It is high time we reduce “routine” blood work in neonatal units

Background: Perinatal and neonatal mortality rates are quality indicators of antenatal, neonatal and postnatal care. This study describes perinatal outcomes for Malta over the 15 year period 2008–2022 to inform future practice and healthcare provision.Methodology: Aggregate anonymous data on perinatal outcomes from 2008 to 2022 were obtained from the National Obstetric Information System (NOIS), Directorate for Health Information and Research (DHIR). Data for each variable was grouped into three 5-year intervals (2008–2012, 2013–2017 and 2018–2022) to investigate trends over time.Results: Total births increased over time (p-value 0.008), mainly driven by singleton pregnancies (p-value 0.004), while multiple pregnancies remained stable. Live births increased (p-value 0.008), however, there was no statistically significant difference in stillbirth rate. There were no statistically significant changes in post-term, preterm or low birthweight deliveries (p-value 0.73). The neonatal mortality rate showed a downward trend from 4.92 per 1,000 live births for the years 2008–2012 to 3.92 per 1,000 births for the 2018–2022 epoch, but this could not be statistically confirmed. Data for ART pregnancies was only available as of 2013, analysis of which showed a significant increase in trend over the years with a p-value of <0.05.Conclusion: This study’s findings highlight important public health implications for Malta and the world. The stable rates of preterm and low birth weight, and the decline in stillbirths, suggest improvements in maternal and infant health. However, Malta still lags behind the rest of Europe. This along with the overall increase in the number of births, may be attributed to the growing number of immigrants within the pregnant population, who have specific healthcare needs which need specific attention. These results can help inform public health policies and improve maternity and neonatal services in Malta and regions with similarly increasing immigrant populations.

The Neonatal Intensive Care Unit (NICU) presents significant sensory and emotional challenges for preterm infants and their families. Early maternal separation, aberrant sensory exposures, and potential limitations to parental bonding pose risks to infants' neurodevelopment and overall health, whilst families may experience emotional distress. This study of current scientific literature evaluates the necessity and potential impact of using the recording of maternal sounds to simulate intrauterine auditory environments in NICUs. A narrative review of studies assessing sensory interventions in NICUs was conducted, focusing on outcomes related to infant neurodevelopment, family bonding, and caregiver experiences. Data were synthesized to determine the effectiveness and uniqueness of audio-stimulation of infants using recordings of maternal sounds compared to existing interventions. Maternal sound stimulation, including voice and heartbeat playback, has been shown to promote neurodevelopment by enhancing auditory cortex maturation, reducing stress responses, and improving breastfeeding outcomes in preterm infants. It may also help in reducing the incidence of cardiorespiratory events, mitigation of pain responses during procedures, and improvement in sleep regulation. While the benefits of maternal sound recordings are well established in specific areas, further research is needed to evaluate their long-term impact on cognitive development, emotional well-being, and attachment outcomes in preterm infants. Additionally, the broader effects of this intervention on family bonding and wellbeing, particularly in diverse NICU settings, require more extensive exploration. Recordings of maternal sounds hold significant promise as a targeted, practical solution to address the sensory needs of preterm infants and also help in strengthening the infant-family bond.