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Congenital anomalies account for four in 10 of newborn deaths

Malta and Ireland have the highest percentage of newborn deaths due to congenital anomalies, a pan-European report has found, pointing out that this could be due to abortion being illegal in both countries.

Figures released last week as part of the comprehensive European Perinatal Health Report (EPHR), which compares data on maternal and infant health across Europe, shows that 41.7 per cent of babies born with congenital anomalies in 2004 died.

Figures for Ireland - where terminations are also illegal - are close to Malta's, with 40.1 per cent.

The report itself points out that abortion is illegal in the two countries, implying that in other countries foetuses with congenital anomalies would be candidates for abortion. Such anomalies are a leading cause of foetal and neonatal deaths and there are wide international variations in prenatal screening policies, regulations on termination of pregnancies and the timing and attitude of the medical profession to children born with severe malformation, the report says.

Statistics collected by the Malta Congenital Anomalies Registry show that 3.4 per cent of babies born between 2001 and 2003 suffered from a congenital anomaly.

The EPHR report also shows that in 2004 Malta had the highest rate of labour inductions, with 37.9 per cent of all births born following an induction. The island also has the third highest rate of elective caesarean deliveries carried out before labour starts.

The statistic suggests a light attitude on the part of the medical profession to this sort of surgery, an argument which midwives have made for years.

But Malta is not alone. In fact, between 70 and 90 per cent of multiple births in Malta, Germany, Spain, Italy, Luxembourg and Austria were by caesarean section during this period, compared to 36 per cent of those in The Netherlands, between 40 and 50 per cent in Slovenia, Lithuania, Finland and Norway and just over half in Flanders, Brussels, Estonia, France and Sweden.

The report also ranks Malta as the highest scorer of triplets or higher multiple births but with the seventh-lowest number of twin births among 25 European countries in 2004.

However, figures collected by the National Obstetric Information System show that 2004 had an abnormally high rate of triplet and quadruplet births.

In fact, while 2004 saw four sets of triplets and two sets of quadruplets born, this was more than double the number in other years from 2000 to last year. The next highest number of triplets - three sets - were born in 2003, 2005 and 2006, while only one other set of quadruplets was born in 2007.

Donald Felice, president of the Malta College of Obstetricians and Gynaecologists, said that given the small size of Malta, and its small number of births, it is extremely difficult to compare the rate of multiple births with other countries.

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