Perinatal and late neonatal mortality in the Maltese Islands : a socio-biological study.

Abstract

In the Maltese islands, the annual still-birth rates and neonatal mortality rates are now below 10 per 1000, so it would seem unnecessary for perinatal and neonatal science to define the relation between pregnancy events and the development of newborns. However one must bear light on the recent trends towards childbearing along with the increasing opportunity provided by assisted reproductive technologies which have increased the number of women considering pregnancy at later ages. This case control study aimed to identify social and biological risk factors which may be associated with these mortalities by comparing these deaths to live births occurring at Karin Grech Hospital between 1993 and 1995. The main information source in this study was the data collected progressively from the Maternity Information System. The total study population was 184 perinatal and late neonatal deaths and 368 controls from live birth survivors. The results of this study show that in Malta advanced maternal age, low birth weight and preterm birth were associated with these deaths as has been established in other countries. The clinico-pathological associations related to these deaths were congenital abnormalities in low and appropriate birthweights, while in very low birthweight conditions originating in the perinatal period were implicated These associations highlight the importance of considering the setting up of a perinatology unit run by obstetricians and neonatologists in KGH. Future studies could focus on a better understanding of the causes of low birth weight and preterm delivery among a population which is a small and relatively homogenous community.