Lay summaries are provided below of the Research Grants given in 2025
Dr Kate Hodgson, Prof Brett Manley, A/Prof Louise Owen, A/Prof Marta Thio, Dr Tugba Alarcon Martinez, Dr Shiraz Badurdeen, and Prof Peter Davis
Royal Women’s Hospital
(Sum provided $35,000)
Worldwide, more than 13 million babies are born preterm, before 37 weeks’ gestation, each year. While survival rates have improved markedly over recent decades for babies born preterm, survivors of preterm birth face the risk of lifelong disability, including chronic lung disease and cerebral palsy. Deferred (delayed) cord clamping is the process by which a baby remains attached to the umbilical cord for at least 1 minute after birth. In preterm babies, deferred cord clamping improves survival. The importance of this practice relies upon deferring cord clamping until babies breathe. However, many preterm babies need breathing support with a face mask to begin regular breathing after birth. For these babies, the cord must be clamped early to move the baby to a special resuscitation table. Therefore, they 1) miss out on the benefits of deferred cord clamping and 2) receive pressure via a face mask, which may damage their fragile lungs.
Nasal high-flow therapy (high flow) provides gentle, warm, blended air and oxygen via two small nasal prongs. High flow is already used in many settings for preterm babies, but has not been used prior to clamping the umbilical cord. Applying high flow to babies prior to cord clamping may support and stimulate breathing. This would allow deferred cord clamping to occur, and limit damage to babies’ lungs from face mask ventilation.
This innovative pilot study aims evaluate the feasibility of providing high flow during deferred cord clamping in very preterm infants born before 32 weeks’ gestation. We will enrol 20 very preterm babies who will receive high flow while still attached to the umbilical cord. The main outcomes will be 1) the feasibility of high flow during deferred cord clamping and 2) the acceptability to doctors and nurses caring for preterm babies. We will also study what level of breathing support babies require, their oxygen levels and their heart rate. The findings from this study will help plan a larger randomised trial to know the effect of high flow during deferred cord clamping on outcomes for preterm babies. This is a novel trial of babies soon after birth, targeting vulnerable preterm babies during the first minutes during a critical transition period. Optimising this transition from the placenta to breathing air may improve critical long-term outcomes.
Dr Melinda Pattanasri, Dr Pinar Cingiloglu, Dr Charlotte Reddington, Dr Claudia Cheng, Dr Lucy Richards, A/Prof Martin Healey, A/Prof Michelle Peate and, Dr Shiva Roudbaneh
The Royal Women’s Hospital
(Sum provided $10,300)
This study aims to explore how menstruation is experienced differently due to cultural beliefs, practices and backgrounds and how this information impacts women and their menstrual health. It is believed a study like this hasn’t been performed in Australia before, and Australia with its diverse multi-cultural background provides the perfect population to explore these questions. The information from this study will give insights into:
A/Prof Katie Ayers, Prof Sonia Grover, Ms Chloe Hanna and, Ms Kristiina Siiankoski
Murdoch Children’s Research Institute
(Sum provided $72,244)
During fetal development the Müllerian ducts become crucial components of the female reproductive tract including the uterus, the fallopian tubes and the upper vagina. When this process is disrupted, it can lead to Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome, a congenital condition characterised by the underdevelopment or absence of the uterus and the upper part of the vagina. MRKH is thought to affect approximately 1 in 4,500 to 5,000 females and can be isolated (Type I) or associated with additional congenital anomalies including skeletal or kidney malformations (Type II).
