dc.contributor.author |
Cronin, Robin |
en |
dc.contributor.author |
Li, Minglan |
en |
dc.contributor.author |
Thompson, John |
en |
dc.contributor.author |
Gordon, Adrienne |
en |
dc.contributor.author |
Raynes-Greenow, Camille H |
en |
dc.contributor.author |
Heazell, Alexander EP |
en |
dc.contributor.author |
Stacey, Tomasina |
en |
dc.contributor.author |
Culling, Vicki M |
en |
dc.contributor.author |
Bowring, Victoria |
en |
dc.contributor.author |
Anderson, Ngaire |
en |
dc.contributor.author |
O'Brien, Louise M |
en |
dc.contributor.author |
Mitchell, Edwin |
en |
dc.contributor.author |
Askie, Lisa M |
en |
dc.contributor.author |
McCowan, Lesley |
en |
dc.date.accessioned |
2019-10-01T20:19:55Z |
en |
dc.date.issued |
2019-04-02 |
en |
dc.identifier.citation |
EClinicalMedicine 10:49-57 01 Apr 2019 |
en |
dc.identifier.issn |
2589-5370 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/48249 |
en |
dc.description.abstract |
Background:Maternal supine going-to-sleep position has been associated with increased risk of late stillbirth (≥ 28 weeks), but it is unknown if the risk differs between right and left side, and if some pregnancies are more vulnerable. Methods:Systematic searches were undertaken for an individual-level participant data (IPD) meta-analysis of case-control studies, prospective cohort studies and randomised trials undertaken up until 26 Jan, 2018, that reported data on maternal going-to-sleep position and stillbirth. Participant inclusion criteria included gestation ≥ 28 weeks', non-anomalous, singleton pregnancies. The primary outcome was stillbirth. A one-stage approach stratified by study and site was used for the meta-analysis. The interaction between supine going-to-sleep position and fetal vulnerability was assessed by bi-variable regression. The multivariable model was adjusted for a priori confounders. Registration number: PROSPERO, CRD42017047703. Findings:Six case-control studies were identified, with data obtained from five (cases, n = 851; controls, n = 2257). No data was provided by a sixth study (cases, n = 100; controls, n = 200). Supine going-to-sleep position was associated with increased odds of late stillbirth (adjusted odds ratio [aOR] 2.63, 95% CI 1.72-4.04, p < 0.0001) compared with left side. Right side had similar odds to left (aOR 1.04, 95% CI 0.83-1.31, p = 0.75). There were no significant interactions between supine going-to-sleep position and assessed indicators of fetal vulnerability, including small-for-gestational-age infants (p = 0.32), maternal obesity (p = 0.08), and smoking (p = 0.86). The population attributable risk for supine going-to-sleep position was 5.8% (3.2-9.2). Interpretation:This IPD meta-analysis confirms that supine going-to-sleep position is independently associated with late stillbirth. Going-to-sleep on left or right side appears equally safe. No significant interactions with our assessed indicators of fetal vulnerability were identified, therefore, supine going-to-sleep position can be considered a contributing factor for late stillbirth in all pregnancies. This finding could reduce late stillbirth by 5.8% if every pregnant woman ≥ 28 weeks' gestation settled to sleep on her side. |
en |
dc.format.medium |
Electronic-eCollection |
en |
dc.language |
eng |
en |
dc.relation.ispartofseries |
EClinicalMedicine |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.rights.uri |
https://creativecommons.org/licenses/by-nc-nd/4.0/ |
en |
dc.title |
An Individual Participant Data Meta-analysis of Maternal Going-to-Sleep Position, Interactions with Fetal Vulnerability, and the Risk of Late Stillbirth. |
en |
dc.type |
Journal Article |
en |
dc.identifier.doi |
10.1016/j.eclinm.2019.03.014 |
en |
pubs.begin-page |
49 |
en |
pubs.volume |
10 |
en |
dc.rights.holder |
Copyright: Elsevier Ltd |
en |
pubs.end-page |
57 |
en |
pubs.publication-status |
Published |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/OpenAccess |
en |
pubs.subtype |
research-article |
en |
pubs.subtype |
Journal Article |
en |
pubs.elements-id |
774389 |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
School of Medicine |
en |
pubs.org-id |
Obstetrics and Gynaecology |
en |
pubs.org-id |
Paediatrics Child & Youth Hlth |
en |
dc.identifier.eissn |
2589-5370 |
en |
pubs.record-created-at-source-date |
2019-06-14 |
en |
pubs.dimensions-id |
31193832 |
en |