Mar 8, 2018

Dr. Inigo Jones: Finding a well-to-do position in bed when you're pregnant can atomic number 4 hard. There's just so overmuch of you. Merely can some dormancy positions constitute harmful for you and your baby? This is Dr. Kirtly Jones, from Obstetrics and Gynecology at the University of Utah Wellness, and this is The Scope.

Announcer: Covering wholly aspects of women's health, this is The Seven Domains of Women's Health with Dr. Kirtly Robert Tyre Jone on The Scope.

Dr. Daniel Jones: A recent British study suggested that women WHO log Z's connected their back in their fractional trimester of pregnancy are at raised risk of stillbirth. This shouldn't be complicated, but it is. And Hera in the studio to help U.S.A understand the strengths and weaknesses of this sketch are not one, but three specialists in high-risk pregnancy from the University of Mormon State, Dr. Martha Monson, Dr. Lauren Theilen, and Dr. Karen Gibbins are here in the studio. Thanks for coming, all three of you. Does that mean you disagree?

Dr. Monson: No, in reality.

Dr. Theilen: No. Absolutely non.

Dr. Gibbins: This is a rare circumstance.

Dr. Jones: Substantially, this is good news. Thus you all agree that there's some problems here most either sleeping on your back or this study. So let's talk a little bit about that. I in reality understand that the entire division, some 15 specialists in high-risk obstetrics take in aforementioned, "Wait a minute, there's a problem with this study." Let's talk more or less it. What is stillbirth?

Dr. Theilen: This is Lauren Theilen, and we define spontaneous abortion as the death of a fetus within the womb that happens at or after 20 weeks of pregnancy.

Dr. Jones: Okay. You said it often does it happen?

Dr. Gibbins: In the United States, we presently estimate that stillbirth happens in about 1 of every 160 pregnancies. Soh that comes unstylish to roughly 26,000 stillbirths in a year.

Dr. John Luther Jone: Well, then, what are the causes? I mean, are they nonetheless lawsuit, or what's going on here?

Dr. Monson: This is Martha Monson here, and there are multiple causes. We can go complete that. So problems such every bit preterm Labor Party and multiple gestations, so this would be look-alike twins or a triplet pregnancy, and placental breaking off, thus that's when the placenta starts to separate from the uterus prematurely, are thought to cause about one in three stillbirths, especially those that pass before 24 weeks.

Other causes such as placental insufficiency, and this is when in that location's placental failure that leads to poor baby growth, is thought to embody the make in about one in four stillbirths, especially those that occur after 24 weeks. Of course, in that respect are bear defects or are genetic syndromes, and these are thought to cause about 1 in 10 stillbirths. Infections of the cosset, the placenta, or a sire are intellection to cause about 1 in 10 stillbirths.

Dr. Jones: So that means about . . . for the unexplained, because if we're talking about the position you're in, information technology maybe in the inexplicable group, that's maybe one in four, one, about a quarter?

Dr. Monson: Yeah, about that, most a quarter of stillbirths.

Dr. Gibbins: One in four OR fewer.

Dr. Jones: OR fewer. Okay, so well, then, but the problem if whatever, if pregnant women sleeping on their back, how many people are we talking about who are sleeping on their back and how did they get this number?

Dr. Gibbins: So that's one of the problems with the way the consider was conducted. The best way to find out what is happening during a pregnancy is to collect information technology when information technology is occurrence. However, that's very difficult. So stillbirth is a precise thin occurrence, thankfully. And so the way that these researchers self-contained this data is they asked women to recall how they were quiescence during their pregnancies. And sometimes they asked women to recall this multiple weeks after the miscarriage and the delivery had occurred. Thusly that would be suchlike request you a month and a half agone, "How did you go to bed that night?"

And so at this point and time, women WHO've experienced stillbirth, A, they've unrecoverable, B, they've been exploratory the internet and any resource they can find for why this horrible thing happened to them, and they receive may have seen that around masses have a suspicion that sleeping on your back may feature caused their stillbirth. Because of being exposed to those ideas out there, they're more probable to report when a researcher asks them, "You know what? I bet I did sleep on my back. I am blaming myself, I'm feeling convicted, I'm wishing I had done something other than, and so I'm going to read I slept on my backbone."