MRKH can be diagnosed at birth (i.e. Type II with associated anomalies) or during adolescence. Women with MRKH can face a multitude of health challenges including a lack of periods, infertility and issues with sexual function. Treatment includes both non-surgical and surgical interventions, such as the creation of a neovagina. The physical and psychosocial burden of MRKH can be traumatic, and an early diagnosis, comprehensive management, and robust psychological support are crucial to clinical care. A genetic diagnosis can also be vital in providing optimal care. It can confirm the clinical diagnosis of MRKH and help distinguish between MRKH subtypes, informing on the risk of associated anomalies and allowing early invention. It can provide a rational explanation, reducing stigma. It can guide counselling and inform options for having biological children through assisted reproductive technologies. But despite the importance of a genetic finding, less than 10% of girls or women with MRKH receive a clinical genetic diagnosis. This is because there is a poor understanding of the genes that are disrupted in MRKH and the limited scope of genomic technologies applied, highlighting an inequity in healthcare and the need for new approaches.
Recently “multi-omics” methods, where researchers not only investigate the DNA (the genome) but also the complete RNA (the transcriptome) and protein set (the proteome) of a cell or tissue, have become an important diagnostic tool in a number of conditions. Indeed, our group have successfully applied this approach to find new genetic causes of premature menopause and 46,XY gonadal dysgenesis.
Here we propose to use a multi-omics approach to identify novel genetic causes of MRKH and increase genetic diagnostic rates. Multi-omic methods will be applied to blood samples from a cohort of women with MKRH for whom no genetic cause has been identified. Our research team is well placed to carry out this research. A/Prof Katie Ayers has expertise in the genetics of female reproductive development and MRKH and brings an established cohort of MRKH research participants. Professor Sonia Grover, paediatric gynaecologist and surgeon and Chloe Hanna, clinical co-ordinator at the Royal Children Hospital will drive further recruitment and translate findings into education and changed medical practice. Ms Kristiina Siiankoski who established MRKH Australia Pty Ltd in 2020 brings lived experience and co-design expertise to ensure that our research addresses the priorities of the MRKH community.
We believe the outcome of this innovative project will be the discovery of novel causes of MRKH leading to increased genetic diagnostic rates and improved health outcomes for girls and women with MKRH.
Dr Hannah Gordon (PI), Dr Anthea Lindquist (PI), Associate Professor Roxanne Hastie, Professor Stephen Tong, Dr Alexis Shub, Professor Sue Walker, Dr Parinaz Mehdipour, Ms Anna Forsythe, Dr Richard Hiscock, Ms Jessica Atkinson
Mercy Hospital for Women
(Sum provided $68,000)
Almost one in five Australian women will have pre-existing or gestational diabetes in pregnancy. Maternal diabetes is associated with adverse short-term outcomes for neonates; and yet the school-age educational and developmental outcomes for the offspring of affected pregnancies remain poorly understood. Improving our understanding of diabetes in pregnancy and the implications for affected children will have a significant impact for the clinical management of this common condition.
Additionally, alternative treatments for diabetes in pregnancy beyond insulin have not been thoroughly investigated. In non-pregnant patients, metformin is the first line treatment of diabetes, preferred over insulin as it is not administered by injection and is not associated with weight gain. However, metformin crosses the placenta. It is used in pregnancy with caution due to incompletely described long-term implications for children exposed in-utero. Women need hypoglycaemic agents that are safe and acceptable, and current data is insufficient to ensure the long-term safety of metformin, despite some reassuring international data in this area.
The proposed research forms two chapters of my PhD thesis, and its aims are therefore twofold. I will be using a population-wide, linked Victorian dataset to investigate:
The prevalence of diabetes in pregnancy has tripled over the past twenty years. We urgently need high quality ‘big’ data to understand the long-term implications of this disease and its treatment on children exposed in-utero.
This study cohort includes every birth in Victoria between 2005 and 2021, with pregnancy outcome data from the Victorian Perinatal Data Collection. These birth data have been linked with medication prescribing data from pregnancy identified by the Pharmaceutical Benefits Scheme and National Diabetes Services Scheme, in addition to educational outcome data from the Australian Early Development Census and the National Assessment Program – Literacy and Numeracy (NAPLAN). This dataset includes over 850,000 children, providing a unique opportunity to understand the long-term childhood impacts of diabetes itself and diabetes medications such as metformin using advanced statistical analyses.
