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The AFFIRM study: Can promoting Awareness of Fetal movements and Focussing Interventions Reduce fetal Mortality - a stepped wedge cluster randomised trial.

Rates of stillbirth in the UK are amongst some of the highest in developed countries.

The majority of stillbirths occur in normally formed infants, with (retrospective) evidence of placental insufficiency being the commonest clinical finding.

A mother’s perception of decreased fetal movements appears to be an early biomarker both of placental insufficiency and subsequent stillbirth.

The AFFIRM study will test to see if rates of stillbirth may be reduced by introducing an interventional package of care. This will try to increase a pregnant women’s awareness of the need for prompt reporting of decreased fetal movements.

This will be followed by a care management plan to identify any possible placental issues, with timely delivery in confirmed cases.

The study has a stepped wedge cluster design. This means that all the participating hospitals in the UK will not begin the introduction of the care package at the same time. Hospitals will take part one after another. Eventually, all the hospitals taking part in AFFIRM will be introducing the care package.

View a helpful video from the NHS regarding fetal movement