Threefold increase in stillbirth when sleeping on back in pregnancy

Threefold increase in stillbirth when sleeping on back in pregnancy

Researchers have shown that pregnant women can lower the risk of stillbirth by sleeping on their side and NOT on their back.

Now the finding forms part of official NHS guidance designed to bring about reductions in the number of babies who are stillborn in the UK - amounting to nine a day, or one in every 225 births.

This study included 851 bereaved mothers and 2,257 women with ongoing pregnancy and has now resulted in a multi-authored article available in EClinicalMedicine, published by The Lancet. Systematic searches were undertaken for an individual-level participant data (IPD) meta-analysis of case–control studies, prospective cohort studies and randomised trials undertaken up until 26 Jan, 2018, that reported data on maternal going-to-sleep position and stillbirth. Participant inclusion criteria included gestation ≥ 28weeks', non-anomalous, singleton pregnancies. The primary outcome was stillbirth.

The chief finding is that going to sleep lying on the back from 28 weeks of pregnancy increased the risk of stillbirth by 2.6 times. This heightened risk occurred regardless of the other known risk factors for stillbirth.

There were no significant interactions between supine going-to-sleep position and assessed indicators of fetal vulnerability, including small-for-gestational-age infants, maternal obesity, and smoking.

Going-to-sleep on left or right side appears equally safe. No significant interactions with our assessed indicators of fetal vulnerability were identified, therefore, supine going-to-sleep position can be considered a contributing factor for late stillbirth in all pregnancies. This finding could reduce late stillbirth by 5.8% if every pregnant woman ≥ 28weeks' gestation settled to sleep on her side.

"The next phase is to ensure that there is consistent advice from healthcare professionals and we will be looking to see if there are ways of helping to support women to sleep in the side position.

"Only a small proportion of women will be affected," continued the author. "But the studies that we did following the first findings suggested that women were quite happy to change their going to sleep position if it was better for their babies."