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Fetal surveillance from 39 weeks’ gestation: an alternative to earlier induction of labour to reduce stillbirth in South Asian born women? A Retrospective Cohort Study
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  • Miranda Davies-Tuck,
  • Mary-Ann Davey,
  • Ryan Hodges,
  • Euan Wallace
Miranda Davies-Tuck
Hudson Institute of Medical Research

Corresponding Author:[email protected]

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Mary-Ann Davey
Monash University
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Ryan Hodges
Monash Health
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Euan Wallace
Monash University
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Objectives: In July 2017, Victoria’s largest maternity service implemented a new clinical guideline aimed to reduce the rates of stillbirth at term for South Asian-born women. Here we present the evaluation of the change in care on rates of stillbirth, neonatal and obstetric interventions. Design: Cohort Study Setting: Victoria’s largest metropolitan university-affiliated teaching hospital. Population: All women receiving antenatal care who gave birth in the term period between January 2016 and December 2020. Methods: Differences in rates of stillbirths, neonatal deaths, perinatal morbidities, and interventions after July 2017 were determined. Multigroup interrupted time-series analysis was used to assess changes in rates of induction of labour. Main Outcome Measures: Rates of stillbirths, neonatal deaths, perinatal morbidities, and obstetric interventions. Results: 3506 south Asian-born women gave birth prior to, and 8532 after the change. There was a 64% reduction in term stillbirth (95%CI 87% to 2%; p=0.047) for south Asian-born women after the change in practice from 2.3 per 1000 births to 0.8 per 1000 births. The rates of early neonatal death (3.1 per 1000 vs 1.3 per 1000; p=0.03) and SCN admission (16.5% vs 11.1%; p<0.001) also decreased. There were no significant differences in admission to NICU, Apgar<7 at 5 minutes, birthweight or differences in the trends of induction of labour per month. Conclusions: Fetal monitoring from 39 weeks’ may offer an alternative to routine earlier induction of labour to reduce the rates of stillbirth without causing an increase in neonatal morbidity or obstetric interventions.
07 Oct 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
07 Oct 2021Assigned to Editor
07 Oct 2021Submission Checks Completed
10 Oct 2021Reviewer(s) Assigned
20 Nov 2021Review(s) Completed, Editorial Evaluation Pending