Professor Lyndell Lim, A/Prof Alison Nankervis, Dr Alexis Shubb, A/Prof Andrew Symons, Dr Jennifer Conn, A/Prof Jennifer Wong, Dr John Regan, Prof Georgia Soldatos
Centre for Eye Research Australia
(Sum provided $72,950)
Diabetic retinopathy (DR) is a serious eye condition that affects 1 in 3 people with diabetes. If not detected early, it can lead to blindness. Around 65,000 Australians are currently suffering from reduced vision due to DR.
One condition that particularly worsens DR is pregnancy. Women with pre-existing diabetes who become pregnant are at high risk of significant medical complications for themselves and their babies, including permanent blindness in the mother. Blindness from DR is completely preventable if it is detected early, before any vision is lost.
Unfortunately, women with pre-gestational diabetes find it extremely difficult to attend eye screening examinations during their pregnancy, due to the large number of other medical appointments that they need to attend that often take priority over their eye health.
To address this issue, we are proposing a trial of a new method of eye screening with an artificial intelligence (AI) assisted camera that will be situated in specialist obstetric clinics. This camera can quickly take pictures of the eye and immediately inform patients on the spot whether they have any signs of DR that requires follow up with an eye specialist. This screening can be done while the patient is waiting to see their obstetrician, or immediately after their appointment.
This “one stop shop” approach allows pregnant women to get their diabetic eye checks at the same time as their obstetric appointment. This will increase the number of women who are able to get their eyes checked in a timely manner, ultimately preserving the sight of the mothers. This means these mothers can not only see the face of their newborn baby, but also watch them grow and thrive.
Prof Claudia Nold,Prof Marcel Nold, Dr Ina Rudloff, A/Prof Ramesh Nataraja, Dr Maurizio Pacilli, Dr Steven Cho
The Hudson Institute of Medical Research
(Sum provided $67,250)
In Australia, up to 11% of babies are born prematurely, of which 3,000 infants (1.6%) are born extremely preterm before 32 weeks of gestation. Fortunately, significant progress in neonatal intensive medical care has improved survival rates of preterm babies even born as early as 23 weeks of gestation. Sadly, however, this exposes ever more babies to serious diseases of prematurity including necrotizing enterocolitis (NEC), a devastating disease in which parts of the baby’s gut become increasingly inflamed and porous, and ultimately die.
Over the last 50 years, NEC-associated mortality of up to 65% has changed little. Clinicians have no predictive biomarker and there are still only limited preventative and no direct therapy for NEC. Clinicians are left with only supportive measures such as fluid resuscitation, bowel rest and antibiotics and even today NEC is still one of the most common causes of death in preterm babies between days 15 and 60 of life. Those who are fortunate enough to survive often face long-term consequences such as disability, epilepsy and poor growth.
A major risk factor for NEC is late onset sepsis (LOS), a life-threatening response to severe infection often leading to organ dysfunction. Predicting if a baby suffering from LOS is moving along the path of developing NEC is very challenging, as both diseases can present with overlapping non-specific symptoms, such as a fever, signs of respiratory distress or feeding problems. Unfortunately, 34-57% of babies presenting with LOS will develop NEC, but just which baby is the big question. Due to the devastating nature of both LOS and NEC, clinicians need to respond with antibiotic treatments, which is not without risk. Although antibiotics in most cases are lifesaving, they can further increase the risk of progression to NEC as antibiotics disrupt the developing microbes of the neonatal gut (the so-called microbiome) or can lead to the selection of resistant bacteria. Consequently, identifying biomarkers to predict which baby suffering from LOS goes on to develop NEC will be helpful to optimize treatment strategies to reduce morbidity and mortality.
