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10/07/2015
The research, which has been published in The Obstetrician & Gynaecologist (TOG), looked at strategies to prevent stillbirth. Stillbirth can be associated with congenital abnormalities, maternal health conditions, fetal growth restriction, maternal infections during pregnancy and complications during childbirth.
Professor Gordon Smith, from the University of Cambridge and the author of the report, said that maternal risk factors include if a mother is over the age of 40, smoking, obesity and if it is a first baby.
He said that women should be encouraged to address certain risk factors – such as smoking – however, the only way to prevent antepartum stillbirth (in an otherwise apparently healthy infant) is to induce delivery.
However, he explained: "Of course this requires identifying women at high risk and needs to be balanced against the risks inherent in early delivery and preterm birth.
"We know that careful and timely monitoring of SGA babies using ultrasound measurements of placental blood flow helps reduce the risk of death. However, routine care currently identifies less than a quarter of SGA babies prior to delivery, so better ways of screening for SGA are urgently required."
Professor Smith added that while various suggestions had been made to prevent stillbirth, like women with a high risk of preeclampsia taking low dose aspirin, the potential impact of the interventions on the overall rates of stillbirth was "limited".
Commenting on the review, Louise Silverton, Director for Midwifery at the Royal College of Midwives (RCM), said: "There is a clear need for further research in this area. It is important that these studies are large enough to demonstrate the effectiveness (or not) of the intervention.
"Stillbirth rates are low in the UK, but they could and should be even lower. There is a pressing need to address some of the underlying factors that contribute to poor health and lifestyle choices, such as smoking and obesity that can have an impact on stillbirth rates. This includes tackling poverty and social exclusion."
She continued: "There is also a pressing need to for maternity services to be reaching out to those women who are only engaging with maternity services late into their pregnancy or are poor attenders at appointments."
Ms Silverton said midwives also need time to carry out a thorough initial assessment of a woman, with ongoing risk assessments during pregnancy. Women also need to be aware of the normal pattern of fetal movement for their baby and to tell someone if this changes.
"Continuity of care and of carer can play a crucial part in further reducing stillbirth rates," she concluded.
The full review can be read here.
(JP)
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Improved Monitoring Would Reduce Stillbirth Risk – Review
A new review has said that an improvement in monitoring pregnant women would reduce the risk of stillbirth.The research, which has been published in The Obstetrician & Gynaecologist (TOG), looked at strategies to prevent stillbirth. Stillbirth can be associated with congenital abnormalities, maternal health conditions, fetal growth restriction, maternal infections during pregnancy and complications during childbirth.
Professor Gordon Smith, from the University of Cambridge and the author of the report, said that maternal risk factors include if a mother is over the age of 40, smoking, obesity and if it is a first baby.
He said that women should be encouraged to address certain risk factors – such as smoking – however, the only way to prevent antepartum stillbirth (in an otherwise apparently healthy infant) is to induce delivery.
However, he explained: "Of course this requires identifying women at high risk and needs to be balanced against the risks inherent in early delivery and preterm birth.
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"We know that careful and timely monitoring of SGA babies using ultrasound measurements of placental blood flow helps reduce the risk of death. However, routine care currently identifies less than a quarter of SGA babies prior to delivery, so better ways of screening for SGA are urgently required."
Professor Smith added that while various suggestions had been made to prevent stillbirth, like women with a high risk of preeclampsia taking low dose aspirin, the potential impact of the interventions on the overall rates of stillbirth was "limited".
Commenting on the review, Louise Silverton, Director for Midwifery at the Royal College of Midwives (RCM), said: "There is a clear need for further research in this area. It is important that these studies are large enough to demonstrate the effectiveness (or not) of the intervention.
"Stillbirth rates are low in the UK, but they could and should be even lower. There is a pressing need to address some of the underlying factors that contribute to poor health and lifestyle choices, such as smoking and obesity that can have an impact on stillbirth rates. This includes tackling poverty and social exclusion."
She continued: "There is also a pressing need to for maternity services to be reaching out to those women who are only engaging with maternity services late into their pregnancy or are poor attenders at appointments."
Ms Silverton said midwives also need time to carry out a thorough initial assessment of a woman, with ongoing risk assessments during pregnancy. Women also need to be aware of the normal pattern of fetal movement for their baby and to tell someone if this changes.
"Continuity of care and of carer can play a crucial part in further reducing stillbirth rates," she concluded.
The full review can be read here.
(JP)
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