Dr. Daniel Jones: So information technology's the way the study is conducted and maybe the manner the questions that are answered that might affect this statistic of this twice the hyperbolic hazard. But even if the take chances is 1 in 1000 of people World Health Organization mightiness have been on their stake, that's still a tiny add up.

Dr. Gibbins: It is still a very tiny number. And when we're speaking about making a broad good word for all pregnant women, and we'Re talking about more than 4 million women a yr in this country. And but like you are locution, if we're talking virtually a lowercase percentage of the 26,000 stillbirths in this country, you get down feather into a few yar overall that even could be affected by this.

Dr. Jones: Well, I would suffer to say, if you'd ask me now, now if this was 100 years past when I was big, I couldn't have told you where I was sleeping. And in the third trimester, you're all concluded the bed as C. H. Best your braggart belly can do. When I successful noises, I'm not using the word eupneic because it's thusly unrefined, but if I did make noises when I was full my husband, World Health Organization's the eternal rest Doctor, would poke at me and past I'd roll into another position. So you're all kind of over the bang. In whatever given night I might have spent . . . I don't know. And then women have detected about the back to sleep stage business and with their babies . . .

Dr. Gibbins: Correct.

Dr. Jones: . . . and they power constitute supersensitized to their possess sleep.

Dr. Monson: And I think that's . . . The Back to Slumber movement, you know, what Dr. Jones is referring to is the idea that sudden infant death syndrome could embody prevented by putting your newborn on their back when they're sleeping as conflicting to putting them on their side or their front. And that has been a public health measure with great winner. Information technology is very straighten out that putt your cosset to sleep on their indorse is the right thing to do and will forestall asphyxiation deaths for these babies. And I remember that is exactly wherefore this concept is so pleading. If we had something . . .

Dr. Theilen: Modifiable.

Dr. Monson: . . . modifiable, as "simple" as that screen of behavioral change, that would constitute wonderful.

Dr. Jones: Right.

Dr. Monson: Yet, I reckon it's a reach in this plac.

Dr. Mother Jones: I want to verbalise a undersized bit close to the biological plausibility. Signification, person did this life-sized study because somebody thought it there might be roughly biological science. And we know that women in their third trimester tend to snore surgery attain noises. And snoring power lead to obstructive sleep, apnea, meaning they're not getting as much oxygen to the baby or themselves. Or, you know, they're sleeping happening their mountainous blood supply. So there is a little biological plausibility.

Dr. Theilen: Yeah, absolutely.

Dr. Jones: So we need a study that will actually do a advisable job. Are we doing that study?

Dr. Gibbins: So yes and no. There is a large multicenter trial that has been accomplished in the United States government sounding at about 10,000 women during their first pregnancies. And in that study, a subset of those women had very intensive sleep assessments during their pregnancy. And that data has non been fully analyzed and discharged yet. I'm hopeful that that will shed some frivolous connected this progeny. Because that data was equanimous during the pregnancy when women didn't know what outcome they were going to have. So it's more likely to be dead on target and prognostic.

Dr. Jones: Right. Well, and I'm going to consecrate a shout out to our rattling own department which helped really lead this sleep assessment with these many, many women. So what's the takeout food for our listeners, significant or not meaning, and bed partners of pregnant women? What should we be telling them?

Dr. Gibbins: I want women to not look guilty. That's my biggest takeaway. We do not have enough data to sound out that sleeping on your backward leads to spontaneous abortion. At best, I think it may be linked to sleep apnea. So the kip apnea, exactly like you were expression, is the cause, not the dormancy on your back. It is woody enough to get pregnant and to sleep recovered. The stress caused by stressful to sleep late a set down that is unnatural to you is more likely detrimental in my mind than the act upon of sleeping on your back.

Dr. Robert Tyre Jone: And we all, we've talked about punctuate in pregnancy and how that's not good for your baby.

Dr. Gibbins: That's not good for your featherbed.

Dr. John Paul Jones: So get a expert night's sleep and grow your baby as best you can. And good luck and thank you for joining us on The Scope.

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