Research priorities for stillbirth: process overview and results from <scp>UK</scp> Stillbirth Priority Setting Partnership

Heazell, Alexander; Whitworth, Melissa; Whitcombe, Jo; Glover, Steven William; Bevan, Charlotte L.; Brewin, Jane; Calderwood, Carmelita; Canter, Andrew; Jessop, F. A.; Johnson, Gail; Martin, Isobel; Metcalf, Leanne

doi:10.1002/uog.15738

Cited by 78 publications

(98 citation statements)

References 21 publications

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“…Although the ISA project is in progress, preliminary data support the Lancet Stillbirths Series and a recent UK project. 103 Major topics included: stillbirth prevention by application of tests and development of novel investigations for optimum timing of delivery, the need to increase understanding of placental pathways in stillbirth and the causes of unexplained stillbirth, optimum bereavement care, and subsequent pregnancy care.…”

Section: The Research Agendamentioning

confidence: 99%

Stillbirths: recall to action in high-income countries

et al. 2016

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Variation in stillbirth rates across high-income countries and large equity gaps within high-income countries persist. If all high-income countries achieved stillbirth rates equal to the best performing countries, 19 439 late gestation (28 weeks or more) stillbirths could have been avoided in 2015. The proportion of unexplained stillbirths is high and can be addressed through improvements in data collection, investigation, and classification, and with a better understanding of causal pathways. Substandard care contributes to 20-30% of all stillbirths and the contribution is even higher for late gestation intrapartum stillbirths. National perinatal mortality audit programmes need to be implemented in all high-income countries. The need to reduce stigma and fatalism related to stillbirth and to improve bereavement care are also clear, persisting priorities for action. In high-income countries, a woman living under adverse socioeconomic circumstances has twice the risk of having a stillborn child when compared to her more advantaged counterparts. Programmes at community and country level need to improve health in disadvantaged families to address these inequities.

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Section: The Research Agendamentioning

confidence: 99%

Stillbirths: recall to action in high-income countries

et al. 2016

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“…Since 2005, the number of patient safety incidents involving multiple pregnancies, including unexpected stillbirth and neonatal death, has risen by 419% in UK, and peaked in 2013-14, resulting in payouts of over £90m ($117m, €105m) 45 The recent global drive to prevent stillbirth has highlighted multiple pregnancy as a major risk factor in high income countries,6 with calls to prioritise evaluation of timing of delivery and outcomes in twin pregnancies 7…”

Section: Introductionmentioning

confidence: 99%

Prospective risk of stillbirth and neonatal complications in twin pregnancies: systematic review and meta-analysis

Cheong-See

Schuit

Arroyo-Manzano

et al. 2016

BMJ

188

150

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Objective To determine the risks of stillbirth and neonatal complications by gestational age in uncomplicated monochorionic and dichorionic twin pregnancies.Design Systematic review and meta-analysis.Data sources Medline, Embase, and Cochrane databases (until December 2015). Review methods Databases were searched without language restrictions for studies of women with uncomplicated twin pregnancies that reported rates of stillbirth and neonatal outcomes at various gestational ages. Pregnancies with unclear chorionicity, monoamnionicity, and twin to twin transfusion syndrome were excluded. Meta-analyses of observational studies and cohorts nested within randomised studies were undertaken. Prospective risk of stillbirth was computed for each study at a given week of gestation and compared with the risk of neonatal death among deliveries in the same week. Gestational age specific differences in risk were estimated for stillbirths and neonatal deaths in monochorionic and dichorionic twin pregnancies after 34 weeks’ gestation.Results 32 studies (29 685 dichorionic, 5486 monochorionic pregnancies) were included. In dichorionic twin pregnancies beyond 34 weeks (15 studies, 17 830 pregnancies), the prospective weekly risk of stillbirths from expectant management and the risk of neonatal death from delivery were balanced at 37 weeks’ gestation (risk difference 1.2/1000, 95% confidence interval −1.3 to 3.6; I2=0%). Delay in delivery by a week (to 38 weeks) led to an additional 8.8 perinatal deaths per 1000 pregnancies (95% confidence interval 3.6 to 14.0/1000; I2=0%) compared with the previous week. In monochorionic pregnancies beyond 34 weeks (13 studies, 2149 pregnancies), there was a trend towards an increase in stillbirths compared with neonatal deaths after 36 weeks, with an additional 2.5 per 1000 perinatal deaths, which was not significant (−12.4 to 17.4/1000; I2=0%). The rates of neonatal morbidity showed a consistent reduction with increasing gestational age in monochorionic and dichorionic pregnancies, and admission to the neonatal intensive care unit was the commonest neonatal complication. The actual risk of stillbirth near term might be higher than reported estimates because of the policy of planned delivery in twin pregnancies.Conclusions To minimise perinatal deaths, in uncomplicated dichorionic twin pregnancies delivery should be considered at 37 weeks’ gestation; in monochorionic pregnancies delivery should be considered at 36 weeks.Systematic review registration PROSPERO CRD42014007538.

