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The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...

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Mothers working to prevent early stillbirth study (MiNESS 20-28): a case-control study protocol.

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This study investigates modifiable risk factors for pregnancy loss between 20-28 weeks gestation. Findings will inform public health campaigns and antenatal care to reduce early stillbirth rates.

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Area of Science:

  • Perinatal Medicine
  • Epidemiology
  • Public Health

Background:

  • 1600 babies die annually in the UK before, during, or immediately after birth (20-28 weeks' gestation).
  • This early bereavement significantly impacts parental well-being, similar to late stillbirth.
  • Understanding modifiable risk factors is crucial for clinical practice and parental decision-making.

Purpose of the Study:

  • To identify the proportion of pregnancy loss risk (20-28 weeks' gestation) linked to exposures addressable by public health initiatives and antenatal care.
  • To provide evidence for interventions aimed at reducing early stillbirth and associated inequalities.

Main Methods:

  • A case-control study design involving non-anomalous singleton pregnancy losses (20+0 to 27+6 weeks' gestation) and matched controls.
  • Data collection through researcher-administered questionnaires and medical record extraction.
  • Calculation of unadjusted and confounder-adjusted odds ratios (ORs) to identify significant risk factors (OR≥1.5).

Main Results:

  • The study is designed to detect exposures associated with early stillbirth with sufficient statistical power (p<0.05, β>0.80).
  • Specific findings on modifiable risk factors will be detailed upon study completion.

Conclusions:

  • Results will inform the development of targeted antenatal care strategies and educational materials.
  • The study aims to empower healthcare professionals and expectant parents with knowledge to mitigate the risk of early stillbirth.