Over the last 12 years, the team has advanced knowledge in the field of early life diseases, aiming to develop new diagnostic and therapeutic strategies. For this purpose, the researchers collect blood samples from preterm babies at different time points and record their clinical data. While some of these babies develop normally without any diseases of prematurity, others are diagnosed with LOS, of which many subsequently also fall ill with NEC. To build on the initial biomarker study, the team now aim to dive deeper into our blood analysis to identify differences in the babies suffering from LOS that later developed NEC compared to those that do not. Discovery of differential biomarkers will be invaluable as they can guide diagnosis of preterm babies with LOS by performing a simple blood test, informing clinicians whether babies are at risk of developing NEC or not.
Professor Ian Wicks. Dr Behnaz Heydarchi
Walter and Eliza Hall Institute of Medical Research
(Sum provided $71,340)
Rhesus D (RhD) is a blood group antigen found on some human red blood cells (RBCs). When an RhD negative (RhDneg) mother is carrying an RhD positive (RhDpos) baby, foetal RBCs enter the maternal circulation and can induce an antibody (Ab) response to the RhD molecule [1]. This response increases with each pregnancy, destroying foetal RBC and causing haemolytic disease of the foetus and newborn (HDFN). HDFN has been a major cause of neonatal jaundice, recurrent miscarriage and stillbirth throughout history, and continues to be so in many countries [2]. In the 1960s, an Australian (Dr John Gorman), suggested that giving anti-RhD containing plasma to RhDneg pregnant women might prevent HDFN. Remarkably, this proved to be highly effective and since then, has reduced perinatal death rates from HDFN by over 98% in those countries able to provide it [3]. Anti-RhD prophylaxis contains polyclonal immunoglobulin G (pIgG) derived from the pooled plasma of RhDneg male donors who are immunised with RhDpos RBC. The supply of RhD-pIgG is expensive and resource intensive to maintain and, in some jurisdictions, has been discontinued due to ethical concerns [4]. For example, in the UK, donor plasma is sourced from North America to minimize any risk of transmission of variant Creutzfeldt-Jakob disease.
There are also associated risks of immunisation against other alloantigens on RBCs. Many countries have inadequate anti-RhD prophylaxis programs due to cost and insufficient public healthcare resources. As a result, many countries now rely on imports from the United States, where plasma is sourced from paid donors. Additionally, deriving anti-RhD plasma obviously depends on altruistic blood donors, who sometimes become unwell after repeated immunization with ‘foreign’ RBCs. Maintaining Australian (Aus) volunteer donors to produce RhDpIgG (Aus RhD-pIgG) is also increasingly difficult, especially since the COVID pandemic. RhDpIgG prophylaxis has also been used to treat immune thrombocytopenia (ITP), further straining supplies. There is consensus that developing recombinant anti-RhD monoclonal antibodies (mAbs) could ensure a standardised and scalable supply, free of the multiple concerns associated with donor-derived RhD-pIgG. Given the limited success encountered with previous anti-RhD mAbs, we collaborated with Australian Red Cross Lifeblood (ARCL) to isolate and characterise anti-RhD mAbs from existing RhD blood donors. In work funded by the Norman Beischer Medical Research Foundation (NBMRF), for the first time, we employed cutting-edge technologies to characterise and isolate anti-RhD mAbs from 27 Aus anti-RhD donors. Preliminary studies have demonstrated that these mAbs exhibit comparable efficacy to commercial RhD-pIgG in laboratory experiments. In this study, we aim to evaluate their developability for generation of a mAb pool and advancement to pre-clinical and clinical stages.
Dr Lucy Richards, Dr Pinar Cingiloglu, Dr Samantha Mooney, Dr Lenore Ellett, Associate Professor Emma Readman
Mercy Hospital for Women
(Sum provided $19,253)
Hysteroscopy is a procedure that involves inserting a camera through the vagina and cervix to visualize the inside of the uterus or womb. It is the gold standard diagnostic test for patients with abnormal menstrual bleeding or abnormalities detected on pelvic ultrasound. Hysteroscopy can be performed under general anesthesia while the patient is asleep or while the patient is awake. For approximately 19 in every 20 people, the procedure is successful and well-tolerated when performed while the patient is awake. Many women prefer this approach to avoid the risks associated with general anesthesia and to minimize time off work. Additionally, performing hysteroscopy on an outpatient basis offers substantial cost savings for healthcare services (up to 10 fold less than an inpatient procedure) and can alleviate the burden on long inpatient surgical waiting lists.
