Abstract
<title>Abstract</title> <p>Background Maternal mortality remains a major public health challenge in low-resource settings, with delayed recognition of obstetric danger signs contributing to preventable maternal deaths. Evidence on awareness levels in Somalia remains limited. This study assessed awareness of danger signs during pregnancy and associated factors among pregnant mothers attending Daynile General Hospital in Mogadishu, Somalia. Methods A facility-based cross-sectional study was conducted among 422 pregnant women attending antenatal care (ANC) between April 28 and June 20, 2026. Participants were selected using systematic random sampling. Data were collected using a structured interviewer-administered questionnaire. Bivariate and multivariate logistic regression analyses were performed to identify associated factors. Results Only 112 (26.54%) participants demonstrated good awareness of danger signs. Vaginal bleeding (18.01%) and blurred vision (15.17%) were the most frequently recognized signs, while 62.56% could not identify any danger sign. Maternal age ≥ 30 years (AOR = 0.32, 95% CI: 0.14–0.74), ≤ 2 ANC visits (AOR = 0.47, 95% CI: 0.27–0.82), and intended pregnancy (AOR = 0.31, 95% CI: 0.14–0.69) were negatively associated with good awareness. Experiencing a danger sign (AOR = 2.56, 95% CI: 1.11–5.90), receiving health talks during ANC (AOR = 2.80, 95% CI: 1.32–5.92), and hemoglobin ≥ 10 g/dL (AOR = 2.05, 95% CI: 1.16–3.60) were positively associated with good awareness. Conclusions Awareness of obstetric danger signs was critically low. Strengthening routine health education during ANC and promoting early and regular attendance may improve maternal awareness and facilitate timely recognition of complications.</p>