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“…Priority partnership initiatives focused on developing research priorities for preterm birth (14), miscarriage, and stillbirth (15) exist in the United Kingdom. Canadian health research funding bodies and organizations are including patient-oriented research as key components of both Federal—Canadian Institutes of Health Research (CIHR) and Provincial—Alberta Health Services (AHS) strategic plans.…”

Section: Introductionmentioning

confidence: 99%

Study Protocol: Determining Research Priorities of Young Albertan Families (The Family Research Agenda Initiative Setting Project—FRAISE)—Participatory Action Research

Bright

Ginn

Keys

et al. 2018

Front. Public Health

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Introduction: Pregnancy and childrearing can be an exciting and stressful time for new parents. The maternal-child health landscape has changed dramatically over the last few decades and research priorities need to address these rapid changes. There have been limited attempts to engage and collaborate with members of the public to develop research priorities for families who are expecting or parenting an infant to age 24 months. The work that has been completed has attempted to identify parental preference for information delivery and barriers to uptake of parenting programs but has not investigated parental research priorities.Methods: In collaboration with provincial research units and strategic clinical networks (SCN), we will use principles of participatory action research (PAR) as our theoretical framework/method, and a modified James Lind Alliance priority setting approach to prioritize a list of research questions that parents/knowledge users believe will support the health of their families. This will result in a top 10 list of parent/knowledge user-identified research priorities. This project will consist of three phases. In the first phase, we developed a steering committee of parents/knowledge users, healthcare providers, community agencies, and researchers to design a survey about health priorities for families. In the second phase, we will distribute the survey to diverse groups of parents/knowledge users/providers and hold a series of meetings to identify and prioritize potential questions from new parents about health issues from conception to age 24 months. In the third phase, we will collaboratively disseminate and translate findings.Discussion: This study will highlight parental health concerns and recommend parent-identified research priorities to inform future research projects needed to support the health of families between conception to age 24 months. Understanding the health research priorities of families in the community will help ensure future research contributes to meaningful changes in the health of young children, parents/knowledge users, and families.Ethics: This study and protocol have received ethical approved from the Conjoint Health Research Ethics Board at the University of Calgary (REB17-0014).Dissemination: The top 10 research priorities will be published and additional findings from the study will be distributed through pamphlets and newsletters.

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Research priorities for stillbirth: process overview and results from UK Stillbirth Priority Setting Partnership

Cited by 78 publications

References 21 publications

Stillbirths: recall to action in high-income countries

Stillbirths: recall to action in high-income countries

Prospective risk of stillbirth and neonatal complications in twin pregnancies: systematic review and meta-analysis

Study Protocol: Determining Research Priorities of Young Albertan Families (The Family Research Agenda Initiative Setting Project—FRAISE)—Participatory Action Research

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