![Honorary Professor Vicki Flenady](/sites/default/files/profiles/4825.jpeg)
Overview
Background
Professor Vicki Flenady is the Director of the Centre of Research Excellence in Stillbirth (Stillbirth CRE), based at Mater Research – The University of Queensland. She is a nationally and internationally renowned clinical perinatal epidemiologist with specific expertise in stillbirth.
Professor Flenady has over 150 publications (including more than 30 Cochrane systematic reviews) with more than 50 in the last five years. She has also authored four book chapters and numerous state-wide and hospital clinical outcome reports. She led two papers in The Lancet Stillbirths Series in 2011 (one an accompanying research paper) and co-authored all others as a member of the series steering committee overseeing the production and dissemination of the series of six papers, two supplemental papers, and five commentaries. She is a member of the Study Group for The Lancet’s 2016 Ending Preventable Stillbirths series, leading one paper and co-authoring all others (five in total). Other key research publications as lead/senior author include a suite of papers on the development of global indicators for maternity and newborn care and evaluation of classification systems for the development of a new WHO classification system for stillbirth and neonatal death. She has also authored or co-authored books and developed many national and state guidelines pertaining to stillbirth and neonatal death.
Professor Flenady's successful bid to establish Australia's first Stillbirth CRE has formally brought together parents, parent advocates, health care professionals, researchers, professional colleges, and policy makers, to reduce stillbirths and improve the quality care for women and families after stillbirth. A collaboration of academic institutions and not-for-profit organisation, The Stillbirth CRE is an Australia-wide initiative aiming to reduce the rate of stillbirthin Australia and ensure quality, respectful care for all families who experience the tragedy of stillbirth.
Professor Flenady is currently leading two NHMRC funded studies; a large-scale cluster randomised controlled trial testing the role of a mobile phone app for women on decreased fetal movements in reducing stillbirth, and a multisite study to identify causes of stillbirth and the value of recommended investigations for stillbirth. Through the Perinatal Society of Australia and New Zealand (PSANZ), Vicki leads a collaboration promoting best practice in perinatal mortality through bi-national guidelines and clinician education with a major focus on investigation into the causes of stillbirth and bereavement care.
Professor Flenady has won a number of awards including: the 2008 National Institute of Clinical Studies evidence into practice award for implementing the Perinatal Society of Australia and New Zealand Perinatal Mortality Audit Guidelines; the 2011 Eileen Potter Award for Translating Research Into Practice; the 2016 Excellence in Research Award Mater Medical Research institute; the 2013 the Medal of Distinction Women’s Healthcare Australasia honouring her outstanding contribution at a national level to improving health of women through service provision, leadership and advocacy; and the 2018 Distinguished researcher award from the International Stillbirth Alliance.
Availability
- Honorary Professor Vicki Flenady is:
- Available for supervision
- Media expert
Fields of research
Research impacts
At the core of Professor Flenady's research program is the translation of research into clinical practice change. Through PSANZ and the Stillbirth CRE, she has authored key clinical practice guidelines relating to perinatal health, including the care of women who report decreased fetal movements during pregnancy, and recommended clinical practice following stillbirth or neonatal death (available at the Stillbirth CRE website). Professor Flenady was recognised for her role in implementing these guidelines into practice with a National Institute of Clinical Studies evidence into practice award in 2008.
Also together with PSANZ and the Stillbirth CRE, Professor Flenady has convened education programs for clinicians around the detection and management of fetal growth restriction, and around clinical practice following stillbirth or neonatal death, via the IMproving Perinatal Mortality Review and Outcomes Via Education (IMPROVE) workshops.
Most recently, Professor Flenady led the Stillbirth CRE's collaborative submission to the Select Committee on Stillbirth Research and Education inquiry and report on the future of stillbirth research and education in Australia. She was a witness at the Brisbane public hearing together with members of the Stillbirth CRE executive committee. The written submission can be downloaded here and transcript for the Brisbane public hearing downloaded here.
