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The Auckland Stillbirth Study
						
				
				
						Well, we have been going for over a year now and 
						already there are some interesting things beginning to 
						emerge from this study. But first, for those that don't 
						know, what is the Auckland Stillbirth Study (or TASS for 
						short)? The study aims to gain a greater understanding 
						of third trimester stillbirth in order to help reduce the incidence of 
						this tragic event.
				
				
						Why study risks for stillbirth? 
						In New Zealand there are more than 600 perinatal deaths each year, 
						that is 30 per cent higher than the road toll and 14 times the cot death rate. The 
						rate of stillbirth in New Zealand (as in other developed countries is no longer 
						declining, and over the last few years appears to be rising again.
				
				
						Around 200 of these babies die in the third trimester, at a time when if the baby 
						was born it would have a high chance of survival. If we can better predict which 
						babies might be at greatest risk, then we might be able to manage those 
						pregnancies accordingly. However, we are currently not so good at predicting which 
						pregnancy is at risk, in fact we often do not know why the baby died at all. This is 
						partly due to our low post mortem rate in New Zealand (and especially South 
						Auckland) but even with post mortem we at times do not have an explanation for 
						the death.
				
				
						What does the study involve? 
						The study is being conducted across all 3 Auckland DHB's for 3 years (we started in 
						July 2006). We seek to recruit women who have experienced a third trimester 
						stillbirth (in a singleton pregnancy without major congenital  abnormality). If the 
						woman agrees to take part then I contact her and arrange a time for the interview, 
						this takes about 1 to 1 and a half hours and I do it in her home (unless she wants to 
						meet elsewhere).
				
				
						The interview covers a wide range of questions from general health, sleep patterns, 
						stress to fetal movements and family violence. This is a case control study, so we 
				
		
		
				also recruit (and do the same interview with) women who are still 
				pregnant (or who have just had a live baby). These women are 
				randomly selected from the booking lists of each DHB (we match 
				them to the gestation at which the stillbirth occurred). We also 
				collect a wide range of clinical data.
				
						You may have already heard from me, either because of a woman 
						you are caring for who has had a fetal loss, or to help me in the 
						recruitment of controls. THANK YOU to all those who have helped so far in this 
						study, couldn't do it without you.
				
				
						Preliminary demographic results: 
						During the first year there were 74 eligible cases (32 of them in CMDHB) The post 
						mortem rate at CMDHB (for those in the study is about 22% (compared to over 50% 
						at the other DHB's...perhaps it is an area that is worth us thinking about). 53 of 
						them consented to be part of the study. Stillborn babies are more likely to be small 
						for gestational age with 36% of them being under the 10th percentile (using 
						customised charts) and only 4% of controls being small. Women who have a high 
						body mass index (over 30( at the beginning of pregancy also appear to be at almost 
						twice the risk of stillbirth. Women of European ethnicity have a reduced risk and 
						those of Pacific Island an increased risk (we don't know as yet how much this is 
						related to obesity, something we hope to explore with this study). Maori women do 
						not as yet appear to have a significant risk either way. 
						...watch out for big mothers and small babies!
				
				
						The other study investigators are:
				
				
				
		
		
				Dr Lesley McCowan 
				Prof Ed Mitchell 
				Dr John Thompson 
				Dr Alec Ekeroma 
				Dr Jane Zuccollo)
		
		
				Thank you again for all those who have helped with recruitment and data collection. Do feel free to contact me if you want any more information on the study.
		
		
				
						
								Tomasina 
								<a href="mailto:t.stacey@auckland.ac.nz">
										t.stacey@auckland.ac.nz
								</a>