1. To identify modifiable risk factors for late stillbirth amenable to public health campaigns.
2. In particular to confirm/refute the novel findings regarding maternal sleep factors, including maternal sleep position and risk of late stillbirth identified by the Auckland Stillbirth Study.
3. To clarify the relationship between altered patterns of fetal movements and risk of late stillbirth.
4. To explore the interaction between maternal sleep variables, infant factors (such as fetal growth restriction (FGR), reduced fetal movements) and risk of late stillbirth.
||Study design: Case-control study.
Cases: Women with singleton pregnancies and late stillbirth (not due to congenital abnormality) recruited from 40 obstetric units in the Midlands and the North of England.
Controls: Women with singleton ongoing pregnancies, recruited to match the gestation and hospital of birth of the stillbirths.
Methods: Interviewer administered questionnaire which asks many questions regarding potential modifiable factors associated with stillbirth. Interviews will be conducted by trained midwives (cases) or nurses/midwives (controls).
|Countries of Recruitment
|Target number of participants
||The UK has one of the highest rates of stillbirth in high-income countries, with more than 3,600 stillbirths every year. The rate of stillbirth has decreased very little over the last 20 years, which urgently needs addressing. Over the same time period identification of preventable factors amenable to public health campaigns have reduced mortality from sudden infant death syndrome. The most efficient way to identify modifiable factors is a case-control study.
A recent case-control study investigating modifiable factors associated with stillbirth (the Auckland Stillbirth Study) found that mothers who did not go to sleep on their left side had a two-fold risk of late stillbirth (≥28 weeks gestation) compared to mothers who did go to sleep on their left side. To infer causality, investigation in several populations is required, hence these novel findings need confirmation before an intervention strategy can be implemented
This study aims to confirm or refute the findings of the Auckland Stillbirth Study with regard to sleep practices and any potential interaction with reduced fetal movements or fetal growth restriction. Participants will be recruited from maternity units in the Midlands and North of England. We aim to interview 291 women with a singleton late stillbirth without congenital abnormality and a control group of 582 women with ongoing pregnancies at a gestation matched to that at which stillbirths occurred.
These data will increase our understanding modifiable factors in late stillbirth including maternal sleep position, reduced fetal movements, fetal growth restriction and stillbirth. This will determine whether an intervention study should be considered. If there is a causal relationship between maternal sleep position and late stillbirth we estimate that up to 37% of late stillbirths might be prevented.
||Action Medical Research- £191,000
|Ethics Board Approval
||13/NW/0874- NRES Committee North West - Greater Manchester Central
|Study contact name
||Jayne Budd Lead Research Midwife
||The University of Manchester
||Dr Alexander Heazell. Senior Clinical Lecturer and Honorary Consultant in Obstetrics, Clinical Director of the Tommy's Research Centre (University of Manchester)
Professor Ed Mitchell. Professor of Child Health Research (University of Auckland). Department of Paediatrics, University of Auckland.
Dr Tomasina Stacey. Lecturer in Maternal care. Univerity of Leeds.
Dr Bill Martin. Consultant in Maternal Fetal Medicine (NHS) Birmingham Women’s Hospital.
Dr Devender Roberts. Consultant in Obstetrics and Fetal Medicine. Maternity and Imaging Dept. Liverpool Women’s Hospital.
Professor Lesley McCowan. Head of Department of Obstetrics and Gynaecology. University of Auckland.
|(expected) Year of completion
|Citation details of journal articles
||Platts J, Mitchell EA, Stacey T, Martin BL, Roberts D, McCowan L, Heazell AE: The Midland and North of England Stillbirth Study (MiNESS). BMC Pregnancy Childbirth. 2014, 14: 171-10.1186/1471-2393-14-171.