Normal sized babies who slow down significantly in their growth may be at risk of stillbirth

A NEW “red flag” has been found by researchers investigating the link between a babies size and their risk of stillbirth.

Dr Julia Francis and her husband Dave with their son Elliot, 2 took part in the study into how to reduce stillbirths. Picture: Andrew Henshaw

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MELBOURNE researchers have found a new warning sign that may indicate a baby’s life is at risk in late pregnancy.

Mercy Hospital for Women found normal-sized babies who had a significant slowdown in growth in the third trimester are likely suffering from a poorly functioning placenta — a major risk factor for stillbirth.

It’s hoped that by identifying babies at risk, and monitoring them closely, more lives could be saved.

Lead author, obstetrician and gynaecologist Dr Teresa MacDonald said weight was used as a measure of how well the placenta was delivering oxygen and nutrients to the baby. Babies who are underweight for their gestational age face a higher risk of stillbirth and are closely monitored during pregnancy, and delivery can be brought forward.

“But babies that are small only account for half of all stillbirths — the other half occur in babies who are classed as a normal size,” Dr MacDonald said.

Her research at Mercy Perinatal and University of Melbourne followed 347 first-time mothers who had ultrasounds at 28 and 36 weeks to track the baby’s weight and growth.

It found babies who were a normal size, but whose growth dropped significantly — about 30 percentiles on the growth chart over an eight-week period — performed worse on all three measures of how well their placentas were working.

This was confirmed by three tests — one that found the babies had more blood flow to their brain during pregnancy, a sign they were not getting enough oxygen.

They also had more acid in their blood at birth, indicating they had less placental oxygen reserves to cope with the stress of labour.

When they were born, they had less body fat, showing they weren’t getting the nutrients they needed from the placenta.

“We have identified a previously unrecognised group of babies that are potentially at risk of stillbirth,” Dr MacDonald said.

The risk of stillbirth — which in Australia is when a baby dies after 20 weeks — is seven in 1000.

“Stillbirth does happen, it’s a huge tragedy globally, and within Australia, and it can affect anyone,” Dr MacDonald said, adding this finding would give doctors and midwives important new information that babies in this situation might require additional monitoring.

More research was needed to know if intervening in these pregnancies, such as inducing labour, would be beneficial and should lead to changes in   clinical   practice, she said.

Dr Julia Francis, an obstetrics and gynaecology registrar, who is pregnant with her second child, took part in the study during her first pregnancy with Elliot, now 2.

He was born at 37 weeks because he wasn’t maintaining the growth he had shown earlier in pregnancy and she developed high blood pressure.

Mercy Health Foundation’s Pram Jam raises funds for Mercy Perinatal by asking Australians to be sponsored to walk or run any distance with their pram between November 20 and 26.

www.pramjam.org.au

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