Neonatal Intensive Care Admissions and Outcomes in Malta from 2019 to 2022—A Retrospective Observational Study

OBJECTIVE: This retrospective observational four-year review (2019-2022) evaluated neonatal admissions to Malta's NICU and their outcomes. STUDY DESIGN: Data from neonates up to 28 days meeting NICU admission criteria with available EMRs were analyzed, focusing on demographic data such as gestation and birth weight, need for resuscitation at birth, admission reasons, and outcomes related to nutrition, respiratory support, congenital anomalies, prematurity-related complications, phototherapy, and infection. RESULTS: Total admissions numbered 1303 (7.3% of total births), out of which 1234 had available electronic medical records and were included in the final analysis. The main reasons for admission were respiratory distress syndrome (27.7%), transient tachypnoea (16.3%), and sepsis (13.5%). Among preterm infants, conditions related to prematurity were observed at expected frequencies and are reported descriptively. Feeding practice resulted in delayed attainment of full enteral nutrition compared to international standards, with an exclusive breastfeeding rate below the EU average. Sepsis and CLABSI rates were low, indicative of robust infection prevention and control measures. CONCLUSIONS: This study provides a descriptive overview of NICU admissions and outcomes stratified by gestational age at a single tertiary center in Malta, and highlights areas for improvement. The findings highlight expected patterns of prematurity-related morbidity and differences in clinical management, particularly in nutritional and respiratory support. Future prospective studies incorporating standardized data collection and detailed maternal and demographic variables are needed to better inform neonatal care and service planning.