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What did the project achieve?
This study has led to practical advice for pregnant women, supported by NHS England, being made widely available to help prevent stillbirth.
In this three year study, Professor Alexander Heazell and his team specifically looked at mothers’ sleep positions in late pregnancy in relation to the risk of stillbirth. The study was called the Midlands and North of England Stillbirth Study, or MiNESS.
The MiNESS team worked with 291 women who had experienced a stillbirth and 733 women who had a live birth. The study confirmed findings from earlier studies in New Zealand and Australia that, in the third trimester (after 28 weeks of pregnancy), pregnant women who go to sleep on their back are more likely to have a stillbirth.
After the results were published in the British Journal of Obstetrics and Gynaecology (BJOG) in November 2017, a public health campaign was launched advising women to go to sleep on their side, rather than on their back, in the third trimester of pregnancy. The ‘Sleep on Side’ campaign received wide media coverage. It is estimated that, if all pregnant women in the UK went to sleep on their side in the third trimester, there would be a 3.7% decrease in stillbirth,1 saving around 130 babies’ lives a year.2
This new advice has the potential to save up to 100,000 babies a year internationally, sparing parents from the heartache of stillbirth.
References
1 Heazell, APE et al; Association between maternal sleep practices and late stillbirth – findings from a stillbirth case‐control study. British Journal of Obstetrics and Gynaecologists (BJOG) Volume 125, Issue 2. January 2018. Pgs 254-262
2 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0179396
This research was completed on
Around 3,900 babies are stillborn each year in the UK – 2.6 million worldwide – bringing heartbreak to their bereaved families.1-5 Losing a baby in such tragic circumstances is deeply upsetting and the grief can be overwhelming. Dr Alexander Heazell, of the University of Manchester, is leading a team of researchers who are investigating whether there are things women could do during pregnancy to reduce their chances of experiencing stillbirth and protect their babies.
Action Medical Research, New Zealand charity Cure Kids and Sands are together funding this study.
How are babies’ lives affected now?
“The UK has one of the highest stillbirth rates of high-income countries,6 with around 11 babies being stillborn every day,”1-5 says Dr Heazell. “What’s more, that rate has hardly decreased since 1990.6 Losing a baby in this way is devastating, with long-lasting effects on bereaved parents.”
The death of a baby before birth can be just as painful as losing a child of any other age. It can be hard for parents to know how to cope. Feelings of intense grief, anger and guilt are all common.
Stillbirth often happens unexpectedly, with no obvious explanation. Many parents want to know why their baby has died, whether it might happen again if they try for another baby and what they can do to stop it.
More research into the risk factors for stillbirth is needed before we can give every family affected proper answers to these questions and protect more babies from stillbirth.
How could this research help?
“We hope to identify what we call ‘modifiable risk factors’ for stillbirth,” explains Dr Heazell. These risk factors are things in day-to-day life that increase expectant mothers’ chances of having a stillborn baby that – importantly – the women have the power to alter, either alone or with medical help.
“We believe that identifying, and avoiding, risk factors that are strongly associated with stillbirth will reduce the number of babies who are stillborn,” continues Dr Heazell.
If this research is successful, it could form the basis of a public health campaign advising pregnant women on ways to reduce their chances of stillbirth. “If we found, for example, that drinking a large amount of coffee or sleeping in a particular position was associated with stillbirth we could advise women to avoid doing this. Of course we won’t know this until we’ve completed our research,” explains Dr Heazell.
The ultimate aim is to spare parents from the heartache of stillbirth and save babies’ lives.
References
1. Office for National Statistics. Statistical bulletin: Births in England and Wales, 2012. Key Findings. http://www.ons.gov.uk/ons/rel/vsob1/birth-summary-tables--england-and-wa... Website accessed 28 November 2013.
2. General Register Office for Scotland. (2011) Vital Events Reference Tables 2012 (Section 4: Stillbirths and Infant Deaths), Table 4.1 Live births, stillbirths, perinatal, neonatal, postneonatal and infant deaths, Scotland, 1946 to 2012. http://www.gro-scotland.gov.uk/files2/stats/ve-ref-tables-2012/ve12-t4-1... Website accessed 28 November 2013.
3. Northern Ireland Statistics and Research Agency. Deaths in Northern Ireland 2012. Statistical Bulletin 21 May 2013. http://www.nisra.gov.uk/archive/demography/publications/births_deaths/de... Website accessed 28 November 2013.
4. NHS Choices. Stillbirth. http://www.nhs.uk/conditions/Stillbirth/pages/definition.aspx Website accessed 21 November 2013.
5. Cousens S et al. National, regional, and worldwide estimates of stillbirth rates in 2009 with trends since 1995: a systematic analysis. Lancet 2011; 377(9774): 1319-30.
6. Flenady V et al. Stillbirths 5: Stillbirths: the way forward in high-income countries. Lancet 2011; 377: 1703–17.
| Project Leader | Dr A E P Heazell, MBChB PhD MRCOG |
| Project Team | Professor E Mitchell, BSc MBBS FRACP FRCPCH DSc FRSNZDr T Stacey MA MPH PhDDr W L Martin BMedSci MD MRCOGDr D Roberts MRCOGProfessor L M E McCowan MD FRNZCOG |
| Project Location | Maternal and Fetal Health Research Centre, Institute of Human Development, University of Manchester; Mid-Yorkshire Hospitals NHS Trust |
| Project Location Other | Department of Maternal-Fetal Medicine, Birmingham Women's Hospital NHS Foundation Trust Maternity and Imaging Department, Liverpool Women's Hospital NHS Foundation Trust |
| Project duration | 3 years |
| Date awarded | 2 September 2013 |
| Project start date | 1 October 2013 |
| Project end date | 31 December 2017 |
| Grant amount | £191,080 |
| Grant code | GN2156 |
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