Works
Search Professor Vicki Flenady’s works on UQ eSpace
2021
Journal Article
Prospective cohort study: Causes of stillbirth in Australia 2013–2018
Sexton, Jessica K., Mahomed, Kassam, Marsden, Tania, Coory, Michael, Gardener, Glenn, Ellwood, David, Gordon, Adrienne, Shand, Antonia W., Yee Khong, Teck, Gordon, Louisa G. and Flenady, Vicki (2021). Prospective cohort study: Causes of stillbirth in Australia 2013–2018. Australian and New Zealand Journal of Obstetrics and Gynaecology, 61 (5), 667-674. doi: 10.1111/ajo.13334
2021
Journal Article
Effectiveness of neonatal "near miss" audits in reducing perinatal morbidity and mortality: a systematic review protocol
Medeiros, Poliana, Bailey, Cheryl, Andrews, Christine, Liley, Helen, Pollock, Danielle, Gordon, Adrienne and Flenady, Vicki (2021). Effectiveness of neonatal "near miss" audits in reducing perinatal morbidity and mortality: a systematic review protocol. JBI evidence synthesis, Publish Ahead of Print (3), 847-853. doi: 10.11124/jbies-21-00069
2021
Conference Publication
Investigating the utility of the customised fetal growth chart: a pragmatic randomised controlled trial
Gibbons, Kristen, Beckmann, Michael, Flenady, Vicki, Gardenre, Glenn and Gray, Peter (2021). Investigating the utility of the customised fetal growth chart: a pragmatic randomised controlled trial. IEA World Congress of Epidemiology 2021, Virtual, 3-6th September 2021. Oxford, United Kingdom: Oxford University Press. doi: 10.1093/ije/dyab168.225
2021
Journal Article
Interventions relating to fetal movements for improving pregnancy outcomes
Davies-Tuck, Miranda, Middleton, Philippa, Weller, Megan E., Gordon, Adrienne, Smith, Valerie, Walker, Susan P. and Flenady, Vicki (2021). Interventions relating to fetal movements for improving pregnancy outcomes. Cochrane Database of Systematic Reviews, 2021 (7) CD014714, 1-11. doi: 10.1002/14651858.CD014714
2021
Journal Article
Evaluation of an online education module designed to reduce stillbirth
Andrews, Christine, Meredith, Natasha, Seeho, Sean, Weller, Megan, Griffin, Alison, Ellwood, David, Middleton, Philippa, Jennings, Belinda and Flenady, Vicki (2021). Evaluation of an online education module designed to reduce stillbirth. Australian and New Zealand Journal of Obstetrics and Gynaecology, 61 (5) ajo.13380, 675-683. doi: 10.1111/ajo.13380
2021
Journal Article
Development of a core outcome set for interventions to prevent stillbirth
Kim, Bobae V., Aromataris, Edoardo C., Middleton, Philippa, Townsend, Rosemary, Thangaratinam, Shakila, Duffy, James M. N., Lint, Willem, Coat, Suzette, Flenady, Vicki, Khalil, Asma and Mol, Ben W. (2021). Development of a core outcome set for interventions to prevent stillbirth. Australian and New Zealand Journal of Obstetrics and Gynaecology, 61 (5) ajo.13369, 658-666. doi: 10.1111/ajo.13369
2021
Journal Article
Evaluation of Movements Matter: a social media and hospital‐based campaign aimed at raising awareness of decreased fetal movements
Chan, Lilian, Gordon, Adrienne, Warrilow, Kara, Wojcieszek, Aleena, Firth, Tracy, Loxton, Felicity, Bauman, Adrian and Flenady, Vicki (2021). Evaluation of Movements Matter: a social media and hospital‐based campaign aimed at raising awareness of decreased fetal movements. Australian and New Zealand Journal of Obstetrics and Gynaecology, 61 (6) ajo.13360, 846-854. doi: 10.1111/ajo.13360
2021
Journal Article
Evaluation of pregnancy outcomes among women with decreased fetal movements
Turner, Jessica M., Flenady, Vicki, Ellwood, David, Coory, Michael and Kumar, Sailesh (2021). Evaluation of pregnancy outcomes among women with decreased fetal movements. JAMA Network Open, 4 (4), e215071. doi: 10.1001/jamanetworkopen.2021.5071
2021
Journal Article
Making every birth count: Outcomes of a perinatal mortality audit program
Flenady, Vicki, Kettle, Imogen, Laporte, Johanna, Birthisel, Deborah, Hardiman, Leah, Matsika, Admire, Whelan, Nikki, Lehner, Christoph, Payton, Diane, Utz, Miles, Wojcieszek, Aleena M., Lawford, Harriet, Walsh, Teresa and Ellwood, David (2021). Making every birth count: Outcomes of a perinatal mortality audit program. Australian and New Zealand Journal of Obstetrics and Gynaecology, 61 (4), 540-547. doi: 10.1111/ajo.13325
