The recent fall in postperinatal mortality in New Zealand and the Safe Sleep programme

Acta Paediatr. 2016 Nov;105(11):1312-1320. doi: 10.1111/apa.13494. Epub 2016 Jul 18.


Aim: Postneonatal mortality rates changed very little from 2000 until recently. There has been a decrease in mortality in New Zealand from 2009 to 2015. This study describes an infant Safe Sleep programme and postulates it is the cause for the recent decrease in deaths.

Methods: The Safe Sleep programme involved as follows: a focus on preventing accidental suffocation, a 'blitz' approach to SUDI education, the targeted provision of portable infant Safe Sleep devices (ISSD) and the development of Safe Sleep policy across all district health boards (DHBs).

Results: Participation in the education 'blitz' by health professionals exceeded one in 23 live births, distribution of Safe Sleep leaflets exceeded two for every live birth, and over 16 500 ISSDs have been distributed to vulnerable infants. Postperinatal mortality fell 29% from 2009 to 2015 (2.8 to 2.0/1000 live births). The fall has been greatest for Māori and in regions with the most intensive programmes.

Conclusion: The recent fall in postperinatal mortality has not happened by chance. It is likely that the components of end-stage prevention strategy, a focus on preventing accidental suffocation, the education 'blitz', the targeted supply of ISSDs and strengthened health policy, have all contributed to varying degrees.

Keywords: Health education; Postperinatal mortality; SUDI; Safe Sleep; Sudden infant death.

MeSH terms

  • Asphyxia / ethnology
  • Asphyxia / mortality
  • Asphyxia / prevention & control*
  • Beds / standards*
  • Beds / supply & distribution
  • Beds / trends
  • Culturally Competent Care / methods
  • Culturally Competent Care / standards*
  • Health Promotion / methods
  • Health Promotion / standards*
  • Humans
  • Infant
  • Infant Equipment / standards
  • Infant Equipment / supply & distribution
  • Infant Equipment / trends
  • Infant Mortality / ethnology
  • Infant Mortality / trends*
  • Infant, Newborn
  • New Zealand / epidemiology
  • Outcome Assessment, Health Care
  • Sleep*
  • Sudden Infant Death / ethnology
  • Sudden Infant Death / prevention & control*
  • Supine Position