Priority Area One

Improving care and outcomes for women with risk factors for stillbirth

Priority Area One leads: Professor Vicki Flenady, Professor David Ellwood, Dr Adrienne Gordon

 

This priority area focuses on research to enable informed decision-making in the care of women during pregnancy to avoid stillbirth and other adverse newborn outcomes. The current lack of an individualised evidence-based approach to a woman’s risk status has resulted in concerning increases in early term and late preterm birth. Indigenous and other disadvantaged groups often have constellations of risk factors (e.g. obesity, smoking, substance use, inadequate nutrition) and poor antenatal care attendance. We will develop interventions to enhance culturally appropriate, accessible antenatal care to improve outcomes. In collaboration with the Perinatal Society of Australia and New Zealand (PSANZ) and the Stillbirth Foundation Australia, we have developed a suite of resources for women and clinicians across maternity hospitals to promote best practice in the care of women with Decreased Fetal Movements (DFM). We are also testing a mobile phone program for women to help raise awareness of DFM (the "My Baby’s Movements" trial - see study information below).

In collaboration with PSANZ, we will develop a clinical guideline with an educational program on best practice in antenatal detection and management of fetal growth restriction. Through our international collaborations, we will be pursuing the role of maternal sleep position practices to reduce the risk of stillbirth. We will also undertake research examining the performance of tests to predict stillbirth.

  • The My Baby's Movements (MBM) trial

    Leads: Professor Vicki Flenady, Dr Glenn Gardener

    mbm2My Baby’s Movements (MBM) is a mobile phone program delivered through an interactive app and SMS. The program is designed to help women understand their baby’s movements and encourages prompt contact with health care providers if any concerns arise. The study design is a stepped wedge cluster randomised controlled trial.

    >>Download MBM flyer

  • Preventing Term Stillbirth in South Asian Born Mothers

    Leads: Professor Euan Wallace, Dr Miranda Davies-Tuck

    Despite decreases in the rates of both neonatal death and SIDS, the rate of stillbirth has remained largely unchanged in Australia for well over a decade. One group of women who have a much higher rate of stillbirth than other women giving birth in Australia are south Asian born women. My studies have shown that not only is the rate of stillbirth at the end of pregnancy significantly higher in South Asian women (i.e. India, Pakistan, Sri Lanka, Afghanistan and Bangladesh) than Australian-born women, the rate also increases earlier in pregnancy and more rapidly. This difference appears to be due to “accelerated placental ageing” in south Asian born women such that South Asian born women have shorter pregnancies and are more likely to have signs of fetal compromise at the end of pregnancy. Most maternity hospitals offer induction of labour or fetal surveillance for women whose pregnancy extends beyond 41 weeks. This is to reduce the risk of stillbirth. However, this may be too late for South Asian women.

    This project aims to assess the impact of a new clinical guideline of surveillance or induction of labour for South Asian women at 39 weeks.