The AFFIRM trial for prevention of stillbirth

Dr Elizabeth Camacho, Professor Jane Norman, Dr Sarah Stock, Professor Alexander Heazell

Researchers supported by Tommy’s are looking at whether a package of care and resources for pregnant women can help stop stillbirths.

Start: January 2014

End: June 2020

Why do we need this research?

The rate of stillbirth in the UK are among the highest in the developed world. A 2016 study in The Lancet ranks it as 26th out of 49 high-income countries. Tommy's believes that this is unacceptable.

Most of the time, stillborn babies appear to have grown completely normally. Often, it is only discovered after birth that there was something wrong with the placenta: the organ that provides babies with the oxygen and nutrients that they need in the womb. An early sign that something might have gone wrong is if a mother notices that her baby is moving less than usual – this is known as reduced fetal movement.

Tommy’s have been supporting a trial to try and prevent stillbirth from happening, by focusing on women who report their babies are moving less than normal.  

The AFFIRM trial

The AFFIRM trial, which ran from 2014 to 2016, aimed to see whether a simple ‘care bundle’ can reduce stillbirths by raising awareness of, and acting on, reduced fetal movement.

The AFFIRM care package was made up of:

-          information for pregnant women raising awareness of monitoring reduced fetal movements

-          more tests and clinical help when babies are moving less than normal.

The study generated huge interest, involving around 450,000 pregnant women across the UK. The results of the AFFIRM trial showed a small drop in the rate of stillbirth among women receiving the care package. However, this drop wasn’t large enough to be completely certain that it was caused by the care package, rather than being caused by chance.

Watch this video to learn more about the results of the AFFIRM trial.

What’s next for the AFFIRM trial?

Our researchers are now carrying out an analysis to show whether the AFFIRM care package is cost-effective to implement, compared to standard care. The team will be assessing the cost of extra resources needed to provide the care package, including additional scans. Along with the results of the trial, the cost-effectiveness analysis will provide policymakers with the information they need to decide whether to implement the care package across the NHS.

What difference will this project make?

If the care package studied in the AFFIRM trial is found to be cost-effective, it could be implemented it across the NHS. This could provide women whose babies are moving less than normal with additional support when they need it, and potentially help to reduce stillbirth rates in the UK.

 

More research projects

Help us find out how things go wrong in pregnancy

Read Tommy's new and views

  • Picture of Jennie Agg

    Blog

    A personal meaning of motherhood and Mother's Day

    We asked our lovely friend and supporter, Jennie Agg, what motherhood and Mother's Day means to her. In this piece, she speaks of her difficult past experiences of Mother's Day, how she has grappled with a sense of being in limbo, and the ultimate purity of her feeling of mother love.

  • Collage of photos showing six women who have experienced baby loss, miscarriage and infertility

    Blog

    Advice to help you cope on Mother’s Day

    In the lead up to Mother's Day, you might find yourself thinking about how to process your emotions and what to do on the day itself. The anticipation can often feel scary or daunting, and finding ways to look after yourself is important. In this blog, you'll find advice from a few of our lovely supporters who understand how you're feeling.

  • Mother holding newborn baby

    News

    Giving some pregnant women progesterone could prevent 8,450 miscarriages a year, say experts

    New research has revealed the benefits of giving progesterone to women with early pregnancy bleeding and a history of miscarriage.

  • Tim Draycott, Clinical Director of Tommy’s National Centre for Maternity Improvement, giving a presentation to audience at the 'Portraying Pregnancy' event

    News

    Tommy's hosts breakfast morning at the Foundling Museum

    Tommy’s spent yesterday morning at the charming Foundling Museum in London, celebrating the work of Tommy’s National Centre for Maternity Improvement alongside the opening of the museum’s new exhibition, ‘Portraying Pregnancy’.