The Midland and North of England Stillbirth Study (MiNESS)

Jayne Platts, Edwin A Mitchell, Tomasina Stacey, Bill L Martin, Devender Roberts, Lesley McCowan, Alexander EP Heazell

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background
The United Kingdom has one of the highest rates of stillbirth in Europe, resulting in approximately 4,000 stillbirths every year. Potentially modifiable risk factors for late stillbirths are maternal age, obesity and smoking, but the population attributable risk associated with these risk factors is small.

Recently the Auckland Stillbirth Study reported that maternal sleep position was associated with late stillbirth. Women who did not sleep on their left side on the night before the death of the baby had double the risk compared with sleeping on other positions. The population attributable risk was 37%. This novel observation needs to be replicated or refuted.

Methods/Design
Case control study of late singleton stillbirths without congenital abnormality. Controls are women with an ongoing singleton pregnancy, who are randomly selected from participating maternity units booking list of pregnant women, they are allocated a gestation for interview based on the distribution of gestations of stillbirths from the previous 4 years for the unit. The number of controls selected is proportional to the number of stillbirths that occurred at the hospital over the previous 4 years.

Data collection: Interviewer administered questionnaire and data extracted from medical records. Sample size: 415 cases and 830 controls. This takes into account a 30% non-participation rate, and will detect an OR of 1.5 with a significance level of 0.05 and power of 80% for variables with a prevalence of 57%, such as non-left sleeping position.

Statistical analysis: Mantel-Haenszel odds ratios and unconditional logistic regression to adjust for potential confounders.

Discussion
The hypotheses to be tested here are important, biologically plausible and amenable to a public health intervention. Although this case–control study cannot prove causation, there is a striking parallel with research relating to sudden infant death syndrome, where case–control studies identified prone sleeping position as a major modifiable risk factor. Subsequently mothers were advised to sleep babies prone (“Back to Sleep” campaign), which resulted in a dramatic drop in SIDS. This study will provide robust evidence to help determine whether such a public health intervention should be considered.
Original languageEnglish
Pages (from-to)171
Number of pages1
JournalBMC Pregnancy and Childbirth
Volume14
Issue number1
DOIs
Publication statusPublished - 21 May 2014
Externally publishedYes

Fingerprint

Stillbirth
England
Sleep
Sudden Infant Death
Pregnancy
Public Health
Mothers
Interviews
Prone Position
Maternal Age
Causality
Sample Size
Population
Medical Records
Pregnant Women
Obesity
Logistic Models
Smoking
Odds Ratio
Observation

Cite this

Platts, J., Mitchell, E. A., Stacey, T., Martin, B. L., Roberts, D., McCowan, L., & Heazell, A. EP. (2014). The Midland and North of England Stillbirth Study (MiNESS). BMC Pregnancy and Childbirth, 14(1), 171. https://doi.org/10.1186/1471-2393-14-171
Platts, Jayne ; Mitchell, Edwin A ; Stacey, Tomasina ; Martin, Bill L ; Roberts, Devender ; McCowan, Lesley ; Heazell, Alexander EP. / The Midland and North of England Stillbirth Study (MiNESS). In: BMC Pregnancy and Childbirth. 2014 ; Vol. 14, No. 1. pp. 171.
@article{b80845c28bc440009d16cd5e93c12a25,
title = "The Midland and North of England Stillbirth Study (MiNESS)",
abstract = "BackgroundThe United Kingdom has one of the highest rates of stillbirth in Europe, resulting in approximately 4,000 stillbirths every year. Potentially modifiable risk factors for late stillbirths are maternal age, obesity and smoking, but the population attributable risk associated with these risk factors is small.Recently the Auckland Stillbirth Study reported that maternal sleep position was associated with late stillbirth. Women who did not sleep on their left side on the night before the death of the baby had double the risk compared with sleeping on other positions. The population attributable risk was 37{\%}. This novel observation needs to be replicated or refuted.Methods/DesignCase control study of late singleton stillbirths without congenital abnormality. Controls are women with an ongoing singleton pregnancy, who are randomly selected from participating maternity units booking list of pregnant women, they are allocated a gestation for interview based on the distribution of gestations of stillbirths from the previous 4 years for the unit. The number of controls selected is proportional to the number of stillbirths that occurred at the hospital over the previous 4 years.Data collection: Interviewer administered questionnaire and data extracted from medical records. Sample size: 415 cases and 830 controls. This takes into account a 30{\%} non-participation rate, and will detect an OR of 1.5 with a significance level of 0.05 and power of 80{\%} for variables with a prevalence of 57{\%}, such as non-left sleeping position.Statistical analysis: Mantel-Haenszel odds ratios and unconditional logistic regression to adjust for potential confounders.DiscussionThe hypotheses to be tested here are important, biologically plausible and amenable to a public health intervention. Although this case–control study cannot prove causation, there is a striking parallel with research relating to sudden infant death syndrome, where case–control studies identified prone sleeping position as a major modifiable risk factor. Subsequently mothers were advised to sleep babies prone (“Back to Sleep” campaign), which resulted in a dramatic drop in SIDS. This study will provide robust evidence to help determine whether such a public health intervention should be considered.",
keywords = "stillbirth, perinatal mortality, perinatal death, Risk Factors, sleep position, reduced fetal movements, fetal growth restriction",
author = "Jayne Platts and Mitchell, {Edwin A} and Tomasina Stacey and Martin, {Bill L} and Devender Roberts and Lesley McCowan and Heazell, {Alexander EP}",
year = "2014",
month = "5",
day = "21",
doi = "10.1186/1471-2393-14-171",
language = "English",
volume = "14",
pages = "171",
journal = "BMC Pregnancy and Childbirth",
issn = "1471-2393",
publisher = "BioMed Central",
number = "1",

