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Impacts on Causes of Perinatal Death After Safer Baby Bundle Implementation in Victoria, Australia

Keeth L B Mayakaduwage1,2,3, Tanya Farrell2, Roshan J Selvaratnam1,2,3

  • 1The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia.

The Australian & New Zealand Journal of Obstetrics & Gynaecology
|December 19, 2025
PubMed

Insights

The Safer Baby Bundle (SBB) reduced unexplained stillbirths and those from specific perinatal conditions. This initiative shows promise for national expansion to further decrease perinatal mortality.

Area of Science:

  • Perinatal Health
  • Public Health Interventions
  • Obstetrics and Gynecology

Background:

  • The Safer Baby Bundle (SBB) was implemented in June 2019.
  • SBB is associated with reduced perinatal mortality.
  • Early impact assessment on specific causes of death is crucial for intervention refinement.

Purpose of the Study:

  • To evaluate changes in the causes of perinatal death before and after SBB implementation in Victoria, Australia.
  • To assess the effectiveness of the SBB in reducing stillbirths and neonatal deaths.
  • To identify specific causes of perinatal death impacted by the SBB.

Main Methods:

  • Retrospective population-based cohort study of singleton births (≥28 weeks gestation) from 2014 to 2020.
  • Exclusion of births with congenital anomalies and terminations.
  • Comparison of perinatal death causes in pre-SBB (Jan 2014–Jun 2019) and post-SBB (Jul 2019–Dec 2020) periods using chi-squared tests.

Main Results:

  • At SBB sites, stillbirths due to specific perinatal conditions decreased (RR: 0.30) and unexplained antepartum fetal deaths declined (RR: 0.53).
  • No significant changes in any cause of neonatal death were observed at SBB sites.
  • Non-SBB sites showed increased stillbirths from placental dysfunction and antepartum hemorrhage, but decreased neonatal deaths from hypoxic events and neurological conditions.

Conclusions:

  • SBB implementation significantly reduced unexplained stillbirths and those from specific perinatal conditions.
  • No increase in any cause of neonatal death was observed, supporting SBB's safety.
  • Findings support national expansion of SBB, with continued focus on remaining stillbirth causes.
Abstract

Keywords:
bundle of carecause of deathperinatal careperinatal mortalityquality improvementstillbirth

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