2021
Journal Article
Developing a core outcome set in interventions to prevent stillbirth: a systematic review on variations of outcome reporting
Kim, Bobae V., Aromataris, Edoardo C., de Lint, Willem, Middleton, Philippa, Townsent, Rosemary, Khalil, Asma, Duffy, James M., Flenady, Vicki, Thangaratinam, Shakila and Mol, Ben W. (2021). Developing a core outcome set in interventions to prevent stillbirth: a systematic review on variations of outcome reporting. European Journal of Obstetrics and Gynecology and Reproductive Biology, 259, 196-206. doi: 10.1016/j.ejogrb.2020.12.036
2021
Journal Article
Parents’ experiences of care offered after stillbirth: an international online survey of high and middle‐income countries
Horey, Dell, Boyle, Frances M., Cassidy, Jillian, Cassidy, Paul Richard, Erwich, Jan Jaap H. M., Gold, Katherine J., Gross, Mechthild M., Heazell, Alexander E. P., Leisher, Susannah Hopkins, Murphy, Margaret, Ravaldi, Claudia, Siassakos, Dimitrios, Storey, Claire, Vannacci, Alfredo, Wojcieszek, Aleena and Flenady, Vicki (2021). Parents’ experiences of care offered after stillbirth: an international online survey of high and middle‐income countries. Birth, 48 (3), 366-374. doi: 10.1111/birt.12546
2021
Journal Article
Parent engagement in perinatal mortality reviews: an online survey of clinicians from six high income countries
Boyle, Frances M., Horey, Dell, Siassakos, Dimitrios, Burden, Christy, Bakhbakhi, Danya, Silver, Robert M. and Flenady, Vicki (2021). Parent engagement in perinatal mortality reviews: an online survey of clinicians from six high income countries. BJOG: An International Journal of Obstetrics and Gynaecology, 128 (4), 696-703. doi: 10.1111/1471-0528.16529
2021
Journal Article
Systematic review of ambient temperature exposure during pregnancy and stillbirth: methods and evidence
Sexton, Jessica, Andrews, Christine, Carruthers, Selina, Kumar, Sailesh, Flenady, Vicki and Lieske, Scott (2021). Systematic review of ambient temperature exposure during pregnancy and stillbirth: methods and evidence. Environmental Research, 197 111037, 111037. doi: 10.1016/j.envres.2021.111037
2021
Journal Article
Systematic review: fetal death reporting and risk in Zika-affected pregnancies
Leisher, Susannah Hopkins, Balalian, Arin A., Reinebrant, Hanna, Shiau, Stephanie, Flenady, Vicki, Kuhn, Louise and Morse, Stephen S. (2021). Systematic review: fetal death reporting and risk in Zika-affected pregnancies. Tropical Medicine and International Health, 26 (2), 133-145. doi: 10.1111/tmi.13522
2021
Journal Article
Towards respectful supportive care after stillbirth for every woman
Flenady, Vicki and Boyle, Frances M. (2021). Towards respectful supportive care after stillbirth for every woman. BJOG: An International Journal of Obstetrics and Gynaecology, 128 (1) 1471-0528.16455, 110-110. doi: 10.1111/1471-0528.16455
2021
Journal Article
Healthcare costs of investigations for stillbirth from a population-based study in Australia
Gordon, Louisa G., Elliott, Thomas M., Marsden, Tania, Ellwood, David A., Khong, T. Yee, Sexton, Jessica and Flenady, Vicki (2021). Healthcare costs of investigations for stillbirth from a population-based study in Australia. Australian Health Review, 45 (6), 735-744. doi: 10.1071/ah20291
2021
Journal Article
Counting stillbirths and COVID 19—there has never been a more urgent time
Homer, Caroline S. E., Leisher, Susannah Hopkins, Aggarwal, Neelam, Akuze, Joseph, Babona, Delly, Blencowe, Hannah, Bolgna, John, Chawana, Richard, Christou, Aliki, Davies-Tuck, Miranda, Dandona, Rakhi, Gordijn, Sanne, Gordon, Adrienne, Jan, Rafat, Korteweg, Fleurisca, Maswime, Salome, Murphy, Margaret M., Quigley, Paula, Storey, Claire, Vallely, Lisa M., Waiswa, Peter, Whitehead, Clare, Zeitlin, Jennifer and Flenady, Vicki (2021). Counting stillbirths and COVID 19—there has never been a more urgent time. The Lancet Global Health, 9 (1), e10-e11. doi: 10.1016/S2214-109X(20)30456-3
2020
Journal Article
Antenatal interventions for preventing stillbirth, fetal loss and perinatal death: an overview of Cochrane systematic reviews
