Collaborative Maternity and Newborn Dashboard for the COVID-19 pandemic
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Department of Obstetrics and Gynaecology, University of Melbourne
Collaborative Maternity and
Newborn Dashboard for the
COVID-19 pandemic
Report #5. Period ending 31 Mar 2021
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #4 14th April 2021
Table of Contents
About this report.............................................................................................................. 5
CoMaND members ..................................................................................................................... 5
Ethics and governance ............................................................................................................... 5
Reporting .................................................................................................................................... 5
Funding....................................................................................................................................... 5
Acknowledgments ...................................................................................................................... 6
Contacts ..................................................................................................................................... 6
1. Data summary (Jan 2018-Mar 2021) ......................................................................... 7
1. Total number of babies included in this report ......................................................... 9
2. Total number of pregnancies included in this report................................................. 9
3. Unadjusted stillbirth rate (all gestations) ............................................................... 10
4. Term stillbirth rate (unadjusted) ............................................................................ 10
5. Preterm births < 37 weeks ..................................................................................... 11
6. Preterm births < 32 weeks ..................................................................................... 11
7. Preterm births < 28 weeks ..................................................................................... 12
8. Induction of labour (all births) ............................................................................... 12
9. Elective Caesareans ............................................................................................... 13
10. Emergency Caesareans .......................................................................................... 13
11. Instrumental Delivery ............................................................................................ 14
12. Normal Vaginal Delivery ........................................................................................ 14
13. NICU admissions in level 6 hospitals....................................................................... 15
14. SCN admissions in level 6 hospitals ........................................................................ 15
15. SCN admissions in level 5 hospitals ........................................................................ 16
16. SCN admissions in level 4 hospitals ........................................................................ 16
17. Birthweight < 3rd centile (all gestations) ................................................................ 17
18. Birthweight < 3rd centile > 40 weeks ....................................................................... 17
19. Apgar scores < 7 at 5 minutes in term babies.......................................................... 18
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 202120. Exclusively breast milk fed (unadjusted)................................................................. 18
21. Birthweight > 4000g............................................................................................... 19
22. Birthweight > 90th centile....................................................................................... 19
23. Maternal BMI >=25 ................................................................................................ 20
24. Maternal BMI >=30 ................................................................................................ 20
25. Gestational Diabetes Mellitus (GDM) ..................................................................... 21
26. GDM therapy ......................................................................................................... 21
27. Induction of labour or CS for Preeclampsia / Eclampsia .......................................... 22
28. MBS billings for antenatal attendances by doctor or midwife in Victoria................. 22
29. Born Before Arrival (BBA) ...................................................................................... 23
30. Gestational age at first antenatal visit .................................................................... 23
31. Maternal influenza vaccination coverage ............................................................... 24
32. 3rd and 4th degree perineal tears ............................................................................ 24
33. Episiotomy ............................................................................................................ 25
34. General Anaesthesia for Caesarean births .............................................................. 25
35. Post-partum haemorrhage (Adjusted) .................................................................... 26
36. Severe post-partum haemorrhage >=1500ml.......................................................... 26
37. Maternal Length of Stay (LOS)................................................................................ 27
38. Baby Length of Stay (LOS) ...................................................................................... 28
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 2021Victorian coronavirus data for current report period
Downloaded from https://www.dhhs.vic.gov.au/victorian-coronavirus-covid-19-data on 8th June 2021
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 2021About this report
The COVID-19 pandemic has resulted in a range of major changes to healthcare provision in maternity hospitals across
Victoria to mitigate the anticipated strain on health services and infection risk to patients and health care workers.
The CoMaND project combines routinely collected data from maternity health services in Victoria to produce a
periodic report of key health and service performance indicators during the COVID-19 pandemic. The CoMaND project
is based within the Department of Obstetrics and Gynaecology at the University of Melbourne and is registered with
the Australian and New Zealand Clinical Trials Registry (ACTRN12620000878976).
CoMaND members
The participating health services contributing data to this report are:
• Mercy Health [Mercy Hospital for Women (MWH), Werribee Mercy Hospital (WMH)]
• The Royal Women’s Hospital (RWH), The Women’s at Sandringham (TWS)
• Monash Health [Monash Medical Centre (MMC), Casey Hospital (CH), Dandenong Hospital (DH)]
• Northern Health [The Northern Hospital (TNH)]
• Western Health [Joan Kirner Women’s and Children’s Hospital (JKWCH)]
• Eastern Health [Box Hill Hospital (BHH), Angliss Hospital (AH)]
• Peninsula Health [Frankston Hospital (FH)]
An estimated 44,000 women give birth in these hospitals each year. This fifth CoMaND report captures all public
hospital births in metropolitan Melbourne, including the four level 6 maternity services (MHW, RWH, MMC, JKWCH),
three level 5 services (FH, TNH and BHH) and five level 4 services (WMH, TWS, CH, DH, AH). From October 2020,
JKWCH was upgraded from a level 5 to a level 6 maternity service, and coding of births adjusted accordingly.
