Stillbirth and other pregnancy complications: predicting who’s at risk

Research Training Fellowship*: Dr Lucy E Higgins

Around 4,000 babies are stillborn each year in the UK, over 60,000 are born prematurely and many others stop growing properly within the womb.^1-7 Dr Lucy Higgins, of the University of Manchester, is looking for a way to identify these babies during pregnancy so they can get early help. She is taking her lead from the fact that many women who suffer a stillbirth say their baby moved around less than usual in the hours or days before they experienced their tragic loss.

What is the problem and who does it affect?

“Up to 15 per cent of pregnant women notice at least once during their pregnancy that their baby has stopped moving around as much as usual,” says Dr Higgins.^8,9 “This causes much anxiety. For most babies, it turns out to be nothing to worry about. A few, though, are not so lucky. Some stop growing properly within the womb, some are born prematurely and some, sadly, are stillborn.”

“If an expectant mother notices changes in her baby’s movement patterns, we can check the health of the baby by monitoring its heart rate and performing an ultrasound scan. This tells us whether the baby is OK right now. Unfortunately though, for most pregnant women, we can’t predict whether their baby will stay healthy as the pregnancy continues.”

What is the project trying to achieve?

Dr Higgins is looking for a way to predict whether a baby is at risk if their mother notices it has stopped moving around as much as usual in the womb.

She is investigating the potential of two possible tests: analysing blood samples taken from the mother and performing ultrasound scans to check the health of the placenta. Around 300 pregnant women are taking part in her study.

Dr Higgins explains: “If our new tests could identify which babies are likely to go on to be stillborn, born prematurely, or stop growing properly, then we’d have a vital window of opportunity. Those babies could be monitored closely during the rest of the pregnancy and, if they seem in danger, they could be delivered early.”

What are the researchers’ credentials?

Dr Higgins is a talented young doctor near the beginning of her career. “Throughout this fellowship, my supervisors, who are leading experts in this line of research, will provide support that is second to none,” she explains.

“It is always a privilege to be involved in a woman’s journey through pregnancy, when extremes of human emotion can be experienced – from the elation of a healthy birth to the devastation of bereavement through stillbirth. Knowing that my work could make the journey through pregnancy safer for babies is absolutely fantastic.”

* Research Training Fellowships:

Each year, Action Medical Research awards these prestigious grants to help the brightest and best doctors and scientists develop their career in medical research.

References

1. Office of National Statistics Release 10 October 2012 Childhood Mortality statistics: Childhood, infant and perinatal 2010, Childhood, Infant and Perinatal mortality in England and Wales, Table 1

http://www.ons.gov.uk/ons/publications/re-reference-tables.html?edition=...

Stillbirths  in England and Wales = 3,714 in 2010

2. Northern Ireland Registrar. (2011) General Annual Report 2011 (Section 4: Stillbirths and Infant Deaths, Table 4.1, Stillbirths numbers and rates, 1961-2011. http://www.nisra.gov.uk/archive/demography/publications/annual_reports/2... Stillbirths in N. Ireland = 91 in 2011

3. General Register Office for Scotland. (2011) Vital Events Reference Tables 2011 (Section 4: Stillbirths and Infant Deaths), Table 4.1  Live births, stillbirths, perinatal, neonatal, postneonatal and infant deaths, Scotland, 1946 to 2011. Infant deaths in Scotland = 299 in 2011. http://www.gro-scotland.gov.uk/statistics/theme/vital-events/general/ref... [Accessed on 1February2013]

Estimated number of stillbirths per year for the UK = 3714+91+299 = 4104. Note: this figure is calculated from figures from single years, i.e. 2010 for England and Wales and 2011 for N. Ireland and Scotland.

4. Office of National Statistics. (24 Jan 2013) Live births in England and Wales by characteristics of the mother 1, 2011 [Online]. Available from http://www.ons.gov.uk/ons/search/index.html?newquery=Birth+Summary+Table... [Accessed: 25 January 2013] No. of live births = 723,913

5. Northern Ireland Statistics and Research Agency Registrar General Annual Report 2011 (Section 3 Births, Table 3) [Online] Available from http://www.nisra.gov.uk/demography/default.asp98.htm [Accessed: 25 January 2013]. No. of live births = 25,273

6. General Register Office for Scotland Vital Events Reference Tables 20011 (Section 3 Births; Table 3.1b) [Online]. Available from http://www.gro-scotland.gov.uk/statistics/theme/vital-events/general/ref... [Accessed 25 January 2013]. No. of live births = 58,590

7. Office of National Statistics News Release 24 July 2007. Pre term birth data (2005) - 7.7% live births in England and Wales are born preterm (before 37 weeks gestation). [Online] Available from http://www.ons.gov.uk/ons/publications/re-reference-tables.html?edition=... [Accessed 25 January 2013]

Preterm birth, defined as childbirth occurring at less than 37 completed weeks or 259 days of gestation http://www.who.int/bulletin/volumes/88/1/08-062554/en/

Calculation made by Action Medical Research based on figures in references 4-7 for the total number of live births a year in the UK and the percentage of all preterm live births in England and Wales, respectively. Estimate assumes incidence of premature live birth is the same for the UK overall as it is for England and Wales.

Total no. of live births in UK = 723,913 + 25,273 + 58,590 = 807,776

Estimated number of premature live births in UK = 807,776 x 7.7% = 62,199

8. Sergent F et al. Gynecol Obstet Fertil 2005; 33:861-9.

9. Froen JF et al. J Perinat Med 2004; 32:13-24.