A care package that aims to reduce the risk of stillbirth only reduces the rate by a small margin, according to a recent study.
The AFFIRM trial tested whether raising awareness about the importance of fetal movement and introducing a consistent care package when women presented reduced fetal movement could reduce stillbirth rates.
The results of the trial concluded that there was only a small marginal drop in stillbirth rate, from 44 in 10,000 births after standard care to 41 in 10,000 births when the care package was implemented.
However, the study found that the induction of labour increased from 35.9% in the control period to 40.7% during the care package trial.
There was also an increase in admissions of babies to special care units for more than 48 hours after the intervention.
The study was a randomised controlled trial which included outcomes of 409,000 pregnancies across 37 maternity units across the UK.
In conclusion, “The intervention package, in its present form, was not effective; it led to a significant increase in interventions and cannot be recommended.
“Other studies on the efficacy of RFM [reduced fetal movement] strategies are ongoing and, together with the AFFIRM findings, will provide the best evidence on the likely effectiveness of RFM awareness as a stillbirth reduction strategy and can help clinicians and policy makers make informed decisions as to how RFM awareness might fit into a stillbirth reduction strategy.”
The study ‘Awareness of fetal movements and care package to reduce fetal mortality (AFFIRM): a stepped wedge, cluster-randomised trial’ was published in The Lancet and can be found here.
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