<![CDATA[Background: Gestational anemia continues to represent a prominent public health hurdle owing to its harmful impacts on maternal and neonatal health. Even with the regular supply of IFA supplementation during prenatal care, anemia rates remain elevated, showing that maternal awareness and supplement compliance may be important behavioral factors associated with the condition. Objective: This study aimed to evaluate the independent associations of maternal awareness and IFA supplement compliance with anemia status among pregnant women. Methods: An observational cross-sectional investigation was executed involving 66 pregnant women visiting prenatal clinics at Pinang Jaya Primary Health Center, Bandar Lampung, Lampung, Indonesia. Maternal awareness and IFA compliance were gauged through structured surveys, whereas anemia was established via hemoglobin assessment. Data evaluation utilized Chi-square tests alongside multivariable binary logistic regression to compute adjusted odds ratios and 95% confidence intervals. Results: The prevalence of anemia reached 57.6%. Following adjustment for maternal age, parity, pregnancy trimester, and employment, individuals with weak awareness exhibited 4.26 times greater odds of anemia relative to those with proper understanding (AOR = 4.26; 95% CI: 1.31 to 13.81; p = 0.016). Likewise, non-compliant participants experienced 4.29-fold higher odds of anemia compared to compliant peers (AOR = 4.29; 95% CI: 1.31 to 13.99; p = 0.016). Conclusion: Inadequate maternal awareness and non-adherence to IFA supplementation were independently associated with gestational anemia. As this was a cross-sectional study, these findings reflect associations rather than causal relationships. Embedding behavior-focused nutritional instruction along with adherence support into routine prenatal care may help strengthen maternal anemia prevention efforts across primary care environments.]]>
