Priority Area Four

Improving knowledge of causes and contributors to stillbirth

Priority Area Four leads: Professor Vicki Flenady, Professor Jeremy Oats, Ms Jessica Sexton

Knowledge of the causes and contributing factors in stillbirth is crucially important to parents to understand why their baby died and is also the cornerstone of future prevention of stillbirths. Contributing factors relating to care are identified in a small, but important, proportion of stillbirths. Currently, data quality to understand the important contributors for stillbirth is often suboptimal due to under-investigation, inadequate classification and clinical audit of the circumstances surrounding the death.

Priority area four focuses on developing an evidence-based stillbirth investigation protocol and enhancing the existing Perinatal Society of Australia and New Zealand stillbirth and neonatal deaths classification system and audit mechanisms. The CRE is linking with the Australian Institute of Health and Welfare (AIHW) through its recently established National Maternal and Perinatal Mortality Advisory Group to optimise future implementation. With international collaborators (through ISA and WHO) it will also inform the development of international solutions.

  • Interventions for investigating and identifying the causes of stillbirth: a Cochrane systematic review

    Lead: Dr Aleena Wojcieszek

    Understanding of the causes of stillbirth is at the cornerstone of prevention. Diagnostic tests aim to find the causes of stillbirth, but there are a myriad of tests available and no consensus on the best approach to using these tests. This review assesses the effect of different tests, protocols or guidelines for investigating and identifying the causes of stillbirth on outcomes for parents, including psychosocial outcomes, economic costs, and rates of diagnosis of the causes of stillbirth.

    The review has been published in the Cochrane Database of systematic reviews and can be accessed here.

  • Causes of stillbirth and neonatal death: developing a classification system for high-income countries

    Lead: Prof Vicki Flenady

    In this project we aim to develop a system for classifying the causes of stillbirths and neonatal deaths in data-rich settings (high-income countries and upper-middle income countries). Three workshops have been held to gather global experts in perinatal death classification, as part of the recent International Stillbirth Alliance conferences (Cork, 2017; Glasgow 2018; Madrid 2019). A draft system is under development and is on track to be pilot-tested in 2020.

  • Investigating the causes of stillbirth; a prospective cohort study examining use and effectiveness of a comprehensive investigation protocole causes of stillbirth

    Leads: Professor Vicki Flenady, Dr Glenn Gardener

  • Placental causes and associated findings in stillbirth classification systems

    Lead: Prof Yee Khong

  • Quality of autopsy in Australia

    Lead: Ms Tania Marsden