DVERSE FETAL AND NEONATAL OUTCOMES AND ASSOCIATED FACTORS AMONG MALARIA INFECTED PARTURIENTS AT WALLAGA UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL, NEKEMTE, ETHIOPIA: A CROSS SECTIONAL STUDY

ABSTRACT Background: Parturient with malaria infection are at increased risk of developing severe clinical manifestations, which may ultimately result in adverse fetal outcomes. Despite this, there is limited evidence on the extent of these adverse outcomes among pregnant women in general, and no study has been conducted in the specific study area to address this gap. Objective: This study was aimed to assess the adverse fetal and neonatal outcomes and associated factors among malaria infected parturients at Wallaga University Comprehensive Specialized Hospital from March 10, 2024 to March 9, 2025. Methods: An institutional-based retrospective cross-sectional study was conducted among malaria-infected parturients. All medical records of parturients diagnosed with malaria at Wallaga University Comprehensive Specialized Hospital from March 10, 2024, to March 9, 2025, were reviewed. Data were collected using a semi-structured checklist developed from relevant literature. Data entry and analysis were performed using Microsoft Excel and SPSS version 27, respectively. Bi-variable and multivariable logistic regression analyses were conducted to assess the association between independent variables and the outcome variable. Variables with a p-value < 0.05 were considered statistically significant, and the strength of association was determined using adjusted odds ratios with 95% confidence intervals. Results: Prevalence of overall adverse fetal and neonatal outcomes was 37.27% (95 C.I; 32.0%-42.9%). 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 less than four ANC contact (AOR=5.70; 95% Cl, 2.56-12.72) were significantly associated with adverse fetal and neonatal outcome. Conclusion: Nearly four in ten fetuses and newborns in this study experienced adverse outcomes, highlighting a significant public health challenge. The risk is highest for mothers who are living in rural areas, experiencing their first pregnancy, or struggling with moderate to severe anemia. Crucially, failing to complete at least four ANC contact is a major predictor of poor outcomes, suggesting that increasing the frequency and accessibility of prenatal care, especially in rural settings, is vital for improving neonatal health. . To improve fetal and neonatal health, healthcare systems must prioritize rural outreach, ensure mothers complete at least four antenatal contact, and provide targeted support for anemia and first-time pregnancies. Keywords: Adverse fetal outcomes, malaria, parturient, Wallaga University Comprehensive Specialized Hospital ix