Introduction: Unattended pregnancies are associated with significant maternal, perinatal morbidity and mortality. The prevalence remains high in Cameroon, particularly in the Adamawa region. The aim of this study was to study the factors associated with the occurrence of maternal and/or perinatal complications in unattended pregnancies in the city of Ngaoundéré. Methods and Materials: We conducted a case-control study, with prospective data collection of women admitted between January 1st and April 30th, 2025, into four hospitals. Results: A total of 363 deliveries were included, 121 cases matched to 242 controls. In univariate analysis, the clinical and biological factors associated with increased risk of complications were: maternal age < 20 years and ≥ 40 years; spinster status; being referred; grand multiparous women; absence of iron intake during pregnancy; maternal malaria and placental malaria. In multivariate analysis using logistic regression, factors associated with maternal complications were: age between 15 and 20 years; spinster status; absence of iron supplementation; and maternal and placental malaria. Concerning perinatal complications, the independent factors identified were: maternal HIV infection; low blood pressure on admission; maternal malaria and placental malaria. Maternal death rate was 1.65%, and perinatal mortality rate was 10.74%. Conclusion: Maternal and perinatal mortality rates were high in unattended pregnancies. Factors associated with the occurrence of adverse outcomes were age between 15 and 20 years, spinster status, absence of iron supplementation, grand multiparous women, and malaria.
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