<![CDATA[Digital health literacy is increasingly recognized as a cognitive factor influencing maternal health decision-making, particularly in urban settings with high digital access such as Tangerang City. Purpose: This study examined the association between digital health literacy and antenatal care (ANC) decision-making among pregnant women, and whether this persisted after adjusting for sociodemographic and healthcare-access factors. Method: A quantitative cross-sectional study was conducted among 100 pregnant women receiving ANC at selected community health centers (Puskesmas) in Tangerang City between January and April 2025, recruited through consecutive sampling. Data were collected using a structured questionnaire including the eight-item eHealth Literacy Scale (eHEALS) and an adapted ANC decision-making measure. Pearson correlation and hierarchical multiple linear regression were performed (p < 0.05). Results: Digital health literacy was positively associated with ANC decision-making (r = 0.46, p < 0.001; 95% CI 0.29–0.60) and remained independently associated after adjustment (B = 0.35, p < 0.001; 95% CI 0.17–0.53). Access to information and family support were also significantly associated, whereas age, education, parity, employment status, and health facility access were not. The final model explained 38% of variance. Implications: Integrating digital health literacy education and family involvement into routine ANC services may strengthen pregnant women's ability to evaluate online information and support appropriate care decisions. Conclusion: Digital health literacy is independently associated with ANC decision-making among pregnant women in this urban setting. Longitudinal and intervention studies are needed to clarify temporal relationships and evaluate digital literacy programs.]]>
