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Dear list members This morning I read both the Lancet response to the Affirm trial and the RCM statement about it. I am curious to hear what people think about the different tone of the responses. The Lancet comment pull no punches – so to speak: Encouraging awareness of fetal movements is harmful<http://links.govdelivery.com:80/track?type=click&enid=ZWFzPTEmbXNpZD0mYXVpZD0mbWFpbGluZ2lkPTIwMTgxMDExLjk2MDc2NjkxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE4MTAxMS45NjA3NjY5MSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3MDQ1MzczJmVtYWlsaWQ9Y2hyaXN0aW5lLm1jY291cnQuMUBjaXR5LmFjLnVrJnVzZXJpZD1jaHJpc3RpbmUubWNjb3VydC4xQGNpdHkuYWMudWsmdGFyZ2V0aWQ9JmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=&&&188&&&http://transit.linexsystems.com/track/click/30370861/www.thelancet.com?p=eyJzIjoiMExrTGg1bEFSRWFocHNTSFZCcU91SzhoUTNnIiwidiI6MSwicCI6IntcInVcIjozMDM3MDg2MSxcInZcIjoxLFwidXJsXCI6XCJodHRwczpcXFwvXFxcL3d3dy50aGVsYW5jZXQuY29tXFxcL2pvdXJuYWxzXFxcL2xhbmNldFxcXC9hcnRpY2xlXFxcL1BJSVMwMTQwLTY3MzYoMTgpMzE3MjAtM1xcXC9mdWxsdGV4dFwiLFwiaWRcIjpcIjJiYTBmOTI0YzdjNTQ3ZDI4MDgzYzA3NWZlOGM4MjQ5XCIsXCJ1cmxfaWRzXCI6W1wiNTI0ODIwZDg1ZmFhMjg0MjczNjNkYjcxYjg3ODVmYzhlYmEyOTc4OVwiXX0ifQ>; While the Royal College of Midwives press release seems very ambiguous: New strategy to reduce stillbirths remains unproven<http://links.govdelivery.com:80/track?type=click&enid=ZWFzPTEmbXNpZD0mYXVpZD0mbWFpbGluZ2lkPTIwMTgxMDExLjk2MDc2NjkxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE4MTAxMS45NjA3NjY5MSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3MDQ1MzczJmVtYWlsaWQ9Y2hyaXN0aW5lLm1jY291cnQuMUBjaXR5LmFjLnVrJnVzZXJpZD1jaHJpc3RpbmUubWNjb3VydC4xQGNpdHkuYWMudWsmdGFyZ2V0aWQ9JmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=&&&189&&&http://transit.linexsystems.com/track/click/30370861/www.rcm.org.uk?p=eyJzIjoiVlc2QVI2UGF5ZUtQY2w0OWMyT2gzWXhwSmNRIiwidiI6MSwicCI6IntcInVcIjozMDM3MDg2MSxcInZcIjoxLFwidXJsXCI6XCJodHRwczpcXFwvXFxcL3d3dy5yY20ub3JnLnVrXFxcL25ld3Mtdmlld3MtYW5kLWFuYWx5c2lzXFxcL25ld3NcXFwvbmV3LXN0cmF0ZWd5LXRvLXJlZHVjZS1zdGlsbGJpcnRocy1yZW1haW5zLXVucHJvdmVuXCIsXCJpZFwiOlwiMmJhMGY5MjRjN2M1NDdkMjgwODNjMDc1ZmU4YzgyNDlcIixcInVybF9pZHNcIjpbXCI5YzMxOTI3MzUyMmQ4ODViNzg4MmFmOGNmNDkzODkyNTFiMzk5Nzc2XCJdfSJ9>. The Lancet comment includes more detail on the research per se, including noting the finding of greater harm in relation to secondary outcomes: higher rate of postneonatal deaths; higher rate of CS, higher rate of neonatal unit admissions and no reduction in perinatal deaths as well as the higher rate of inductions. The RCM statement has less detail but refers to the increased induction and CS rates and rates of admission to NNU >48 hours. The RCM statement is more ambiguous in the wording used around the primary outcome – ‘offers only a marginal drop say researchers.’ The Lancet’s language is more precise: ‘Unfortunately, stillbirths were not significantly reduced by this intervention (AOR 0·90, 95% CI 0·75–1·07) and there was no effect on perinatal mortality (0·98, 0·83–1·17).’ I wonder what list members think lies behind this difference in presentation of the same set of research results? Some possible hypotheses: * The RCM considered that its readership would be more a ‘lay’ readership and so provided less research detail? * A medical publication is able to be more confident and assured in reporting negative outcomes of a trial that concerns maternity care? I’m sure you will have your own thoughts about this. Or did you read it differently? Christine McCourt Professor of Maternal Health & Centre Lead Centre for Maternal & Child Health Research School of Health Sciences<http://www.city.ac.uk/health> City, University of London 1 Myddelton Street London EC1R 1UW Tel: 0207 040 5863 Mob: 0791 235 1476 Twitter: @ProfMcCourt [ps://blogs.city.ac.uk/mchresearch/files/2015/06/cute-newborn-babycute-newborn-babies-21k444f-624x390.j]<https://blogs.city.ac.uk/mchresearch/> Centre for Maternal and Child Health Research | City ... The Centre for Maternal and Child Health Research carries out high quality research that aims to improve the health and care of women, children, families and communities. Read more...<https://blogs.city.ac.uk/mchresearch/> Want to further your clinical and academic career? To find out more about City, University of London’s MSc Advanced Practice Midwifery programme please click here<http://www.city.ac.uk/courses/postgraduate/advanced-practice-in-health-and-social-care-midwifery#course-detail=0>. [cid:image002.jpg@01D39935.C983C990] ######################################################################## To unsubscribe from the MIDWIFERY-RESEARCH list, click the following link: https://www.jiscmail.ac.uk/cgi-bin/webadmin?SUBED1=MIDWIFERY-RESEARCH&A=1