The Australian & New Zealand journal of obstetrics & gynaecology · 2025
Reach and Impact of the Safer Baby Bundle Among Groups Disproportionately Affected by Stillbirth in Victoria, Australia.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Mayakaduwage Keeth L B, Farrell Tanya, Selvaratnam Roshan J, Flenady Vicki, Andrews Christine, Ellwood David, Stuart-Butler Deanna, Ah Chee Valerie, Hudson Robyn, Czarnecki Felicity, Davies-Tuck Miranda
Аннотация
BACKGROUND: Stillbirth disproportionately affects certain maternal demographic groups. The Safer Baby Bundle (SBB) was implemented to reduce stillbirth rates, but its impact across different populations remains unclear.
AIMS: This study evaluated the effect of the SBB on stillbirth and related perinatal outcomes among maternal demographic groups disproportionately affected by stillbirth in Victoria, Australia.
MATERIALS AND METHODS: This retrospective population-based cohort study compared outcomes before (Jan 2014-Jun 2019) and after (Jul 2019-Dec 2020) SBB implementation. Singleton births ≥ 28 weeks were included, excluding congenital anomalies and terminations. Relative risks and interrupted time series analyses were used to assess changes in SBB sites.
RESULTS: Among 233 462 births (Pre-SBB: 182 892; Post-SBB: 50 570), stillbirth rates decreased among Australian-born (1.96-1.46 per 1000; p = 0.08), European-born (2.70-0; p = 0.028), and non-Indigenous women (2.10-1.60; p = 0.027) but increased among Indigenous women (0-3.75; p = 0.002) and remained unchanged for African-born (4.71-5.16; p = 0.83), South Asian-born (2.10-2.18; p = 0.90), and Middle Eastern-born (1.62-1.50; p = 0.92) women. Similar trends were observed for perinatal mortality. Smoking cessation improved for Australian-born (p < 0.001) and non-Indigenous women (p < 0.001) but was unchanged in other groups. Undelivered severe FGR decreased in Australian-born (p < 0.001), African-born (p = 0.012), and South Asian-born (p < 0.001) mothers. DFM reporting improved across all groups. Early-term iatrogenic birth trends declined for Australian-born (p = 0.010) and non-Indigenous women (p = 0.022) but remained unchanged for other groups.
CONCLUSIONS: The SBB was associated with stillbirth reductions in Australian-born and non-Indigenous women but had limited impact on migrant and Indigenous populations. Culturally tailored strategies are needed to ensure equitable outcomes.
AIMS: This study evaluated the effect of the SBB on stillbirth and related perinatal outcomes among maternal demographic groups disproportionately affected by stillbirth in Victoria, Australia.
MATERIALS AND METHODS: This retrospective population-based cohort study compared outcomes before (Jan 2014-Jun 2019) and after (Jul 2019-Dec 2020) SBB implementation. Singleton births ≥ 28 weeks were included, excluding congenital anomalies and terminations. Relative risks and interrupted time series analyses were used to assess changes in SBB sites.
RESULTS: Among 233 462 births (Pre-SBB: 182 892; Post-SBB: 50 570), stillbirth rates decreased among Australian-born (1.96-1.46 per 1000; p = 0.08), European-born (2.70-0; p = 0.028), and non-Indigenous women (2.10-1.60; p = 0.027) but increased among Indigenous women (0-3.75; p = 0.002) and remained unchanged for African-born (4.71-5.16; p = 0.83), South Asian-born (2.10-2.18; p = 0.90), and Middle Eastern-born (1.62-1.50; p = 0.92) women. Similar trends were observed for perinatal mortality. Smoking cessation improved for Australian-born (p < 0.001) and non-Indigenous women (p < 0.001) but was unchanged in other groups. Undelivered severe FGR decreased in Australian-born (p < 0.001), African-born (p = 0.012), and South Asian-born (p < 0.001) mothers. DFM reporting improved across all groups. Early-term iatrogenic birth trends declined for Australian-born (p = 0.010) and non-Indigenous women (p = 0.022) but remained unchanged for other groups.
CONCLUSIONS: The SBB was associated with stillbirth reductions in Australian-born and non-Indigenous women but had limited impact on migrant and Indigenous populations. Culturally tailored strategies are needed to ensure equitable outcomes.