Unfortunately, outpatient hysteroscopy is not available for many women as there are only a small number of public services providing this across Australia. The cost to set up a new outpatient hysteroscopy service is high requiring purchase of re-useable equipment (cameras, light leads, scopes, screen with connecting computer) and arranging ongoing sterilization and maintenance of this equipment. This can make starting a new outpatient hysteroscopy service for small gynaecological units prohibitive. A potential alternative is a single use disposable device where the camera and light source are all integrated, one such device is the LiNA OperaScope.
In this study, the researchers plan to perform a cost effectiveness analysis where it directly compares the expenses associated with using a single-use device versus conventional reusable equipment. Participants undergoing awake hysteroscopy, who consent and are recruited into the study, will be randomly assigned to receive either the single-use or reusable hysteroscope. The team will audit all procedural costs, including reusable and disposable items, staffing, and sterilization, associated with each procedure. Current cost estimates for these items will be obtained from the hospital procurement team and medical device suppliers. To assess effectiveness, both patient and clinician experiences will be evaluated through questionnaires. This data will enable the team to model and compare costs for a hypothetical gynecological unit planning to establish an outpatient hysteroscopy service, assuming one clinic treats six patients per monthly session for a year.
It is anticipated that this study will provide valuable insights to help gynecological services across Australia expand access to outpatient hysteroscopy services
Dr Rose Brazilek, Dr Naba Masad Alfayadh, A/Prof Elisha Riggs
Royal Children’s Hospital
(Sum provided $72,274)
Rahma Health is redefining obstetric health equity in a way that the inspirational Professor Emeritus Norman Beischer AO would have truly loved. The Professor’s public health, policy and research-translation legacies inform much of our work, as we continue in the institutions he built and developed.
Rahma is an ACNC-registered, ATO Endorsed charity that supports families to enjoy the magic of the first 5 years of a child’s life through the provision of culturally-informed, evidence-based information in lay language. Through world-class healthcare information, a community-led approach and the power of technology, Rahma supports Arabic-speaking communities to lead fulfilled, happy, loving lives. Rahma creates Obstetric, Gynaecological and Paediatric resources in Arabic in partnership with the Royal Children’s Hospital, the Raising Children Network, the Parenting Research Centre, the Royal Women’s Hospital, the Asylum Seeker Resource Centre, Palestine Australia Relief and Action, the Australian Islamic Medical Association, Safer Care Victoria and the Federal Department of Health.
Website: https://rahma.health/en
Instagram (Main dissemination platform): https://www.instagram.com/myrahmahealth/
The aim of our Obstetric resources is to reduce adverse outcomes for mothers and their babies, and improve the experience of refugee women during pregnancy and childbirth. An improved childbirth experience is associated with improved mother-baby bonding, reduced perinatal depression and improved mental and physical health for the child [1].
Women in Australia from a refugee background have a higher incidence of stillbirth, perinatal mortality and caesarean births. Women from refugee backgrounds are more likely to be younger than 20 during pregnancy, experience socio-economic disadvantage, have a BMI below 18.5, need an interpreter or have a background of female genital mutilation. In a study conducted in New South Wales in 2013 of all the NSW Midwives Data Collection Database, Lebanese women were found to have the highest rates of stillbirth of all ethnicities in NSW. Victorian research from Cheng and Russell et al 2011 at Monash Health demonstrates that there are higher rates of fetal death, instrumental births, and mother birth-trauma in refugee populations, with Arabic being the language most commonly spoken by refugee populations.
