{'fraction_non_alphanumeric': 0.03865267807840972, 'fraction_numerical': 0.04307012700165654, 'mean_word_length': 5.121621621621622, 'pattern_counts': {'":': 0, '<': 2, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Fetal surveillance from 39 weeks’ gestation: an alternative to earlier induction of labour to reduce stillbirth in South Asian born women? A Retrospective Cohort Study

Objectives: In July 2017, Victoria’s largest maternity service
implemented a new clinical guideline aimed to reduce the rates of
stillbirth at term for South Asian-born women. Here we present the
evaluation of the change in care on rates of stillbirth, neonatal and
obstetric interventions. Design: Cohort Study Setting: Victoria’s
largest metropolitan university-affiliated teaching hospital.
Population: All women receiving antenatal care who gave birth in the
term period between January 2016 and December 2020. Methods: Differences
in rates of stillbirths, neonatal deaths, perinatal morbidities, and
interventions after July 2017 were determined. Multigroup interrupted
time-series analysis was used to assess changes in rates of induction of
labour. Main Outcome Measures: Rates of stillbirths, neonatal deaths,
perinatal morbidities, and obstetric interventions. Results: 3506 south
Asian-born women gave birth prior to, and 8532 after the change. There
was a 64% reduction in term stillbirth (95%CI 87% to 2%; p=0.047)
for south Asian-born women after the change in practice from 2.3 per
1000 births to 0.8 per 1000 births. The rates of early neonatal death
(3.1 per 1000 vs 1.3 per 1000; p=0.03) and SCN admission (16.5% vs
11.1%; p<0.001) also decreased. There were no significant
differences in admission to NICU, Apgar<7 at 5 minutes,
birthweight or differences in the trends of induction of labour per
month. Conclusions: Fetal monitoring from 39 weeks’ may offer an
alternative to routine earlier induction of labour to reduce the rates
of stillbirth without causing an increase in neonatal morbidity or
obstetric interventions.