Maternal anemia continues to pose substantial public health challenges in Indonesia, with consequences extending to pregnancy outcomes and child development. Mid-upper arm circumference (MUAC) offers a practical nutritional assessment in resource-limited settings, while anemia-related knowledge represents the cognitive dimension of maternal health literacy relevant to preventive behaviors. This study examined the relationships of maternal nutritional status measured through MUAC and anemia-related knowledge with hemoglobin concentrations among third-trimester pregnant women in rural Indonesia. A cross-sectional analytical study was conducted from May to August 2024 at Palang Health Center, Tuban Regency. Through purposive sampling, 232 third-trimester pregnant women were recruited. Data collection involved MUAC measurements using standardized tape, hemoglobin assessment via digital hemoglobinometer, and a validated 20-item anemia knowledge questionnaire. Statistical analyses included descriptive statistics, Chi-square tests, and multiple linear regression at α=0.05. Anemia prevalence was 37.9%. Significant associations were observed between nutritional status and anemia status (p<0.001) and between anemia-related knowledge and anemia status (p<0.001). Women with MUAC below 23.5 cm had a higher anemia prevalence (78.2%) than those with adequate MUAC (17.5%); women with poor knowledge had an anemia prevalence of 87.5% versus 20.0% among those with good knowledge. In the linear regression model, each 1-cm increase in MUAC was associated with a 0.112 g/dL higher hemoglobin concentration (B=0.112, p<0.001), and each one-point increase in knowledge score was associated with a 0.286 g/dL higher hemoglobin concentration (B=0.286, p=0.002). The model explained 41.2% of hemoglobin variance (R²=0.412). MUAC and anemia-related knowledge are significant correlates of hemoglobin levels in late pregnancy. Comprehensive anemia prevention strategies may integrate anthropometric screening, individualized nutritional counseling, structured anemia education, and promotion of locally accessible iron-rich foods.
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