AUTHOR=Chillo Serawit Lakew , Woldesemayat Endrias Markos , Dangisso Mesay Hailu TITLE=Do dietary habits and iron-folic acid intake make a difference? Factors associated with anemia in pregnancy: a multi-center cross-sectional study JOURNAL=Frontiers in Global Women's Health VOLUME=Volume 6 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/global-womens-health/articles/10.3389/fgwh.2025.1599842 DOI=10.3389/fgwh.2025.1599842 ISSN=2673-5059 ABSTRACT=BackgroundAnemia in pregnancy impacts the well-being of the women and the conception. Anemia is associated with increased risks of maternal mortality. In Ethiopia, three in ten pregnant women were affected by either mild, moderate, or severe anemia. The recent evidence was limited in the study locations of southern Ethiopia and needs to be updated. No report of anemia as relation to dietary factors observed in the region. This study therefore aimed to assess factors associated with anemia in pregnancy in the region.MethodsA multicenter, cross-sectional study was conducted from January 2 to 30, 2025, in five selected public health facilities in Arba Minch district, South Ethiopia.ResultsA total of 476 (96%) respondents had participated in the survey. Explanatory variables were modeled in logistic regression to test for statistical associations at a P value of <0.05. The study participants were in the age range of 18 to 40 years. Of the respondents who completed the survey, 103 (21.6%, 95%CI 18.2–25.6%) were diagnosed as anemic. Participants who received iron-folic acid during the current pregnancy were 66% less likely to be anemic, AOR (95% CI), 0.34 (0.19, 0.61). Participants with high education status, sleeping under insecticide-treated bed nets (ITN), not being infected with malaria in the current pregnancy, and age category between 20–29 years were less likely to experience anemia in pregnancy. Evidence was limited to support association of women dietary diversity score (WDDS) and anemia in pregnancy, AOR (95%CI), 0.83 (0.49, 1.40).Conclusions and recommendationsAnemia prevalence was a moderate public health problem in the study area. Healthcare workers should encourage antenatal women to receive iron and sleep under insecticide-treated bed nets (ITN) for anemia protection during pregnancy.