Chronic energy deficiency (CED) remains a major nutritional problem among pregnant women in Indonesia, contributing to adverse maternal and neonatal outcomes such as low birth weight (LBW), anemia, and pregnancy-related complications. According to data from the South Lampung District Health Office, the prevalence of CED among pregnant women increased from 5.9% in 2023 to 6.38% in 2024. This study aimed to identify factors associated with CED among pregnant women in South Lampung Regency in 2026. An analytical survey using a case–control design was conducted among a target population of 974 pregnant women. A sample of 182 participants (91 cases and 91 controls) was selected using stratified random sampling followed by simple random sampling. Data were analyzed using univariate analysis, bivariate chi-square tests, and multivariate multiple logistic regression. Bivariate analysis revealed significant associations between CED and dietary intake (p < 0.001; OR = 6.650), infectious diseases (p = 0.005; OR = 2.451), maternal knowledge (p = 0.001; OR = 2.820), and the social environment (p = 0.001; OR = 2.891). Physical activity was not significantly associated with CED (p = 0.875). Multiple logistic regression identified dietary intake as the strongest predictor of CED (p < 0.001; adjusted OR = 6.866) after controlling for maternal knowledge and social environment. In conclusion, dietary intake, infectious diseases, maternal knowledge, and the social environment are key factors associated with CED among pregnant women in South Lampung Regency. Priority should be given to improving maternal nutritional intake through targeted supplementary feeding programs aligned with national My Plate (Isi Piringku) guidelines, supported by routine monitoring and evaluation.
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