Secular trends in obstetric practice in Malta

Abstract

Obstetric practice in Malta has changed dramatically over the last two decades. The study identifies these changing trends that have occurred in the pregnant population in respect to their biological demography and their obstetric problems. Maltese pregnant women have changed their reproductive habits and demonstrate a greater predisposition to having children at a younger age (<20 years) or later in life (>40 years). They are more likely to be primiparous and unmarried. The antenatal course is more likely to be complicated by hypertension, antepartum haemorrhage and diabetes. The pregnancies are more likely to require intervention by induction of labour and Caesarian section. There appears to be an increasing reluctance to intervene by operative vaginal deliveries. In spite of the increasing antenatal problems, a definite fall in perinatal mortality has been demonstrated, though there appears to be a slightly increased infant morbidity rate in the form of prematurity and its attendant complications.