Antenatal care and maternal health outcomes a narrative review of global evidence

Abstract Maternal mortality remains a major global public health challenge, particularly in low- and middle-income countries (LMICs). Although the global maternal mortality ratio has declined since 1990, progress has slowed in recent years, with more than 800 women dying daily from preventable pregnancy-related causes. Antenatal care (ANC) plays a critical role in improving maternal health through early detection and management of pregnancy complications and improved linkage to skilled delivery care. This narrative review synthesizes global evidence on the contribution of ANC to maternal health outcomes, including maternal mortality reduction, quality of care, and health system strengthening. Evidence indicates that while most women globally attend at least one ANC contact, completion of recommended contacts and receipt of essential interventions remain inadequate, particularly in fragile settings such as Somalia. Quality ANC supports timely identification of hypertensive disorders, infections, and anemia while increasing the likelihood of skilled birth attendance and postnatal care utilization. However, persistent disparities in access, service quality, and effective coverage continue to limit the impact of ANC services in many LMICs. Strengthening equitable access, workforce capacity, and quality-adjusted ANC coverage is essential for achieving Sustainable Development Goal (SDG) 3.1 of reducing global maternal mortality.