AFFIRM Study Results

Published on: 28/09/2018

A newly published study, ‘Awareness of fetal movements and care package to reduce fetal mortality (AFFIRM)’ has suggested that women monitoring their baby’s movements during pregnancy only has a marginal effect on preventing stillbirth. This is unexpected news for many, as previous research had indicated that monitoring movements, along with additional checks and early delivery could reduce stillbirth rates by as much as 30%.

Anyone who has worked within the baby loss community hears time and time again of reduced movement being experienced before the loss of a baby. Experts say that around half of women whose pregnancy ends in stillbirth report reduced movements in the womb in the previous week. Jane Brewin, chief executive of baby charity Tommy’s, said: “We know that reduced baby movements is associated with the placenta not working so well and the baby’s health being compromised.
“The advice for mums-to-be remains the same – if your baby’s movements change please consult your midwife or local maternity unit immediately.”

Research is vital in working out what can be done to reduce stillbirths, so the findings are important in looking to the future. We know from previous research that experiencing reduced movements does play a part in an increased risk of stillbirth (see the MiNESS study here), but it’s where that piece of the puzzle fits in with prevention that will be key. We must not revert to old myths about stillbirth being “just one of the things”. We know this isn’t true and that many CAN be prevented. Falling rates of stillbirth following the SBLCB (read more here) show that this is the case.

Prof Joy Lawn, of the London School of Hygiene and Tropical Medicine, who co-authored a recent Lancet study into global figures for stillbirth said: “When a baby is in utero and they stop moving, you have probably already missed the event. The critical thing is more surveillance in pregnancy. It is not ‘if this doesn’t work, nothing works’.”

We understand that early delivery for reduced movements, despite all checks coming back as normal has already been a contentious subject for some midwives. MAMA Academy will shortly be opening a forum specifically for midwives to discuss areas such as this surrounding stillbirth. We strongly believe that midwives on the ground collectively are the people with the knowledge to drive future change. Please get in touch if you are a midwife and would like to be part of our new forum that will be the cornerstone of new projects to help reduce stillbirths in the UK.

You can find a link to the full study here.

The study analysed more than 400,000 pregnancies from 33 hospitals around the UK and Ireland in what is said to be the largest study of fetal movement awareness to date. The results show a marginal drop in the stillbirth rate, from 44 in 10,000 births after standard care to around 41 in 10,000 births with the intervention.

References
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31543-5/fulltext?code=lancet-site
https://bmjopen.bmj.com/content/8/7/e020031
https://www.theguardian.com/lifeandstyle/2018/sep/27/huge-numbers-of-stillborn-babies-may-have-been-missed
http://www.itv.com/news/2018-09-27/more-research-urged-after-bid-to-reduce-stillbirths-sees-marginal-benefits/