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

ABSTRACT Background The Safer Baby Bundle (SBB) was introduced in June 2019 and has been associated with a reduction in perinatal mortality. Assessing its early impact on specific causes of perinatal death can inform future interventions. Aims This study assessed changes in the causes of perinatal death before and after SBB implementation in Victoria, Australia. Materials and Methods A retrospective population‐based cohort study included singleton births ≥ 28 weeks' gestation (excluding congenital anomalies and terminations) from 2014 to 2020. Births were categorised into pre‐SBB (January 2014–June 2019) and post‐SBB (July 2019–December 2020) periods. Chi‐squared tests compared changes in perinatal death causes at SBB and non‐SBB sites. Results At SBB sites, stillbirths due to specific perinatal conditions decreased from 0.26 to 0.08/1000 (RR: 0.30, 95% CI: 0.11–0.84, p = 0.015), and unexplained antepartum fetal deaths decreased from 0.86 to 0.45/1000 (RR: 0.53, 95% CI: 0.34–0.82, p = 0.003). No significant changes in any cause of neonatal death were observed. In contrast, non‐SBB sites saw increases in stillbirths due to placental dysfunction (0.22 to 0.40/1000, RR: 1.80, 95% CI: 1.09–2.95, p = 0.019) and antepartum haemorrhage (0.15 to 0.31/1000, RR: 2.11, 95% CI: 1.18–3.76, p = 0.010). However, neonatal deaths due to hypoxic peripartum events (0.14 to 0.02/1000, RR: 0.12, 95% CI: 0.02–0.89, p = 0.013) and neurological conditions (0.27 to 0.10/1000, RR: 0.38, 95% CI: 0.16–0.88, p = 0.019) declined. Conclusions SBB implementation was associated with a significant reduction in unexplained stillbirths and those due to specific perinatal conditions, without an increase in any cause of neonatal death. These findings support the program's national expansion, with targeted efforts needed to address the remaining causes of stillbirth.