June 14, 2011

expert reaction to BMJ paper on stillbirth risk and sleeping position

A new study made an association between the sleeping position of mothers-to-be and risk of late stillbirth.

Jim Neilson, Professor of Obstetrics & Gynaecology, University of Liverpool and Liverpool Women’s Hospital , said:

“The risk of having a stillborn baby in this study is broadly similar to the risk in the UK, as the New Zealand researchers did not include stillborn babies before 28 weeks, stillborn twins, or babies with malformations.

“There are important public health messages here – that women who are overweight or who smoke are more likely to have a stillborn baby.

“The link with sleeping patterns by the mother is much less clear. More research is needed. Until then, women need not change the position for sleeping in which they feel most comfortable.”

Ms Daghni Rajasingam, spokesperson for the Royal College of Obstetricians and Gynaecologists, said:

“There are many factors which are linked to stillbirth including obesity, increasing maternal age, ethnicity, congenital anomalies and placental conditions. A significant number are unexplained.

“This small scale study looks at another possible factor, however, more research is needed into sleep patterns before any firm conclusions over sleeping positions can be made. In the meantime, women should speak to their midwives if they are concerned.

“All new research into the causes of stillbirth is encouraging and is a step forward in understanding why they happen and improving stillbirth rates in the future.”

Dr Alexander Heazell, Walport Clinical Lecturer at the University of Manchester School of Medicine, said:

“Stillbirth affects in 1 in 200 births in the UK: over 4,000 per year. This study suggests that mothers sleeping on their left are less likely to have a stillbirth than those sleeping on their backs or on their right-hand side. However, even the risk of stillbirth reported in the study for mothers sleeping on their back or right-hand side (3.93 in 1,000) is lower than the current UK rate. It is too early to say whether we should encourage mothers to sleep on their left and more in depth studies are needed to confirm this study’s findings and to understand why sleeping on the left might reduce stillbirths.

“There are several weaknesses in the study, including the fact that mothers were asked to recall their sleeping position 25 days after experiencing a stillbirth. I agree with Professor Smith and Dr Chappell’s editorial, which describes these results as an interesting hypothesis that needs validation.”

‘Association between maternal sleep practices and risk of late stillbirth: a case-control study’, Tomasina Stacey et al., published in the BMJ on Tuesday 14th June 2011.