Reach and Impact of the Safer Baby Bundle Among Groups Disproportionately Affected by Stillbirth in Victoria, Australia.

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.