The Perinatal Outcomes of Maltese and Sub-Saharan African Migrant Women: A Comparative, Retrospective Study

Abstract

A paucity of evidence exists on whether the health and social services introduced in Malta for Sub-Saharan African (SSA) migrants have improved perinatal outcomes.Research Aim:This research aimed to compare the sociobiological characteristics and obstetric and perinatal outcomes between SSA migrant women and a local cohort of Maltese women who delivered neonates in Malta.Design:A retrospective comparison of two samples, SSA migrant women and Maltese women utilized the national obstetrics database kept by the Medical and Health Department during 2007–2016. The database had information about 898 SSA mothers (914 neonates) and 36,083 Maltese mothers (36,736 neonates). Statistical comparison was carried out using Pearson’s chi-square test.Results:SSA migrants were significantly more likely to be younger, married, poorly educated, and less likely to smoke cigarettes or abuse illicit drugs. They were statistically more likely to be multiparous and to poorly avail themselves of available antenatal care. Although SSA migrants had a significantly increased risk for perinatal complications, including preeclampsia–eclampsia, threatened preterm labor, placental abruption, intrauterine growth restriction, anemia, infection, hemorrhage, and blood transfusions, the risk for perineal trauma was lower than that for Maltese women. Significantly increased complications in SSA neonates included prematurity, low birth weight, low Apgar scores, respiratory distress syndrome, sepsis, seizures, and increased mortality.Conclusion:Despite the availability of comprehensive free-at-source obstetric healthcare and social support services, the perinatal outcomes of SSA migrants remained substandard when compared to Maltese women. These findings require further investigation of the adequacy and standard of maternity care offered to SSA migrants.