Background: Preventable pregnancy complications remain a major contributor to maternal morbidity and mortality, particularly in rural and remote areas of Indonesia. Adequate antenatal care (ANC) utilization and early recognition of pregnancy danger signs are essential to improving maternal and neonatal outcomes. This study aimed to assess the association between maternal knowledge and attitudes toward pregnancy danger signs and ANC visit implementation. Method: A cross-sectional study was conducted in June 2025 at Mebung Primary Health Center, Alor District, East Nusa Tenggara, Indonesia. A total of 33 third-trimester pregnant women were recruited using purposive sampling. Maternal knowledge and attitudes were assessed using a structured questionnaire, while ANC visit implementation was evaluated based on compliance with recommended schedules recorded in the Maternal and Child Health (MCH) handbook. Data were analyzed using Spearman’s rank correlation test with a significance level of p < 0.05. Result: Most respondents demonstrated good knowledge (63.6%) and positive attitudes (57.6%) toward pregnancy danger signs. Good ANC utilization was observed in 54.5% of participants. Maternal knowledge showed a significant positive correlation with ANC visit implementation (r = 0.375; p = 0.032), while maternal attitude demonstrated a moderate positive correlation with ANC utilization (r = 0.448; p = 0.009). Conclusion: Maternal knowledge and attitudes toward pregnancy danger signs are significantly associated with ANC visit implementation. Strengthening maternal health education that addresses both knowledge and attitudes may enhance ANC utilization and contribute to the prevention of avoidable maternal and neonatal complications in rural settings.
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