

Methods Pregnant women in the US (n=362) completed an online survey about health and pregnancy. Questions regarding Zika assessed worry about infection (1 item), knowledge (9 items), feasibility of behavioural preventive strategies (6 items), and vaccine attitudes (3 items).

Results Participants were mostly 25–35 years old (67%), non-Hispanic White (65%), had at least some college education (84%) and had been pregnant before (71%). Thirty-three percent were very worried about Zika, 41% somewhat, and 26% not at all worried. The mean knowledge score was 5.2+2.3 (range=0–9). Most answered that mosquitos transmit Zika correctly (86%); only 29% knew that adults could not die from it. The percent correct for the other items ranged from 48% (the virus can stay in semen for an unknown period of time) to 68% (mother-baby transmission). Women reported it would be ‘very hard’ to do the following during pregnancy: not travel to a Zika infested area (31%), abstain from sex (28%), use condoms (25%), use repellant (24%), not have their partner travel to a Zika infested area (19%), and wear long sleeves/pants (18%). A vaccine was viewed as very important (72%). Strategies were endorsed was as follows: vaccinate all women/men, 14–40 years old (38%); only women 14–40 years (20%), women or women/men planning a pregnancy (28%) and women whose partner has Zika (6%). Few (8%) reported not believing in vaccines. Seventy-two percent of the sample said they would agree to a Zika vaccine, 15% said they would decline.

Conclusion Despite intensive media reporting on Zika, pregnant women had gaps in knowledge, other than mosquito transmission. A significant minority of women found it very hard to implement behavioural strategies during pregnancy, particularly prevention of sexual transmission. A Zika vaccine appears to be acceptable with a preference for universal strategies.

Support: National Institutes of Health (R33AI098654)