Work

Reducing Perinatal Mortality in Victoria, Australia: Early Insights From the Safer Baby Bundle Implementation

Year: 2025

Type: article

Abstract: BACKGROUND: The Safer Baby Bundle (SBB) was introduced in Victoria, Australia, to reduce stillbirth and perinatal mortality. Evaluating its impact is critical to informing its national rollout. AIMS: This study assessed the early effect of SBB implementation on stillbirth and perinatal mortality rates in Victoria. MATERIALS AND METHODS: A retrospective population-based cohort study of singleton births ≥ 28 weeks was conducted, comparing outcomes before (January 2014-June 2019) and after (July 2019-December 2020) SBB implementation. Congenital anomalies and terminations were excluded. Interrupted time series analyses and relative risks compared outcomes at SBB and non-SBB sites. RESULTS: There were 398,273 pre-SBB and 108,024 post-SBB births. In SBB sites, a trend towards reduced stillbirth from 2.08 to 1.64/1000 was observed (RR: 0.79, 95% CI: 0.62-1.00, p = 0.05) along with a significant reduction in perinatal mortality from 2.52 to 2.02/1000 (RR: 0.80, 95% CI: 0.65-0.99, p = 0.041). While in non-SBB sites, rates of stillbirth (p = 0.58) and perinatal mortality (p = 0.53) remained unchanged. Pre-implementation, early term iatrogenic births rose monthly by 0.20% in SBB (p < 0.001) and 0.15% in non-SBB sites (p < 0.001). Post-implementation, monthly trends in SBB sites reduced by 0.14% (p = 0.015) with no further significant increases, while non-SBB sites continued to rise by 0.18% per month (p < 0.001). No significant changes were seen in caesarean section, induction of labour, late preterm birth, neonatal death, or neonatal intensive care unit admission trends in SBB sites. CONCLUSIONS: SBB implementation was associated with reduced perinatal mortality without increasing iatrogenic or neonatal harm. These findings support its national implementation to improve perinatal outcomes in Australia.

Source: Australian and New Zealand Journal of Obstetrics and Gynaecology

DOI: 10.1111/ajo.70082