Sands funds innovative and invaluable research into why babies die and how bereavement care for families can be improved. We are proud to announce four new grants to UK researchers worth over £250,000.
Parents and Neonatal Decisions Study: Improving communication during conversations about limiting life-sustaining treatment in neonatal intensive care
The first award is to ‘Parents and Neonatal Decisions Study: Improving communication during conversations about limiting life-sustaining treatment in neonatal intensive care’ by Professor Neil Marlow at UCL Elizabeth Garret Anderson Institute for Women’s Health, London. They have been given £93,865.55 over three years starting in September 2017.
The research Sands is funding is designed to improve the way doctors talk with parents about the decision whether or not to start palliative care for babies who have life-limiting conditions or a poor outlook. The end point may be development of a high-quality training programme that will help doctors have better conversations with parents about changing from treatment in order to try to prolong life to palliative care to make their baby as comfortable as possible at the end of their life.
Inequalities in stillbirth: a meta-narrative review
The second award is to ‘Inequalities in stillbirth: a meta-narrative review’ and Dr Carol Kingdon, at the University of Central Lancashire. They have been awarded £23,436 for six months starting in September 2017.
This project has been designed in response to the need to do more to prevent stillbirth among women identified as from vulnerable groups and/or with complex social needs. In the UK, there are around 3,200 stillbirths each year. While this overall number is falling, the UK still has one of the highest stillbirth rates in the developed world and we don’t really know why. One of the things we do know is that pregnancies to women living in the poorest areas of the UK are over 50% more likely to end in stillbirth or neonatal death, compared with births to women living in the richest areas of the UK. We know some of this increased risk is because of smoking, being overweight, or not attending for regular antenatal care. But we know much less about how social factors such as living in poverty and experience of racism.
Prediction and prevention of perinatal death
The third award is for ‘Prediction and prevention of perinatal death’ by Dr Asma Khalil, St George’s University of London who has been awarded £129,012 over 15 months from December 2017 to February 2019.
This project aims to find a way of identifying babies at high risk of death in the womb or shortly after birth, so that they can be monitored more closely and delivered early if necessary. Effective preventive treatment could also lead to a reduction in the risk of death. There is no single test that can accurately predict the risk of stillbirth in pregnant women. Current national and international guidelines provide a list of risk factors based on clinical characteristics of the mother to assess their risk, but these have limited accuracy.
The plan is to develop a tool or set of interventions to help prevent stillbirth, and this will be tested to ensure it is helpful for a large population of women. Overall, the scoring system and preventive tool will allow doctors and midwives to tailor the care, monitoring and any possible intervention for each woman.
Outcome of resuscitated term babies with no heart rate detected at 10 minutes of age
The fourth award goes to ‘Outcome of resuscitated term babies with no heart rate detected at 10 minutes of age’ by Dr Gemma Sullivan and Professor Ben Stenson, Consultant Neonatologist, Edinburgh Royal Infirmary. They have been awarded £21,500 to survey neonatal units for 24 months, with checks on surviving babies at two years of age.
Sometimes, babies encounter problems during labour and delivery and their heart stops beating. This leads to a reduction in the supply of blood and oxygen to their brain and they need help to get their heart to start again. This process is known as resuscitation and occurs immediately after birth. If there’s a severe lack of blood and oxygen, there can be an injury to the brain that can be fatal or lead to long-term disabilities.
International guidelines advise doctors to consider stopping resuscitation if the heartbeat does not return by 10 minutes. This recommendation is based on studies reporting that the risk of death or serious disability for these babies is very high. But these studies are quite old, and involved babies born more than 10 years ago. In recent years, doctors have started to use cooling treatment for babies who suffer a brain injury around the time of birth, and this may have improved the outlook for surviving babies. It may be that the guidelines are no longer appropriate.