Evidence map›Paper›PMID 39239928›Full record

ArticlePaediatric and perinatal epidemiology2024

Evaluating neonatal mortality in Malta compared with other EU countries: Exploring the influence of congenital anomalies and maternal risk factors.

Merle Wilhelm, Miriam Gatt, Rok Hrzic, Neville Calleja, Hajo Zeeb

Abstract readComparative Study
In one paragraph

Article in Paediatric and perinatal epidemiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Merle WilhelmUniversity of Maastricht, Maastricht, The Netherlands.ORCID https://orcid.org/0009-0002-5166-3608
Miriam GattMalta Congenital Anomalies Registry, Directorate for Health Information and Research, Pietà, Malta.
Rok HrzicDepartment of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
Neville CallejaDirectorate for Health Information and Research, Pietà, Malta.
Hajo ZeebLeibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGlobally, 240,000 babies die in the neonatal period annually due to congenital anomalies (CA). Malta reports the highest neonatal mortality rate (NMR) among EU (European Union) Countries, constituting a public health concern.

objectivesThis study describes the contribution of CA to NMR in Malta, investigating possible associations with known maternal risk factors of maternal age, nationality, and education. Additionally, it provides an update on the contribution of CA to neonatal deaths in Malta and other EU countries.

methodsAnonymous data for births and neonatal deaths were obtained for 2006-2020 from the National Obstetrics Information System (NOIS) in Malta. Regression analyses adjusting for maternal risk factors were run on this data to explore possible associations with NMR. NMRs published by EUROSTAT 2011-2020 were used to compare mortality by underlying cause of death (CA or non-CA causes) for Malta and other EU countries.

resultsBetween 2006 and 2020, 63,890 live births with 283 neonatal deaths were registered in Malta, (NMR 4.4 per 1000 live births). CA accounted for 39.6% of neonatal deaths. No time trends were observed in either total NMR, NMR attributed to CA or mortality due to non-CA causes. Adjusted variables revealed associations for women hailing from non-EU, low-income countries. Malta registered high NMRs compared to EU countries, most marked for deaths attributed to CA.

conclusionsBetween 2006 and 2020, Malta's NMR remained stable. Maternal Nationality, from non-EU low-income countries, was associated with higher neonatal mortality. The influx of such migrants may play a partial role in the high NMRs experienced. Malta's high NMR was primarily driven by early neonatal deaths, which included high proportions of deaths due to CA and is linked to the fact that termination of pregnancy is illegal in Malta.

Indexed as

Congenital AbnormalitiesInfant MortalityAdultCause of DeathEuropeEuropean UnionFemaleHumansInfantInfant, NewbornMaleMaltaMaternal AgePregnancyRisk FactorsYoung Adultanomaliesbirth defectsmaternal agematernal educationmaternal nationality in Maltaneonatal mortality rate

Identifiers

PMID39239928
PMCPMC11603760

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