Side Sleeping 'Reduces Stillbirth Deaths'

Peter Russell

April 11, 2019

Pregnant women who sleep on their side rather than on their back could lower their risk of stillbirth, a study found.

Sleeping on their left or right side was associated with slightly different risk factors, but the principle remained the same, researchers said.

The advice, published in the Lancet's EClinicalMedicine , has been included in the latest advice for preventing stillbirth published by the NHS, designed to bring about reductions in the number of babies stillborn in the UK – amounting to 1 in every 225 births.

The Advice

Researchers conducted a meta-analysis on maternal going-to-sleep position and third trimester stillbirth involving data from five relevant studies.

After adjusting for relevant factors, they found that maternal supine going-to-sleep position from 28 weeks of pregnancy, compared with left side going-to-sleep position, was independently associated with a 2.6-fold increase in late stillbirth. 

They also found that right side going-to-sleep position had no increase in odds compared to left, so that sleeping on either their left or right side reduced the odds of stillbirth, they said.    

Sleeping on their side, pregnant women at 28 weeks or later of pregnancy could reduce the odds of stillbirth by 5.8% compared with those women who slept on their back, the researchers found.

The study, led by Tomasina Stacey, a reader of midwifery practice at the University of Huddersfield, triggered further research, culminating in a large-scale international project that gathered data from the UK, New Zealand, Australia, and the US. It included 851 mothers whose babies had been stillborn and 2257 women with ongoing pregnancy.

Stillborn Research

The main findings were that supine sleep from 28 weeks of pregnancy increased the risk of stillbirth regardless of other known risk factors for stillbirth.

The UK charity Tommy's, which funds research into miscarriage, stillbirth and premature birth, included Dr Stacey's findings about sleep position in its advice to pregnant women.

The NHS incorporated the findings in its Saving Babies' Lives care bundle - a dossier of advice issued as part of a push to halve the rate of stillbirths in the UK. It says that sleeping on your back "doubles the risk of stillbirth" because there may be a reduced flow of oxygen to the foetus.

Commenting on the research, Dr Stacey said: "The next phase is to ensure that there is consistent advice from healthcare professionals, and we will be looking to see if there are ways of helping to support women to sleep in the side position.

"Only a small proportion of women will be affected. But the studies that we did following the first findings suggested that women were quite happy to change their going-to-sleep position if it was better for their babies."

EClinicalMedicine, An Individual Participant Data Meta-analysis of Maternal Going-to-Sleep Position, Interactions with Fetal Vulnerability, and the Risk of Late Stillbirth. Research Paper.


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