Inclusion criteria
All births > 20 weeks at participating maternity hospitals between 1 January 2018 and 31 December 2022 that are
recorded by the hospital maternity data collection system will be collected. Planned homebirths are not captured.
Data sources
The data is extracted from the local health services maternity databases, deidentified and submitted centrally to the
CoMaND database. All hospitals except the Royal Women’s Hospitals use the Birthing Outcomes System (BOS).
Antenatal attendances for the whole of Victoria were calculated from Medicare Billing Statistics for item numbers
16500, 91853, 91858, 16400, 91850 and 91855.
Ethics and governance
Ethics approval was granted by Austin Health (HREC/64722/Austin-2020) and Mercy Health (ref. 2020-031). It is
registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620000878976).
Reporting
This report is distributed to:
• The coordinating principal investigator and site principal investigators
• Chair of the Melbourne Academic Centre for Health, Women’s and Newborn network
• Members of the COVID-19 expert obstetric advisory group to Safer Care Victoria (SCV)
• Senior maternity advisor to SCV / Chair of Consultative Council of Obstetric and Paediatric Morbidity and
Mortality (CCOPMM)
Funding
This project is funded by a philanthropic grant from the Norman Beischer Medical Research Foundation and a
Department of O&G Innovation grant. The investigators have no financial or competing interests for the overall study.
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 2021Study team
Name Role
Lisa Hui Study coordination, design, oversight, data collection, analysis, results
dissemination
Coordinating PI, and site PI for Mercy Health and TNH
Stephanie Potenza Study coordination, design, data collection, analysis, results dissemination
Local CI for MHW, WMH
Kirsten Palmer Site PI for MMC
Study design, data collection, analysis, results dissemination
Daniel Rolnik Study design, data collection, analysis, results dissemination
Ben Mol Study design, data collection, analysis, results dissemination
Joanne Said Site PI for JKWCH Study design, data collection, analysis, results
dissemination
Clare Whitehead Site PI RWH, TWS
Study design, data collection, analysis, results dissemination
Sue Walker Study design, data collection, analysis
Dissemination of results across the Melbourne Academic Centres for Health
Penelope Sheehan Site PI EH
Study design, data collection, analysis, results dissemination
Jolyon Ford Site PI PH
Study design, data collection, analysis, results dissemination
Melvin Barrientos Marzan Research assistant, data cleaning and analysis, report preparation
Acknowledgments
We thank the following hospital staff for their assistance in setting up the data collection within their respective
health services: Tania Fletcher (Mercy Health), Michelle Knight (Monash Health), Lynne Rigg (Royal Women’s
Hospital), Abby Monaghan (Northern Health), Lee-Anne Lynch (Western Health), Pauline Hamilton (Eastern Health),
and Roshanee Perera (Peninsula Health).
Contacts
Coordinating principal investigator
A/Prof Lisa Hui MBBS PhD FRANZCOG CMFM DDU
Department of O&G, University of Melbourne
lisa.hui@unimelb.edu.au Mob. 0426 865 343
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 20211. Data summary (Jan 2018-Mar 2021)
Data period 1 January 2018 – 31 March 2021
Weeks numbered by calendar weeks from 1 Jan 2018 (Sunday-Saturday)
Definition of pre-COVID-19 period = prior to Stage 3 restrictions 31 March 2020 (< week 117 of study period)
Lockdown periods are indicated by grey shading on each chart, corresponding to
• Stage 3 restrictions 31 March to 16 May 2020
• Stage 4 restrictions July 9 to November 20 2020
Weekly outcomes reported as frequency or % of total included births. As the first and last numbered weeks in the
study periods do not contain 7 days, data points for these weeks are not shown in the figures. Figures include
multiple pregnancies unless otherwise indicated.
New indicators in this report
• General Anaesthesia in Caesarean births, post-partum haemorrhage, severe post post-partum
haemorrhage, 3rd and 4th degree perineal tears, episiotomy
See below in section 1.1.5. for full version history of this report.
