According to a recent report by the European Observatory on Health Systems and Policies, Malta “has a ‘high’ number of infant deaths...” which “...needs explaining”.
At 6.3 per 1,000 live births in 2011, Malta’s infant mortality rate was higher than the eurozone average of 3.55 per 1,000 live births and higher than the EU average of 5.76.
The Health Systems in Transitions study indicated that, when interpreting the figures, caution had to be exercised due to the blanket ban on abortion in Malta. “This fact alone,” the report added, “may not fully explain such high mortality rates”. Indeed it does not. It shouldn’t.
It further states that “Malta’s ban on abortion in all circumstances means that babies with lethal congenital disorders are carried to term”, implying that these will eventually die and, thus, swell the infant mortality figures.
It is very strange for the EU report to suggest that the fact that abortion is illegal in Malta seems to be the main cause of infant mortality here. Is this another attempt to force Malta to introduce abortion through the back door? Indeed, the authors of the EU report should do the opposite and suggest strong measures to prevent the emergence of these lethal congenital disorders and to cure them when they arise throughout Europe. Infant mortality in Malta could be the result of environmental toxins that can affect fetal development and may also lead to death at infancy.
On September 11, 2009, Times of Malta carried the story of a young mother who blamed her employer for her child’s death as a direct result of her exposure to a particular chemical at work. The child died a few days after birth, seven months into the pregnancy. The lawyers had argued in court that the causes of death were directly linked to the mother having been exposed to a chemical at work, saying their claims were backed by foreign studies.
Several studies abroad point to the impact of different toxins, originating from the environment, on the development of the foetus. A study in 2011 found that virtually all US pregnant women carry multiple chemicals in their bodies.
The study further suggests that “the effects of environmental toxins can be described separately by what effects they have, such as structural abnormalities, altered growth, functional deficiencies, congenital neoplasia or even death for the foetus”. Children exposed to prenatal tobacco smoke may also experience a wide range of behavioural, neurological and physical difficulties. “Adverse effects include stillbirth, placental disruption, prematurity, lower mean birth weight, physical birth defects (cleft palate etc.), decrements in lung function and increased risk of infant mortality”.
Is this another attempt to force Malta to introduce abortion through the back door?
Other studies in the US on preterm birth indicate that one in 10 babies is born preterm and about five per cent have low birth weight. Preterm birth is defined as birth at less than 37 weeks of gestation and is a major basis of infant mortality throughout childhood.
“Exposures to environmental toxins such as lead, tobacco smoke and DDT have also been linked with an increased risk for spontaneous abortion, low birth weight, or preterm birth.”
Beate Ritz, of the Department of Epidemiology, Environmental Health Sciences and Neurology at the US Institute of the Environment and Sustainability, in a 2008 report on air pollution impacts on infants and children says that “the time between conception and birth may be considered one of the most vulnerable life stages, during which the environment may have tremendous, immediate and lasting effects on health. The foetus undergoes rapid growth and organ development and the maternal environment helps direct these processes, for better or for worse”.
They claim that evidence is said to be accumulating that “environmental exposures can cause infants to be born premature (before 37 weeks of gestation) or low weight (5.5 pounds), or to be born with certain birth defects and that these babies are far more likely to die in infancy”.
When commenting on air pollution and infant mortality, the same report adds that “in the 1990s, studies started to systematically investigate links between air pollution and infant mortality. Most findings from this research indicated infants living in areas with high levels of a particulate matter had a greater risk of mortality during the first year of life, particularly from respiratory causes. Furthermore, infants exposed to high concentrations of the gaseous pollutant nitrogen dioxide were at increased risk of dying from sudden infant death syndrome (SIDS)”.
On February 21, the Ministry of Health launched the national health systems strategy for consultation. Neville Calleja, acting chief medical officer, when inviting people to attend the launching and discuss the draft strategy, said that “the vision of the Ministry for Health is to actively promote a society that fosters an environment that is conducive to persons attaining their maximum potential for health and well-being”.
“The aim of the strategy,” he added, “is to provide every individual with the opportunity to lead a healthy and active life and to benefit from equitable access to sustainable quality healthcare.”
The strategy does make provision for the good health and wholesome development of the unborn child.
In this context, it is hoped that the strategy will go into the question of the rise in infant mortality in Malta lately, provide for the required research to be held and find the real reasons behind this worrying development. In this regard, it would make perfect sense if Victor Grech, consultant paediatrician and associate professor of paediatrics at the University of Malta, is taken on board.
His paper on congenital abnormalities (http://starskidsmalta.com/medical-writeups/congenital-abnormalities/), especially what he says about teratogens that disrupt embryonic development, diabetic mothers and infant mortality, should be noted.
Top health officials did call for more scientific research to improve and enhance the medical and health services in Malta and Gozo.
Tony Mifsud is coordinator of the Malta Unborn Child Movement.