Tommy’s Manchester team shapes future research on reduced fetal movements

At Tommy’s we campaign to make sure that all pregnant women and birthing people know that a decrease or change in their baby’s movements in the womb may mean their baby is unwell – and reporting changes in baby’s movements to their maternity unit immediately is the best action to take.

Our researchers, based at the Tommy’s Maternal and Fetal Health Research Centre in Manchester are also working to find out the best way of caring for women and birthing people who experience reduced fetal movement (RFM) so that we can help to prevent stillbirth.

A new study, led by the Centre’s Dr Dexter Hayes, will help scientists and clinicians researching RFM – including our team in Manchester and others around the world – to collect the most useful information that will help them produce the most reliable research possible.

Our team’s work should also help with influencing national treatment guidelines that help healthcare teams know how best to care for women and birthing people whose babies are moving less often than usual.

Dr Hayes’ team started by finding and combining lots of data from older research studies. The studies were either raising awareness of the importance of babies’ movements, or they looked at how women with reduced movements were treated in hospital.

The team found that these studies showed that there is definitely a benefit to encouraging women to keep track of their baby’s movements, but it’s hard to draw conclusions on how best to raise awareness and how best these women should be treated in hospital. This is because many research studies and trials measured different outcomes so it’s difficult to compare them.

As a result, Dr Hayes and colleagues have now developed and published, in the British Journal of Gynaecology, a list of the most important pregnancy outcomes for mothers and babies which should be measured as standard in all future research studies into RFM.

This work will now help researchers make comparisons between studies of interventions to see which are the most effective.

This list of pregnancy outcomes (‘core outcome sets’) has been put together after 3 rounds of online surveys that asked UK and international researchers, clinicians and parents to rate potential outcomes to see which were considered the most important – 128 people filled in surveys with 84 completing all 3.  

Our researchers then held meetings where the final core outcome sets for mothers and babies were agreed.  

For researchers working on studies relating to raising awareness of RFM, the most important outcomes to collect data on and measure for mothers are: how acceptable (or easy to understand) they find RFM information; the duration of RFM before mothers went to hospital; mother’s knowledge of RFM; and the number of times they presented at hospital with RFM.

For babies, the most important neonatal outcomes to measure in research studies are: gestational age at birth, neonatal death, perinatal death and stillbirth.

For studies relating to how RFM is managed in hospital, the most important outcomes to measure for mothers are: whether labour was induced as a result of them reporting RFM, and whether they had a caesarean.

For babies the core outcomes in research studies are: birthweight, gestation at birth, a type of brain damage called hypoxic ischaemic encephalopathy, neonatal death, NICU admission, stillbirth, preterm birth, and perinatal death.  

Dr Hayes, a University of Manchester postdoctoral researcher based at the Tommy’s Maternal and Fetal Health Research Centre at Saint Mary's Hospital, Manchester, says:

“Most women and birthing people who go into hospital with concerns about their baby’s movements go on to have a healthy child, but some babies with RFM may not be growing as they should or may be at risk of stillbirth. Getting the right treatment and care as soon as possible is key to saving their lives.  

“Because of the work done by organisations such as Tommy’s and Kicks Count in researching RFM and then raising awareness, many more women and birthing people now know that they should call their midwife or maternity unit immediately if they notice a change.  

“But previously there was no agreement among midwives and doctors on the best way of caring for them, in part because previous research studies have given varied results. We believe this needs to change. We hope our core outcome sets will help support good quality research and consensus on the best care for mothers and babies.”  

In the UK, 1 in every 250 pregnancies end in stillbirth – when a baby dies after 24 weeks gestation. Sadly, there was a recent rise in stillbirths in England and Wales. 

The Tommy’s Maternal and Fetal Health Research Centre at the University of Manchester is made up of internationally renowned clinicians, scientists and researchers working to better understand stillbirth and associated pregnancy complications, find ways to identify pregnancies at risk, and development treatments to reduce it.