evidence: Objectives Antenatal care (ANC) is an essential part of primary healthcare and its provision has expanded worldwide. There is limited evidence of large-scale cross-country studies on the impact of ANC offered to pregnant women on child health outcomes. We investigate the association of ANC in low-income and middle-income countries with short- and long-term mortality and nutritional child outcomes. [...] Despite strong international efforts to expand the worldwide coverage of basic primary health services for women, pregnancy and childbirth still represent a high-risk period for mother and child; especially in low-income and middle-income countries. Reductions in maternal and early child mortality remain high on the global development policy agenda, which can be seen in its inclusion in the Sustainabile Development Goal 3.1 However, nearly 3 million babies die every year during their first month of life, and in low-income and middle-income countries, many of those deaths and morbidities are due to easily preventable causes.2 3 Undetected infections during pregnancy, such as malaria, syphilis, tuberculosis, tetanus or HIV/AIDS, as well as high blood pressure, diabetes and other pre-existing health conditions often complicate or aggravate pregnancy and pose significant risk for mother and child. Antenatal care (ANC)—the services offered to mother and unborn child during pregnancy—is an essential part of basic primary healthcare during pregnancy, and offers a mosaic of services that can prevent, detect and treat risk factors early on in the pregnancy. The detection of high-risk pregnancies through the analysis of socioeconomic, medical and obstetrical factors represents a key element of ANC.