A national obstetric information system was launched in the beginning of 1999 and now covers all deliveries taking place on the islands of Malta and Gozo.

Systematic data collection for NOIS commences once the mother delivers her baby. Information regarding the course and outcome of each pregnancy is recorded by the relevant staff at each centre on a standard NOIS sheet. Once the data are recorded, the sheets are forwarded to the DHIR on a regular basis. At the DHIR the relevant sheets are processed and entered into the NOIS database. The system registers all infants/fetuses of 22 weeks gestation and over or 500g birthweight or more.

The maternity centres actively participating in this information system in 2007 were: St. Lukes / Mater Dei Hospital, Gozo General Hospital, St James Hospital Sliema and Zabbar and St. Philip's Hospital. Home deliveries which are not subsequently referred to a hospital are not captured by this system. During November 2007, the one State hospital in Malta migrated from St. Luke's Hospital to Mater Dei Hospital.

The data in this report describes statistics for all deliveries and births reported to and registered into the system. Data is sent to the Registry from all hospitals on the Maltese Islands. Accuracy and completeness of data sent on the NOIS reporting sheets is the responsibility of the hospital providing data. Unfortunately, towards the end of 2007 the major hospital on the islands encountered some problems with data collection and this accounts for the increased number of unspecified / unknown variables seen in this report as compared to those of previous years.

There were a total of 3853 deliveries reported and registered for the Maltese Islands in 2007. These resulted in a total of 3898 infant/fetal births. These figures show a decrease of 484 births compared to 1999 when the NOIS system was first launched.

* Total births include all reported live and still births Of the registered 3853 deliveries (3898 births), 3575 deliveries (3618 births) occurred in Malta and 278 deliveries (280 births) occurred in Gozo.

The maternities have been grouped into 5-year age groups and the frequency distribution of deliveries according to maternal age group is given. In 2007, the greatest number of deliveries - 1282 (33%), occurred in the age group 25 to 29 years whilst the least number of deliveries 3 (<1%) occurred in the oldest age group 45+ years. There were 4 deliveries in the youngest age group less than 15 years. The minimum age at delivery of the mothers was 13 years while the maximum age was 45 years. The most frequent maternal age at delivery was 30 years and average maternal age was 28 years.

Marital Status

This year, 888 (23%) of all deliveries occurred to mothers who were reported as never married (single); while 2838 (74%) of all deliveries occurred to mothers reported as married, and 126 (3%) were reported as being widowed, separated or divorced. For the remaining one delivery the mother had no marital status specified.

In 2007, according to the data registered in NOIS, no mothers were reported as 'not having support at home to raise the infant".

Nationality

91% (3511) of all deliveries this year, occurred to women of Maltese nationality while 8% (308) were Non-Maltese. In the remaining 1% (34) nationality was not specified.

Parity

There were 51% of mothers who were giving birth for the first time while 49% had given birth before.

Maternal Lifestyles

There were 115 (3%) of mothers who were reported to smoke one or more cigarettes during pregnancy this year. No mothers were reported to drink alcohol regularly during pregnancy and 19 (0.5%) were reported as being drug abusers.

Pathology during Pregnancy

In 2007 there were 20 mothers registered as having made use of assisted reproduction (ART), this includes all forms of ART namely ovulation stimulation, IVF and ICSI.

The most frequently specific obstetric pathology reported was gestational hypertension, with 6.3% of mothers registered as having gestational hypertension.

Diabetes in Pregnancy

In 2007 there were 13 mothers who were reported as being Insulin Dependent Diabetic before this pregnancy while there was one mother reported with Non-Insulin Dependent diabetes prior to pregnancy. In addition, there were a total of 66 mothers registered with gestational diabetes who were controlled without the use of insulin, and 2 mothers registered as having gestational diabetes treated with insulin.

Category of Birth

For this year, there were a total of 3811 (98.9%) singleton and 40 (1.0%) twin deliveries, 1 triplet and 1 quadruplet delivery

Site and onset of Birth

In 2007 of the total 3853 deliveries registered by NOIS, 3847 (99.8%) occurred in a hospital while there were 6 deliveries that occurred at home or another site but were later referred to a hospital. Four of the hospital deliveries were reported as being underwater.

Of the total 3853 deliveries, 47% (1829) were reported as spontaneous onset of contractions, 36% (1372) were induced by drugs or artificial rupture of membranes and 17% (652) were planned caesarian sections.

Method of Birth

In 2007 there were a total of 3898 infant/fetal births. Of these 2458 (63%) were delivered as a vertex delivery, 1287 (33%) by emergency or elective Caesarean Section and 153 (4%) by assisted vaginal delivery (includes forceps, ventouse and breech).

For 2007 there were 1287 infants/fetuses delivered by caesarian section but 1243 caesarian operations performed, this due to the fact that a number of caesarians are done in multiple birth deliveries. The Caesarean section operation rate in 2007 was 32.3% of the total 3853 maternal deliveries.

Gender of Birth

As is usually seen, there were more male infants/fetuses delivered than female.

Birthweight of Infants/Fetuses

In 2007, there were 3620 (93%) of the total births that occurred in the birth weight range of 2500g to 4999g. 223 (6%) of the total births were in the low birth weight range of 1500g to 2499g, while 31 (<1%) of births were of very low birth weight 500g to 1499g. This year there were 4 babies of birth weight less than 500g but 22 completed weeks gestation. 17 babies were of birth weight 4500g and over. In 20 babies, the birth weight was not recorded. The lowest birthweight recorded this year was 300g and this baby was an early neonatal death at 23 weeks gestation. The highest birth weight recorded was 4960g. The average birth weight was 3200g.

Outcome of Birth

The number of live births registered in 2007 was 3886 which accounted for 99.7% of the total births at a national level. The remaining 12 births were reported as stillbirths. Of the livebirths, there were 17 cases of early neonatal deaths and 3 cases of late neonatal deaths. All births of 22 weeks and over irrespective of birth weight are registered into NOIS.