ArticlePloS one2021
Stillbirth rates, service outcomes and costs of implementing NHS England's Saving Babies' Lives care bundle in maternity units in England: A cohort study.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03231007 (Saving Babies' Lives Project Impact and Results Evaluation), which is not on this map. Cited by 18 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Saving Babies' Lives Project Impact and Results Evaluation: a Mixed Methodology Study
Who cites it
18 citing papers in PubMed, 57 citations in OpenAlex.
- Awareness of fetal movements and care package to reduce fetal mortality (AFFIRM): a trial-based and model-based cost-effectiveness analysis from a stepped wedge, cluster-randomised trial.BMC pregnancy and childbirth · 2022Trial
- Tommy's Clinical Decision Support Tool: an intervention development and feasibility study to inform a future randomised controlled trial.Pilot and feasibility studies · 2026Article
- Maternity care bundle for UK women with multiple long-term health conditions: coproduction workshops.BMJ open · 2026Article
- Barriers and enablers to the implementation of a perinatal care bundle: the Perinatal Excellence to Reduce Injury in Premature Birth project.Frontiers in pediatrics · 2026Article
- Understanding enablers and barriers to implementing the Safer Baby Bundle: a mixed-methods study with site leads.BMC health services research · 2025Article
- Audit cycle improves the quality of assistance in the management of stillbirth: A 10 years' experience.Pregnancy (Hoboken, N.J.) · 2025Article
- Article
- Evaluating the implementation of the Saving Babies Lives Care Bundle Version 2 from service user and healthcare professionals' perspectives: a questionnaire study.BMJ open quality · 2025Article
- Safer Baby Bundle intervention for reducing perinatal mortality in Ethiopia: a quasi-experimental study.BMJ paediatrics open · 2025Article
- Impact of a dedicated antenatal specialist service for women with a history of stillbirth: the rainbow clinic.BMC pregnancy and childbirth · 2025Article
- Article
- Quality and reporting of large-scale improvement programmes: a review of maternity initiatives in the English NHS, 2010-2023.BMJ quality & safety · 2024Review
- Experiences of antenatal care practices to reduce stillbirth: surveys of women and healthcare professionals pre-post implementation of the Safer Baby Bundle.BMC pregnancy and childbirth · 2024Article
- Quality framework for remote antenatal care: qualitative study with women, healthcare professionals and system-level stakeholders.BMJ quality & safety · 2024Article
- Evaluating patient experience to improve care in a specialist antenatal clinic for pregnancy after loss.BMC pregnancy and childbirth · 2024Article
- Safer Baby Bundle: study protocol for the economic evaluation of a quality improvement initiative to reduce stillbirths.BMJ open · 2022Article
- The Tommy's Clinical Decision Tool, a device for reducing the clinical impact of placental dysfunction and preterm birth: protocol for a mixed-methods early implementation evaluation study.BMC pregnancy and childbirth · 2022Article
- Impact of intrapartum quality improvement interventions on stillbirths: a systematic review and meta-analysis.Therapeutic advances in reproductive healthArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess implementation of the Saving Babies Lives (SBL) Care Bundle, a collection of practice recommendations in four key areas, to reduce stillbirth in England.
designA retrospective cohort study of 463,630 births in 19 NHS Trusts in England using routinely collected electronic data supplemented with case note audit (n = 1,658), and surveys of service users (n = 2,085) and health care professionals (n = 1,064). The primary outcome was stillbirth rate. Outcome rates two years before and after the nominal SBL implementation date were derived as a measure of change over the implementation period. Data were collected on secondary outcomes and process outcomes which reflected implementation of the SBL care bundle.
resultsThe total stillbirth rate, declined from 4.2 to 3.4 per 1,000 births between the two time points (adjusted Relative Risk (aRR) 0.80, 95% Confidence Interval (95% CI) 0.70 to 0.91, P<0.001). There was a contemporaneous increase in induction of labour (aRR 1.20 (95%CI 1.18-1.21), p<0.001) and emergency Caesarean section (aRR 1.10 (95%CI 1.07-1.12), p<0.001). The number of ultrasound scans performed (aRR 1.25 (95%CI 1.21-1.28), p<0.001) and the proportion of small for gestational age infants detected (aRR 1.59 (95%CI 1.32-1.92), p<0.001) also increased. Organisations reporting higher levels of implementation had improvements in process measures in all elements of the care bundle. An economic analysis estimated the cost of implementing the care bundle at ~£140 per birth. However, neither the costs nor changes in outcomes could be definitively attributed to implementation of the SBL care bundle.
conclusionsImplementation of the SBL care bundle increased over time in the majority of sites. Implementation was associated with improvements in process outcomes. The reduction in stillbirth rates in participating sites exceeded that reported nationally in the same timeframe. The intervention should be refined to identify women who are most likely to benefit and minimise unwarranted intervention.
trial registrationThe study was registered on (NCT03231007); www.clinicaltrials.gov.
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