Clinical, parasitological, and hematologic profile of pregnant women with malaria in Colombia: a retrospective cross-sectional study

Objectives This study aimed to describe the clinical, parasitological and hematological profile of pregnant women with malaria in Colombia and to explore maternal, obstetric and neonatal outcomes according to Plasmodium species. Methods: This retrospective cross-sectional study included the medical records of 166 pregnant women with microscopically confirmed malaria. Clinical, parasitological, hematological, obstetric, and neonatal variables were compared according to infecting Plasmodium species. Regression models were fitted for clinically relevant outcomes. Results: Plasmodium vivax accounted for 80.7% of cases. Anemia and thrombocytopenia were observed in 80.1% and 71.0% of women, respectively. Parasite density was higher in P. vivax than in P. falciparum infections. In adjusted analyses, P. falciparum infection was associated with longer hospital stay (aIRR 1.63), referral to higher-level care (aOR 3.09) and intrauterine growth restriction (aOR 2.80). Anemia was associated with longer hospital stay (aIRR 1.70). Thrombocytopenia was associated with intensive care unit admission (aOR 8.07), intrauterine growth restriction (aOR 6.81), blood transfusion (aOR 5.25) and referral to higher-level care (aOR 3.25). Conclusions: In this Colombian endemic setting, malaria in pregnancy was characterized by frequent anemia and thrombocytopenia. These findings support incorporating hematological parameters, particularly platelet count, into clinical assessment to identify women who may require closer monitoring.