Inducing older mothers could cut stillbirths

INDUCING birth earlier in older first-time mothers could reduce the number of stillborn babies by two thirds, a study has found.

Current guidelines recommend induction be offered when the baby is one or two weeks late, but the latest research – involving 80,000 women over 35 – found that when births were induced at the due date, it led to a large reduction in stillbirths.

Researchers found that inducing birth one to two weeks earlier would cut the rate of stillbirths from 26 per 10,000 pregnancies to eight per 10,000, providing the mothers were thought to be at low risk of complications.

It means applying inductions across the board to older firsttime mothers would prevent one stillbirth for every 562 inductions, but experts say it would create an ‘enormous’ financial impact on the NHS.

The research was led by the London School of Hygiene and Tropical Medicine and the University of Cambridge. Lead author Hannah Knight said: ‘The number of first-time mothers over the age of 35 is rising.

‘Although their risk of experiencing a stillbirth or neonatal death is relatively small, it’s still very important that these women receive the best advice on how to minimise the risks to themselves and their baby.

‘This study represents the strongest evidence yet that moving the offer of induction forward to 40 weeks might reduce the risk of stillbirth in this specific age group, which we know face a greater risk of stillbirth and neonatal death.’

Dr Knight added: ‘While our study suggests bringing forward the routine offer of induction of labour to 40 weeks of gestation in first-time mums aged 35 or over... there are potential downsides to such a policy, such as the increased demand on resources. Further studies are needed to examine the impact of such a change in policy on NHS costs and women’s satisfaction.’

Professor Lesley Regan, president of the Royal College of Obstetricians and Gynaecologists, said: ‘This large study supports emerging research which suggests that moving forward the offer of induction to 40 weeks may play a role in reducing the proportion of stillbirths and neonatal deaths, but it should be emphasised that this study is the first to focus on a specific patient group – firsttime mothers aged 35 and over.

‘ However, as the authors acknowledge, the implications of such a change in policy would be enormous for both the health service and women themselves.’

Janet Scott, of stillbirth charity Sands, said: ‘We hear from too many older mothers whose babies have died after 40 weeks but who had no idea they were at a higher risk, and in retrospect deeply regret their baby was not induced in time.

‘ These new findings must urgently be translated into accessible information for women and the healthcare professionals advising them.’

‘Minimise the risks’