Malta has one of the highest rates of multiple births in Europe but the situation “should” improve with the new law regulating in-vitro fertilization, according to a consultant paediatrician.
The report once again places Malta at the high end for Caesarean sections
“The new law should result in a decrease in high-order multiples, like triplets and more, but this will only happen if two embryos are implanted in most cases. The law allows for three to be implanted in exceptional cases. Let’s hope that not all cases will be deemed exceptional,” Simon Attard Montalto told Times of Malta.
Multiple births, especially those relating to more than two babies, result in increased risk factors for the babies.
According to the European Perinatal Health Report, based on 2010 data, 21 per 1,000 women who gave birth in Malta that year had multiple births. This placed Malta among the top six countries alongside Cyprus, Brussels, the Czech Republic, Denmark and Spain.
The report, launched yesterday, was based on data received by 29 countries, including all EU member states, except Bulgaria, as well as Iceland, Norway, and Switzerland.
It points out that multiple births are one of the consequences of assisted reproduction, such as IVF.
“Babies from multiple pregnancies have a tenfold risk of pre-term birth and are four times more likely to die in the neonatal period. Multiples have higher risks of congenital anomalies and growth restriction, and their mothers’ higher risks of morbidity and mortality,” the report points out. Malta also has one of the highest rates of multiples that include triplets or more – a symptom of the lack of IVF regulation and the number of embryos that can be implanted into a woman.
But this year the Embryo Protection Act came into force and the structures are being put in place to implement it. This includes the recent setting up of the Embryo Protection Authority, which is meant to ensure there is no abuse, among other things.
Prof. Montalto, head of paediatrics at the Medical School, added that the new law might lead to an increase in twins since IVF would be accessible to more couples given it will soon be offered for free. However, it should control the higher-risk multiples.
The report also once again places Malta at the high end for Caesarean sections with over 34 per cent of births being C-sections. The World Health Organisation recom-mends an annual average of C-sections of 10 to 15 per cent.
Last month, Malta Midwives Association president Mary Buttigieg Said noted that unnecessary Caesarean sections cost the national coffers €3.7 million in 2011. When it came to the age of mothers, the majority of Maltese mothers were between the ages of 25 and 34 and 15.5 per cent were over 35 – an age associated with higher-risk pregnancies.
The report states that neonatal mortality rates, that is the death of newborn babies, ranged from 1.2 per 1,000 live births in Iceland to 4.5 in Malta and 5.5 in Romania.
Infant mortality rates ranged from 2.3 per 1,000 live births in Iceland and Finland to 5.5 in Malta, and 9.8 in Romania.
“Between 61 and 85 per cent of all neo-natal deaths in European countries occurred during the early neonatal period. Countries where terminations of pregnancy are not legal may have higher neo-natal mortality rates due to deaths from lethal congenital anomalies, as in Malta,” the report notes.
When it came to breastfeeding within the first 48 hours after birth, data was available from 19 out of the 27 countries.
More than 95 per cent of babies received some breast milk at birth in the Czech Republic, Latvia, Portugal, and Slovenia.
Rates were lowest in Ireland, Scotland, Cyprus, France, and Malta – ranging between 54 and 69 per cent.