Introduction: To assess maternal and perinatal outcomes of pregnancies without antenatal care in
Bamako, Mali.
Methods: A retrospective analytical case-control study was conducted over a 12-month period (January
1–December 31, 2020) at the Referral Health Center of Commune III, Bamako. Cases were women who
delivered without any antenatal care visit, and controls were women who delivered immediately before
or after a case and had attended at least three antenatal visits, in a 1:2 ratio. Data entry was performed
using Word 2016 and analysis with SPSS version 21.1. The Chi-square test and Odds Ratio (OR) with
95% confidence interval (CI) were applied to assess associations. A p-value <0.05 was considered
statistically significant.
Results: Among 3,600 deliveries, 80 were unsupervised pregnancies, corresponding to a frequency
of 2.22%. The most represented age group was 18–25 years (62.5% of cases vs. 64.1% of controls,
p=0.0008). Uneducated women were more frequent among cases (48.8%) than controls (21.2%, p<0.05).
Term pregnancies occurred in 78.7% of cases versus 97.5% of controls (p=0.000001). Maternal anemia
was significantly higher among unsupervised women (35.0% vs. 10.6%, p<0.05). Vaginal delivery was
less frequent in cases (65.0% vs. 88.7%, p<0.05). Neonatal outcomes were poorer in the unsupervised
group: normal Apgar scores (75% vs. 93.2%, p<0.05), preterm birth (22.5% vs. 2.5%), and low birth
weight (16.25% vs. 2.5%).
Conclusion: Pregnancies without antenatal care are associated with adverse maternal and perinatal
outcomes, particularly anemia, prematurity, and low birth weight. Strengthening prenatal care coverage
and improving women’s education are crucial to enhance maternal and neonatal health in low-resource
settings.