Rahma’s community-created and community-owned resources are already having a life-saving impact. The families who use our resources have reported to us that now they have the courage to request interpreters, that they had an improved labour and birth experience due to knowing what to expect, knew their pain management options, knew how to request help if they were concerned, and that their anxiety about birth had decreased due to hearing positive stories through Rahma Health.
Clinicians using Rahma’s resources have also found them “revolutionary” and “very educational”, especially the Obstetric resources about Ramadan fasting in pregnancy. Rahma Health is working with Safer Care Victoria and the Federal Department of Health LEAPP Guidelines to inform clinicians Australia wide about the impact of Ramadan fasting in pregnancy.
This project aims to systematically evaluate the effectiveness of Rahma Health’s Obstetric resources.
Dr Debjyoti Karmakar, and A/Prof Fiona Brownfoot
Mercy Hospital for Women
(Sum provided $69,500)
This research project aims to investigate how errors in monitoring fetal heart rates during labour, known as cardiotocography (CTG) signal artifacts, might affect the health of newborns. CTG is a technology used since the 1960s to monitor the well-being of babies during labour by recording their heart rate and the mother’s contractions. However, sometimes the CTG machine can mistakenly record incorrect information, either by losing the signal or confusing the baby’s heart rate with the mother’s. These errors are known as “signal artifacts.”
The study will analyze data from over 36,000 women who gave birth in Melbourne between 2010 and 2021. We will examine whether there is a connection between these CTG signal artifacts and serious newborn health problems, specifically perinatal asphyxia. Perinatal asphyxia is a condition where a baby doesn’t get enough oxygen before, during, or just after birth, which can lead to brain damage or even death.
The research will be conducted in three parts. First, it will look at the overall data to see how common these signal artifacts are and how they relate to birth outcomes. Next, it will investigate whether high levels of artifacts are linked to an increased risk of perinatal asphyxia. Finally, the researchers will attempt to identify a specific threshold of signal artifacts that could reliably predict the risk of perinatal asphyxia.
This study is crucial because if found that these signal errors are indeed linked to poor outcomes for babies, it could lead to changes in how professionals monitor pregnancies, especially in high-risk cases. This could help doctors make better decisions during labour, potentially saving lives and reducing long-term health issues for newborns.
By understanding and addressing the impact of CTG signal artifacts, it is hoped to improve the safety and effectiveness of fetal monitoring during labour, ultimately ensuring better health outcomes for both mothers and their babies. If funded, this research the way for future innovations in obstetric care and fetal monitoring technology.
Prof. Jayashri Kulkarni AM, Dr Eveline Mu, Dr Qi Li, Mr Anthony de Castella
Monash University
(Sum provided $72,981)
Major depression in women during their childbearing years is extremely common and associated with high morbidity and mortality. As a result, the use of antidepressant medications during pregnancy is widespread. Making decisions about using antidepressants during pregnancy can be difficult, as it requires balancing the mother’s mental health with the developing baby’s well-being. While antidepressant use in pregnancy may be considered a risk to the infant’s health, discontinuing treatment carries the risk of severe maternal depression relapse and, at times, suicidality. Recent evidence suggests that the risk of antidepressant intake during pregnancy for the baby is small or non-existent, and the risk of poor maternal and baby outcomes is small to medium. However, these studies do not clearly indicate the long-term effects, which is concerning.
To address this gap, our study has begun data collection and now we will focus on the one-year follow-up of a three-year study. We aim to change the narrative by tracking mothers throughout their pregnancy and their children for three years after antidepressant use during pregnancy. Most studies focus on short-term outcomes, but we aim to capture the bigger picture by understanding the lasting effects of antidepressant use during pregnancy.
We will work with pregnant women taking antidepressants and compare them with those who are not. Both groups will be followed during pregnancy and for three years postpartum. We will assess the children’s development, behaviour, learning, and the mother’s mental health. Focusing on a three-year follow-up allows us to track developmental differences and identify issues that may emerge later.
