Member focus: Dr Keeth Mayakaduwage leads important research on program to prevent stillbirth
Recently published research on Victoria’s Safer Baby Bundle, led by AMA member Dr Keeth Mayakaduwage, has found implementation of the program was associated with a reduction in stillbirth and a statistically significant reduction in overall perinatal mortality.
The Safer Baby Bundle is a set of evidence-based clinical guidelines and educational resources developed by the NHMRC Centre of Research Excellence in Stillbirth for clinicians and pregnant women to help prevent the tragedy of stillbirth.
Dr Mayakaduwage, along with senior author Associate Professor Miranda Davies-Tuck, evaluated the program in three linked studies published in The Australian and New Zealand Journal of Obstetrics and Gynaecology.
The research examined whether the Safer Baby Bundle reduced stillbirth and perinatal mortality, changed the causes of perinatal death, and whether its benefits were experienced equitably across population groups.
Dr Mayakaduwage — a previous recipient of the AMA’s Women’s Health Award for his extensive contributions to improving stillbirth prevention and antenatal care — was lead author of the research and said the findings provide critical evidence to guide safe, effective, and equitable national implementation.
“We found that the implementation of the program in Victorian maternity services was associated with a reduction in stillbirth and a statistically significant reduction in overall perinatal mortality, without an increase in unintended harms such as caesarean section, induction of labour, preterm birth, or neonatal intensive care admission.
“Stillbirths due to unexplained causes and specific perinatal conditions declined in Safer Baby Bundle sites, suggesting improvements in antenatal detection and management of fetal risk.”
However, Dr Mayakaduwage said the benefits were not observed across all population groups, with no improvement seen among several migrant groups and an increase in perinatal mortality among Indigenous women during the study period.
The NHMRC Centre of Research Excellence in Stillbirth has now adapted the Safer Baby Bundle for Indigenous women and for migrant and refugee communities in Australia.
Dr Mayakaduwage noted that the evaluation was conducted before the rollout of the culturally adapted bundles, and ongoing evaluations will be critical to determine whether these adaptations improve outcomes and equity for these groups.
He also acknowledged Safer Care Victoria and the Consultative Council on Obstetric and Paediatric Mortality and Morbidity for their leadership in rolling out the Safer Baby Bundle across Victoria. Developed by the NHMRC Centre of Research Excellence in Stillbirth, the bundle forms part of the National Stillbirth Action and Implementation Plan.
