Research
The Stillbirth Foundation is pleased to be able to support much-needed research into the causes of stillbirth and thanks those researchers who are committed to ensuring that the stillbirth rate starts to decline in Australia and New Zealand.
Stillbirth Study - a multicentre case-control study
The Stillbirth Foundation Australia continues to support a multi-centre case control stillbirth study, headed by Dr Adrienne Gordon and overseen by Professors Heather Jeffery and Jonathan Morris. The Stillbirth Foundation contributes $75,000 annually to this project that allows for the employment of the research officers who work on this project. The research team are delighted to welcome Angela Carberry and Diana Bond as this year’s research officers.
Angela has recently completed her honours research year at the University of Queensland Perinatal Research Centre and has been accepted in the University of Sydney Masters of Public Health for 2009/10. In addition, she works part-time at the National Perinatal Statistics Unit. Diana obtained her Registered Nurse training in Canada, subsequently specialising in Obstetrics and Gynaecology and high-risk maternity. She is currently employed as part time data manager for the Preterm Prelabour Rupture Of Membranes near Term (PPROMT) trial at Royal North Shore Hospital.
The study commenced in 2006 and aims to recruit 100 stillborn babies and 200 control babies to assess risk factors for unexplained stillbirth by detailed interview, investigations for viral infection and placental examination . It is currently running in 6 Sydney Hospitals with expansion to a further 2 planned for this year. As at February 2009, the study has recruited 31 case studies with 54 matched controls. Of those babies who were stillborn, 65% of families agreed to a post mortem examination which is higher than the overall NSW post mortem rate of 39% for stillborn babies.
A project undertaken alongside this study, carried out by Elizabeth Headley (the Stillbirth Foundation’s funded research officer from last year), Adrienne Gordon and Heather Jeffery was to consider how stillbirths were classified according to the PSANZ Perinatal Mortality Audit Guidelines and whether the suggested core investigations were carried out. All stillbirths that had been delivered at Royal Prince Alfred Hospital (RPAH) between November 2005 and March 2008 were assessed following the introduction of hospital policy which incorporated the PSANZ Guidelines. Prior to the introduction of this policy, 34% of all stillbirths were unexplained compared with an overall unexplained stillbirth rate across NSW of 41%. Following implementation of the new policy, 13% stillbirths born in RPAH remain unexplained. This lower percentage figure of unexplained stillbirth was attributed to the PSANZ Perinatal Mortality Audit Guidelines and found that autopsy and placental examination were the most useful investigations in assisting formal classification of cause of death.
The Perinatal Mortality Audit Guideline incorporating Psychological and Social Aspects of Perinatal Bereavement can be found via this link.
Stillbirth and Viruses
The Stillbirth Foundation Australia has provided $80,000 as a 2009 seeding grant to continue the great work of Professor William Rawlinson and his team of scientists at The Prince of Wales Hospital investigating viruses and stillbirth. Following is a description and update of the study by Jonathan Howard, BSc (Hons), PhD, Postdoctoral Scientist investigating the roles of viruses, bacteria and other infectious agents in stillbirths.
Research Update – South Eastern Area Laboratory Services
The Virology Division of the Microbiology Department of the South Eastern Area Laboratory Services (SEALS) is grateful for the support from the Stillbirth Foundation in providing funding for the Congenital Research Group. The Congenital Research Group is currently conducting several research activities with a focus on congenital infections and stillbirth.
Despite improved obstetric and neonatal care, the rate of stillbirth has been largely unchanged for more than 10 years in Australia, and approximately 40-50% of stillbirths are of unknown cause. However, several infectious agents have been identified as being associated with miscarriage, premature labour and stillbirth. Some babies may be premature or of low birth weight and some may experience developmental problems later in life. In contrast, many live born healthy babies and their mothers may experience the same infections, without severe consequence.
The aims of the Congenital Research Group of the Virology Division are:
- To develop better methods of detecting and diagnosing infection.
- To assess the role of infections in stillbirth, by studying viral and microbial infections in pregnant women and stillborn babies.
- To investigate the way in which infection is transmitted from mother to baby.
- To improve understanding of the causes of stillbirth in the long term.
- To identify potential risk factors for stillbirth, and provide more accurate clinical information, about infection in pregnancy that will allow appropriate decisions to be made by both parents and doctors.
This research would not be possible without the support from Stillbirth Foundation. Equally important is the time and support of doctors, neonatologists, midwives, scientists and obstetricians. Most important, however, is the support of parents and we acknowledge the generosity of parents and families who take time to consider participating in research, in the busy, emotional time surrounding the birth of a baby. Working together, we can improve our knowledge about infection in pregnancy and ultimately improve outcomes for babies, mothers and families.
Autopsy Study 2007
The Stillbirth Foundation was fortunate to be able to assist a study in Queensland that considered the decision making process of parents in relation to autopsy. This was presented as a poster at the International Stillbirth Alliance's Conference in Birmingham in October 2007. To download the poster, please follow this Autopsy Study link.
Stillbirth Literature Review
In July 2007, the Stillbirth Foundation is thrilled to have part funded a stillbirth literature review to be conducted by Dr Vicki Flenady of the Mater Mother's Hospital Brisbane in partnership with ANZSA. This study has cost $47,000 and will involve a review of all the available published studies into stillbirth throughout the world. Surprisingly this review has not been done before and has been met with much admiration and support from the international stillbirth community. From this review, Dr Vicki Flenady plans to discover what is known as a risk factor for stillbirth, what has been proven not to be, and what areas need further research. This information will enable the Stillbirth Foundation more effectively fund the most needed stillbirth studies and may allow for a parent advocacy program into the causes of stillbirth.