Resuscitation of newborns at birth in Australia
Each year, the Australian Institute of Health and Welfare (AIHW) National Perinatal Epidemiology and Statistics Unit publishes their annual report on pregnancy and childbirth in Australia. The report provides national information on women who have given birth and the characteristics and outcomes of their babies.
The annual report provides a “snap shot” of all births and deaths, in addition to data on the number of babies born prematurely and the number of babies requiring special and/ or intensive care following birth. The following outcome data is from the AIHW report: Australia’s Mothers and Babies, 2018. (May 2020)
Outcome data on Australian babies for the year 2018
There were 303,209 births in Australia: 300,911 live births and 2118 stillbirths (fetal deaths)
- 8.7% of infants were born preterm (before 37 completed weeks’ gestation)
- 6.7% of liveborn infants were low birth weight (less than 2500 grams)
- The fetal death (stillbirth) rate was 7.0 per 1000 births
- The neonatal death rate (death of a liveborn infant less than 28 days after birth) was 2.2 per 1000 live births
- The perinatal death rate (death of an infant ≥400 grams/ ≥20 weeks’ gestation up to 28 days of postnatal age) was 9.2 per 1000 births
- Death from a congenital abnormality was the most common reason for perinatal death (30%)
- One in five infants were admitted to a special care nursery or neonatal intensive care unit
The AIHW annual report also includes data on babies Apgar scores at five minutes of age and the types of active resuscitation measures provided at birth. Using this data, it is possible to identify the interventions that newborn babies are most likely to receive and train perinatal staff attending births in these skills accordingly.
In the most recent report published by the AIHW in May, 2020: Australia’s Mothers and Babies, 2018, the following data were reported:
Apgar scores at five minutes of age:
| Of the 300, 911 live births in Australia in 2018 | ||
| Apgar score | % | N= |
| 0-3 | 0.3% | 889 |
| 4-6 | 1.5% | 4,592 |
| 7-10 | 97.9% | 294,583 |
| Not stated | 0.3% | 847 |
Active resuscitation measures at birth
- 81% of newborns did not receive any intervention
- 6.1% received suctioning and/or oxygen*
- 5.7% received intermittent positive pressure ventilation via a mask and self inflating bag or T-piece device.
- 0.6% received endotracheal intubation & intermittent positive pressure ventilation (IPPV)
- 0.2% received external chest compressions and positive pressure ventilation
- 6.7% had other interventions such as stimulation, continuous positive airway pressure, laryngoscopy and tracheal suctioning.
* In the 2020 AIHW report on resuscitation at birth in 2018, the data for “suction” or “oxygen” were pooled- so data on oxygen use were not able to be extracted separately from data on suction.
Implications for neonatal resuscitation training:
- Assistance to establish effective respirations will be required by 6 in every 100 newborn infants in Australia, hence the major focus on operating and troubleshooting positive pressure ventilation devices in this training program
- Less than 1% of Australian newborns will be severely depressed at birth, therefore training in advanced life support interventions such as intubation, umbilical cannulation and administration of medications is not essential for all personnel attending births.
The Australian and New Zealand Committee on Resuscitation (ANZCOR) state:
- All personnel who attend births should be trained in newborn resuscitation skills which include basic measures to maintain an open airway, ventilation via a face mask or supraglottic airway (SGA) device and chest compressions.
- At least one person should be responsible for the care of each newborn
- If it is anticipated that the infant is at high risk of requiring advanced resuscitation, more than one experienced person should be present ( ARC, 2021, Guideline 13.1)