}

Platts, J, Mitchell, EA, Stacey, T, Martin, BL, Roberts, D, McCowan, L & Heazell, AEP 2014, 'The Midland and North of England Stillbirth Study (MiNESS)', BMC Pregnancy and Childbirth, vol. 14, no. 1, pp. 171. https://doi.org/10.1186/1471-2393-14-171

The Midland and North of England Stillbirth Study (MiNESS). / Platts, Jayne; Mitchell, Edwin A; Stacey, Tomasina; Martin, Bill L; Roberts, Devender; McCowan, Lesley; Heazell, Alexander EP.

In: BMC Pregnancy and Childbirth, Vol. 14, No. 1, 21.05.2014, p. 171.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The Midland and North of England Stillbirth Study (MiNESS)

AU - Platts, Jayne

AU - Mitchell, Edwin A

AU - Stacey, Tomasina

AU - Martin, Bill L

AU - Roberts, Devender

AU - McCowan, Lesley

AU - Heazell, Alexander EP

PY - 2014/5/21

Y1 - 2014/5/21

N2 - BackgroundThe United Kingdom has one of the highest rates of stillbirth in Europe, resulting in approximately 4,000 stillbirths every year. Potentially modifiable risk factors for late stillbirths are maternal age, obesity and smoking, but the population attributable risk associated with these risk factors is small.Recently the Auckland Stillbirth Study reported that maternal sleep position was associated with late stillbirth. Women who did not sleep on their left side on the night before the death of the baby had double the risk compared with sleeping on other positions. The population attributable risk was 37%. This novel observation needs to be replicated or refuted.Methods/DesignCase control study of late singleton stillbirths without congenital abnormality. Controls are women with an ongoing singleton pregnancy, who are randomly selected from participating maternity units booking list of pregnant women, they are allocated a gestation for interview based on the distribution of gestations of stillbirths from the previous 4 years for the unit. The number of controls selected is proportional to the number of stillbirths that occurred at the hospital over the previous 4 years.Data collection: Interviewer administered questionnaire and data extracted from medical records. Sample size: 415 cases and 830 controls. This takes into account a 30% non-participation rate, and will detect an OR of 1.5 with a significance level of 0.05 and power of 80% for variables with a prevalence of 57%, such as non-left sleeping position.Statistical analysis: Mantel-Haenszel odds ratios and unconditional logistic regression to adjust for potential confounders.DiscussionThe hypotheses to be tested here are important, biologically plausible and amenable to a public health intervention. Although this case–control study cannot prove causation, there is a striking parallel with research relating to sudden infant death syndrome, where case–control studies identified prone sleeping position as a major modifiable risk factor. Subsequently mothers were advised to sleep babies prone (“Back to Sleep” campaign), which resulted in a dramatic drop in SIDS. This study will provide robust evidence to help determine whether such a public health intervention should be considered.

AB - BackgroundThe United Kingdom has one of the highest rates of stillbirth in Europe, resulting in approximately 4,000 stillbirths every year. Potentially modifiable risk factors for late stillbirths are maternal age, obesity and smoking, but the population attributable risk associated with these risk factors is small.Recently the Auckland Stillbirth Study reported that maternal sleep position was associated with late stillbirth. Women who did not sleep on their left side on the night before the death of the baby had double the risk compared with sleeping on other positions. The population attributable risk was 37%. This novel observation needs to be replicated or refuted.Methods/DesignCase control study of late singleton stillbirths without congenital abnormality. Controls are women with an ongoing singleton pregnancy, who are randomly selected from participating maternity units booking list of pregnant women, they are allocated a gestation for interview based on the distribution of gestations of stillbirths from the previous 4 years for the unit. The number of controls selected is proportional to the number of stillbirths that occurred at the hospital over the previous 4 years.Data collection: Interviewer administered questionnaire and data extracted from medical records. Sample size: 415 cases and 830 controls. This takes into account a 30% non-participation rate, and will detect an OR of 1.5 with a significance level of 0.05 and power of 80% for variables with a prevalence of 57%, such as non-left sleeping position.Statistical analysis: Mantel-Haenszel odds ratios and unconditional logistic regression to adjust for potential confounders.DiscussionThe hypotheses to be tested here are important, biologically plausible and amenable to a public health intervention. Although this case–control study cannot prove causation, there is a striking parallel with research relating to sudden infant death syndrome, where case–control studies identified prone sleeping position as a major modifiable risk factor. Subsequently mothers were advised to sleep babies prone (“Back to Sleep” campaign), which resulted in a dramatic drop in SIDS. This study will provide robust evidence to help determine whether such a public health intervention should be considered.

KW - stillbirth

KW - perinatal mortality

KW - perinatal death

KW - Risk Factors

KW - sleep position

KW - reduced fetal movements

KW - fetal growth restriction

U2 - 10.1186/1471-2393-14-171

DO - 10.1186/1471-2393-14-171

M3 - Article

VL - 14

SP - 171

JO - BMC Pregnancy and Childbirth

JF - BMC Pregnancy and Childbirth

SN - 1471-2393

IS - 1

ER -