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.
Stillbirth Study - a multicentre case-control study
The Sydney Stillbirth Study was a population-based matched case control study of pregnant women > 32 weeks gestation booked into tertiary maternity hospitals in metropolitan Sydney between January 2006 and December 2011. Data collection was performed using semi-structured in depth interviews, standard and molecular tests for infection, and placental histopathology. The study recruited 103 cases and 192 controls. Results to date show that significantly more stillborn infants were identified as having fetal growth restriction durign pregnancy (aOR 7.4 95% CI 2.0-28) as well as being small for gestational age at birth (aOR 3.1 95% CI 1.1-8.8). Mothers of stillborn infants were more likely to sleep on their back in late pregnancy (aOR 4.34, 95% CI 1.2,16.0). Results for infection and placental pathology are currently being collated. Interview data can provide detailed information on known and potential risk factors for stillbirth and is acceptable to families. Idenfitication and management of growth restriction in late pregnancy remains a signficant opportunity for stillbirth prevention and maternal sleep position deserves further investigation. Dr Adrienne Gordon, 31 May 2012PSANZ Perinatal Mortality Audit Guidelines use at RPAHA project undertaken alongside the Sydney Stillbirth Study, 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:
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.