Putting theory into practice to reduce stillbirth

Translating analysis into action with immediate impact, Dr Miranda Davies-Tuck turned her study of perinatal mortality into new clinical practices that dramatically reduce rates of stillbirth.

After previously identifying that women of South Asian origin (India, Pakistan, Bangladesh and Sri Lanka) had higher risk of stillbirth in late pregnancy, she recommended earlier fetal monitoring for this group of women, and the results were striking.

Dr Davies-Tuck said that her initial research showed the rate of stillbirth at 39 weeks among women of South Asian origin was equivalent to what it is for the rest of the population at 41 weeks, suggesting that pregnancy length might be shorter for South Asian women.

Recommendations to reduce stillbirth rates

“This work, published in the American Journal of Obstetrics and Gynecology, provides evidence of the first potential intervention to reduce stillbirth in South Asian women and provides an alternative to earlier routine induction of labour,” Dr Davies-Tuck said.

“Following our recommendations, Victoria’s largest maternity service implemented the new clinical guideline to offer South Asian-born women fetal surveillance from 39 weeks instead of 41 weeks, which is the usual practice,” she said.

“There was a 64 per cent reduction in term stillbirth and significant reductions in rates of early neonatal death and special care nursery admission and the rates of stillbirth at term for South Asian women became equivalent to all other women.”

Intervention to reduce stillbirth

“We have not observed a stillbirth at 40 or 41 weeks since its introduction.”

“There were no significant differences in birthweight, admission to the neonatal intensive care unit, or other important measures of maternal and child health.”

“To our knowledge this is the first stillbirth prevention intervention for migrant women globally,” Dr Davies-Tuck said.