Reproductive performance on the Maltese Islands during the Second World War.

The Maltese Islands are a group of small islands in the central Mediterranean, of which two are inhabited. Malta had a population in 1938 of 242,885, and Gozo then had 25,783 inhabitants. The islands are small: the largest Malta, is 94-87 square miles in area, and Gozo, 26-97 square miles.1 The islands were not occupied during the Second World War, but they were subjected to ferocious bombings and the inevitable deprivations that resulted from their isolated position. War affects the reproductive performance of a population; changes are reflected in the maternal, infant, and neonatal mortality rates, the birth rates, and still-birth rates. The experience of the Maltese Islands provides some valuable insights. After Germany invaded Poland, Great Britain and France mobilized on 1 September 1939. Following the declaration of war, Malta-a British colony-quickly prepared for war. Hostilities there began officially on 11 June 1940 after Benito Mussolini declared war on the Allies. Five hours later, the Maltese Islands suffered an air raid, in the first of eight raids over the next 24 hours. The islands were bombed regularly after that with an increasing tempo. Hostilities on the islands subsided in November 1942 after the Allied offensive opened in Egypt and General Erwin Rommel's army retreated.2 According to the official statistics, throughout this period of about 900 days there were 2,537 alerts, with 492 day raids and 574 night raids. The total tonnage of bombs dropped on the islands during March and April 1942 alone was twice that dropped on London during the years of its worst attacks.3 The blockade enforced by the Axis control of the Mediterranean supply lines had considerable effects. Malta had never been self-supporting and Sicily, its nearest neighbour, had provided much of the islands' imports. On the outbreak of the war, these supplies were abruptly cut off and the islands' supplies were maintained, with varying success, through 1940 and 1941 by Royal Navy and Merchant Marine