1.1.1. Table 1. Births by health service Jan 2018–March 2021
Health Service Births % total births
Monash Health 29,655 20.12%
Mercy Health 31,487 21.37%
RWH (Parkville only) 24,778 16.81%
The Women’s at Sandringham 5,105 3.46%
Western Health 19,617 13.31%
Northern Health 11,396 7.73%
Eastern Health 15,712 10.66%
Peninsula Health 9,622 6.53%
Total 147,372 100%
1.1.2. About the charts
The results displayed in run charts with pre-COVID-19 medians to preserve time order of data. Run charts are a simple
analytical tool designed for the early detection of signals of improvement or degradation in a process over time. The
interpretation includes 2 probability-based rules for non-random patterns of data (alpha error of < 0.05)
• Shift = Six or more consecutive points either all above or all below the median
• Trend = Five or more consecutive points all going up or all going down
[Ref. Perla RJ et al. The run chart: a simple analytical tool for learning from variation in healthcare processes MJ Qual
Saf 2011;20:46e51. doi:10.1136/bmjqs.2009.037895]
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 20211.1.3. Significant signals of note during the pandemic period
• Decrease in pre-term births 90th centile (all gestations, and term) and birthweight >4000g
• Decrease in NICU and SCN admissions in Level 6 hospitals, decrease in SCN admissions in Level 5
hospitals
• Decrease in exclusive breastmilk feeding upon discharge
• Increase in maternal BMI > 25 & > 30
• Increase in gestational diabetes
• Decrease in inductions of labour and CS for the indication of pre-eclampsia/eclampsia
• Decrease in 3rd and 4th degree perineal tears, and increase in episiotomy
• Decrease in the use of general anaesthesia for Caesarean births
• Reduction in maternal and baby length of stay
1.1.4. The next report
Our next report (expected July 2021) will cover the period to May 31 2021
1.1.5. Report history
Report release End of data Reporting changes
date period
#1 7 Dec 20 31 Jul 2020 First version
#2 2 Feb 21 30 Nov 2020 RWH data missing August 2020 onwards
Indicator “exclusively breast milk-fed” substituted for “last feed exclusively
from the breast” due to coding issues
New indicator of gestational diabetes created for 2020 births only
“Congenital anomaly” removed as exclusion criteria for all indicators
#3 10 Mar 21 31 Dec 2020 Sensitivity analysis excluding RWH for entire study period provided for
selected indicators
New indicators: Elective CS, Emergency CS, Instrumental Births, Normal
Births, Born Before Arrival
Data display commences from Jan 2019 for better visualisation
Indicators without significant signals omitted for space reasons: preterm
births 32-36w, 28-31w, 20-27w
#4 15 Apr 21 31 Jan 2021 New indicators added (BOS sites only): GDM therapy, maternal length of
stay, baby length of stay
Indicators omitted in this report for space reasons: no labour onset,
Maternal BMI >=25, VBAC, birthweight >-90th centile at term gestation
# 8 Jun 21 31 Mar 2021 Missing data from RWH added (August 8 2020 – March 31 2021) and
sensitivity analyses removed
New indicators: General Anaesthesia for CS, PPH and severe PPH, 3rd and 4th
degree perinatal tears, episiotomy
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 20211. Total number of babies included in this report
2. Total number of pregnancies included in this report
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 20213. Unadjusted stillbirth rate (all gestations)
4. Term stillbirth rate (unadjusted)
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 20215. Preterm births < 37 weeks
6. Preterm births < 32 weeks
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 20217. Preterm births < 28 weeks
8. Induction of labour (all births)
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 20219. Elective Caesareans
10. Emergency Caesareans
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 202111. Instrumental Delivery
12. Normal Vaginal Delivery
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 202113. NICU admissions in level 6 hospitals
14. SCN admissions in level 6 hospitals
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 202115. SCN admissions in level 5 hospitals
16. SCN admissions in level 4 hospitals
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 202117. Birthweight < 3rd centile (all gestations)
18. Birthweight < 3rd centile > 40 weeks
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 202119. Apgar scores < 7 at 5 minutes in term babies
20. Exclusively breast milk fed (unadjusted)
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 202121. Birthweight > 4000g
22. Birthweight > 90th centile
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 202123. Maternal BMI > 25
24. Maternal BMI > 30
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 202125. Gestational Diabetes Mellitus
26. GDM therapy
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 202127. Induction of labour or CS for Preeclampsia /
Eclampsia
28. MBS billings for antenatal attendances by doctor or
midwife in Victoria
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 202129. Born Before Arrival (BBA)
30. Gestational age at first antenatal visit
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 202131. Maternal influenza vaccination coverage
32. 3rd and 4th degree perineal tears
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 202133. Episiotomy
34. General Anaesthesia for Caesarean births
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 202135. Post-partum haemorrhage (Adjusted)
36. Severe post-partum haemorrhage > 1500ml
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 202137. Maternal Length of Stay (LOS)
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 202138. Baby Length of Stay (LOS)
Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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Dashboard for the COVID-19 pandemic report #5 8th June 2021Department of Obstetrics and Gynaecology | Collaborative Maternity and Newborn
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