My Baby’s Movements: a stepped wedge cluster randomised controlled trial to raise maternal awareness of fetal movements during pregnancy study protocol

My Baby’s Movements: a stepped wedge cluster randomised controlled trial to raise maternal awareness of fetal movements during pregnancy study protocol

Warrilow Kara (1), Gordon Adrienne (1,2), McCudden Lucy (2), Boyle Fran (1), Ellwood David (1,3), Middleton Philippa (4), Flenady Vicki (1)

1) Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Australia; 2) Royal Prince Alfred Hospital, University of Sydney, Sydney Medical School New South Wales, Australia; 3) School of Medicine, Griffith University, Gold Coast, Australia; 4) SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia.

Background:
Stillbirth remains a major global public health burden. Recent research suggests that
supine sleeping in the last trimester of pregnancy increases the risk of stillbirth. Public awareness
campaigns to support side sleeping could provide women with advice on how to change this
modifiable risk factor. The aim of this study was to determine current awareness and practices
around sleep position in pregnant women in Australia to inform future public awareness campaigns.

Methods:
A 27-question online survey was undertaken from November 2017 to January 2018. The
survey was based upon sleep surveys previously undertaken in New Zealand (Cronin et al) and by
Tommy’s pregnancy charity in the UK. It was disseminated via pregnancy websites and social media
platforms to women ≥28 weeks gestation.

Results: 325 women responded to the survey, 13(4%) reported sleeping supine or in a propped-up
position in the past week. 286 (88%) women had read or heard about the importance of side
sleeping in pregnancy. 131 (40.3%) stated that the most helpful information came from the internet
with 1 in 2 specifically accessing pregnancy websites. 125 women (38.5%) had changed their
sleeping position in the third trimester based upon advice they had received, with 98/125 (78%)
saying it was not difficult or only a little difficult to change.

Conclusions:
Australian women have a high awareness of side sleeping in pregnancy and are
willing to change. A public awareness campaign would provide clear advice on a risk factor that
women could change themselves, offering potential for stillbirth prevention.

Ethics statement:
Primary ethical approval was obtained from Mater Misericordiae Ltd Human Research Ethics Committee (EC00332) (MML HREC) in 2015. Further jurisdictional ethics approval was obtained from seven participating HRECs across Australia and New Zealand. Governance clearance was obtained for each of the 26 facilities involved in the trial.

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