The results of our study will inform women and their doctors about the safety of antidepressants during pregnancy, providing evidence-based advice for pregnant women who need antidepressants. Our findings will contribute to the development of guidelines for treating pregnant women and will be valuable for policymakers shaping regulations around the use of antidepressants during pregnancy.
Prof Jayashri Kulkarni, Dr Leo Chen Dr Eveline Mu, Dr Elizabeth Thomas
Monash University
(Sum provided $73,000)
Depression after childbirth is a common illness associated with poor infant developmental outcomes and can pose safety risks to both mother and baby. Antidepressant medications are often ineffective and can cause emotional numbing side effects, which impairs mother-baby bonding. Antidepressant medications are transferred to the baby in breast milk, with unknown effects on the developing brain and body of the infant.
Transcranial magnetic stimulation (TMS) is a proven and well-tolerated treatment for depression without these safety concerns. It has received minimal research in postnatal depression. This project addresses this gap by offering mothers and families an innovative, viable, safe treatment alternative. It also serves to establish an evidence-base for TMS treatment in depression after childbirth, which preserves crucial, early-life mother-baby bonding.
We propose to conduct a pilot study of TMS treatment for 30 women with postnatal depression. As a treatment for postnatal depression, TMS has the noteworthy benefits of:
This will be the first Australian study investigating TMS in postnatal depression. Positive results from this research can encourage future studies of TMS in PND and translate to improved depression and mother/baby outcomes in our community and worldwide.
Dr Billie Bradford, A/Prof Miranda Davies-Tuck, A/Prof Kirsten Palmer, and Prof Ben Mol
Monash University
(Sum provided $44,570)
Maternal perception of regular fetal movements is a reassuring sign that the baby is well. Pregnant women are encouraged to pay attention to fetal movements and contact their maternity care provider if their baby’s movements stop or slow down. This is because perception of decreased fetal movements is an indicator of stillbirth or other problems with the baby that can lead to stillbirth. This is illustrated by the fact that in almost half of stillbirth cases the woman has reported decreased fetal movements before diagnosis of fetal death.
Promoting awareness of fetal movements is a key strategy for stillbirth prevention in Australia and around the world. However, several recently published clinical trials failed to show a significant reduction in stillbirths when fetal movement awareness programmes were implemented. Part of the problem is that there is no agreed definition of decreased fetal movements to prompt women to present when concerned about movements. Kick-counts vary widely between women by as much as 4 and 400 kicks per day. A more recent approach has involved encouraging women to present if they experience subjective perception of a change in movements. However, this definition of reduced fetal movement is open to interpretation and creates worry and uncertainty for women around what is normal. It is not surprising therefore that neither kick-counting nor subjective perception approaches have proved effective in preventing stillbirths in high-quality studies. Key to the success of a fetal movement awareness method is that it is usable and acceptable to all women and that it reliably identifies pregnancies where there is developing fetal compromise.
This study involves development and piloting of a novel fetal movement scoring system which promises an innovative solution to the limitations of previously trialed approaches. The fetal movement scoring system combines the simplicity of fetal movement counting with maternal evaluation of qualitative aspects of their baby’s movements, such as strength and pattern, to generate a fetal movement score that can then be used to guide further assessment if necessary. The system will involve women completing a short self-assessment of their baby’s movements each evening following a prompt sent to their mobile phone. Our previous research has shown that fetal movement features such as strong movements, fetal hiccups and movements in the evening are significantly associated with fetal wellbeing, while decreased frequency, decreased strength, and fetal movements that are quiet in the evening are significantly associated with stillbirth. The tools’ ability to detect ‘at-risk’ fetuses will initially be based on these existing data and further refined and validated in this study.
This study aims to co-design a fetal movement scoring system in consultation with pregnant women and evaluate its acceptability and usability, with the goal to create algorithms allowing us to evaluate reliably of the fetal m ing at-risk pregnancies in future large-scale effectiveness trials.
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