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RESEARCH Open Access© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modif i ed the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit h t t p : / / c r e a t i v e c o m m o n s . o r g / l i c e n s e s / b y - n c - n d / 4 . 0 /.Alfaif i et al. BMC Pediatrics (2025) 25:150 https://doi.org/10.1186/s12887-025-05499-7BMC Pediatrics*Correspondence:Mohamed A. Ahmedrayisdurresearch@gmail.com1 Department of Child Health, College of Medicine, University of Bisha, Bisha, Kingdom of Saudi Arabia2 Faculty of Medicine, University of Khartoum, BO Box 102, Khartoum, Sudan3 Department of Obstetrics and Gynecology, College of Medicine, Qassim University, Buraydah, Saudi ArabiaAbstractBackground Perinatal asphyxia is one of the leading causes of neonatal morbidity and mortality in the world. While there is much published data on the epidemiology of perinatal asphyxia in African countries, there is a lack of data on this topic in Sudan, which is the third-largest country in Africa. This study aimed to determine the prevalence of perinatal asphyxia and its associated factors among neonates delivered at Saad Abuelela Maternity Hospital, Sudan.Methods A cross-sectional study was conducted in Saad Abuelela Maternity Hospital, Sudan. Questionnaires were used to collect maternal sociodemographic, obstetric, and clinical data. The neonates’ clinical data (birth weight, sex of newborn, and Apgar score) were also collected and recorded. Multivariate binary analysis was performed.Results Six hundred and nineteen mother-neonate pairs were included in the study. The mothers’ median (IQR) age and parity was 27.0 (23.0–32.0) years and 3(1–5), respectively. Seventy (11.3%) neonates had perinatal asphyxia. In univariate analysis, the odds of perinatal asphyxia were increased in employed mothers, rural residents, cesarean delivery, preterm infants, and low birth weight neonates. There was no association between age, parity, mother education, mother anemia, sex of the neonates, and perinatal asphyxia. In multivariate analysis, the odds (adjusted) of perinatal asphyxia were increased in cesarean delivery (adjusted odds ratio [aOR] = 2.31, 95.0% CI [conf i dence interval] = 1.33?4.02), preterm delivery (AOR = 6.37, 95.0% CI = 2.34?7.95) and low birth weight (aOR = 2.29, 95.0% CI = 1.26?4.18).Conclusion There was a high prevalence of perinatal asphyxia among newborns delivered at Saad Abuelela Maternity Hospital, Sudan. The factors associated with perinatal asphyxia among neonates were cesarean delivery, low birth weight, and preterm birth.Keywords Perinatal asphyxia, Age, Prevalence, Associated factors, Neonates, QuestionnairePrevalence of perinatal asphyxia and its associated factors among live birth in Khartoum, Sudan: a hospital-based cross-sectional studyJaber Alfaif i1 , Mohamed A. Ahmed 2* , Ghaday S. Almutairi 3 , Norah H. Alhumaidi 3 , Nadiah AlHabardi 3 and Ishag Adam 3