Adverse fetal and neonatal outcomes and associated factors among malaria infected parturient at Wallaga University Comprehensive Specialized Hospital, Western Ethiopia

Malaria during pregnancy remains a major public health challenge, significantly contributing to poor fetal and neonatal outcomes. This study aimed to determine the prevalence and associated factors of adverse fetal and neonatal outcomes among malaria-infected parturient at Wallaga University Comprehensive Specialized Hospital, Western Ethiopia. An institution-based retrospective cross-sectional study was conducted using medical records of 271 malaria-infected parturient from March 10, 2024, to March 9, 2025. Data were extracted using a standardized checklist, entered into Microsoft Excel, and analyzed using SPSS version 27. Multivariable logistic regression was employed to identify independent predictors, with statistical significance set at p < 0.05. The prevalence of adverse fetal and neonatal outcomes was 37.27% (95% CI: 32.0%–42.9%), with low birth weight being the most common complication. Independent predictors included residing in rural area (AOR = 4.97; 95% Cl, 1.92–12.90), being primigravida (AOR = 5.41; 95% Cl, 1.95–15.05), having moderate anemia (AOR = 3.25; 95% Cl, 1.46–7.25), having severe anemia (AOR = 4.89; 95% Cl, 1.95–12.29) and having four or fewer antenatal care contacts (AOR = 5.70; 95% Cl, 2.56–12.72). Nearly four in ten study participants experienced adverse fetal and neonatal outcomes. The risk is highest for participants from rural areas, experiencing their first pregnancy, struggling with moderate to severe anemia, or failing to complete at least five antenatal care contacts. Therefore, targeted interventions should prioritize anemia prevention and management, specialized monitoring for primigravidas, and rural outreach to ensure women complete at least five antenatal care contacts.