Ota, Erika, da Silva Lopes, Katharina, Middleton, Philippa, Flenady, Vicki, Wariki, Windy MV, Rahman, Md. Obaidur, Tobe-Gai, Ruoyan and Mori, Rintaro (2020). Antenatal interventions for preventing stillbirth, fetal loss and perinatal death: an overview of Cochrane systematic reviews. Cochrane Database of Systematic Reviews, 2020 (12) CD009599. doi: 10.1002/14651858.CD009599.pub2
2020
Journal Article
Protocol for the development and validation of a risk prediction model for stillbirths from 35 weeks gestation in Australia
Sexton, Jessica K., Coory, Michael, Kumar, Sailesh, Smith, Gordon, Gordon, Adrienne, Chambers, Georgina, Pereira, Gavin, Raynes-Greenow, Camille, Hilder, Lisa, Middleton, Philippa, Bowman, Anneka, Lieske, Scott N., Warrilow, Kara, Morris, Jonathan, Ellwood, David and Flenady, Vicki (2020). Protocol for the development and validation of a risk prediction model for stillbirths from 35 weeks gestation in Australia. Diagnostic and Prognostic Research, 4 (1) 21, 21. doi: 10.1186/s41512-020-00089-w
2020
Journal Article
Trends in neonatal resuscitation patterns in Queensland, Australia — a 10-year retrospective cohort study
Kapadia, Priyanka, Hurst, Cameron, Harley, David, Flenady, Vicki, Johnston, Trisha, Bretz, Paul and Liley, Helen G. (2020). Trends in neonatal resuscitation patterns in Queensland, Australia — a 10-year retrospective cohort study. Resuscitation, 157, 126-132. doi: 10.1016/j.resuscitation.2020.10.031
Funding
Current funding
Supervision
Availability
- Honorary Professor Vicki Flenady is:
- Available for supervision
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Available projects
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Implementing best practice in care after stillbirth and in subsequent pregnancies
The psychosocial impact on mothers and families and society is substantial, yet the care received by parents in Australia is highly variable. Studies show parents’ needs are frequently unmet. Parents face many critical decisions following stillbirth and more support and guidance is needed, particularly around autopsy consent. For those embarking on subsequent pregnancies, there is a five-fold increased risk of stillbirth. Heightened anxiety and fear in subsequent pregnancies is common, yet there is little guidance for clinicians on the optimal clinical care for these women. The additional economic costs of stillbirth need to be quantified for efficient health service planning. This is a suite of studies around the implementation of best practice for immediate care after a stillbirth and in subsequent pregnancies that follow.
Please see further details by clicking on the study title.
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Stillbirth Bundle of Care
The Stillbirth CRE is leading the development of a bundle of care to address the priority evidence practice gaps in stillbirth prevention for implementation across maternity services. This work is being done in partnership with health departments of New South Wales, Victoria, and Queensland and key stillbirth advocacy organisations, Stillbirth Foundation Australia and Still Aware.
The proposed bundle of care for Australian hospitals is being modeled on the Saving Babies Lives bundle in the United Kingdom, which addresses commonly identified areas of substandard care.
A 20% reduction in stillbirth rates has been seen in the UK and Scotland, where a care bundle has been implemented. We believe that implementation of a similar care bundle in Australia will result in at least the same reduction in stillbirth. We think the bundle will also reduce serious adverse outcomes in liveborn babies, improve health outcomes among mothers, increase mothers' satisfaction with car, and be cost-effective.
Bundle of care elements currently:
- Improving detection and management of fetal growth restriction (FGR)
- Improving awareness and management of decreased fetal movement (DFM)
- Reducing smoking in pregnancy
- Improving awareness of maternal safe sleeping position
- Improving decision-making around timing of birth for women with risk factor
Please see further details by clicking on the study title.
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My Baby's Movements
A stillborn child is devastating for the mother, father and family often resulting in profound and long-lasting adverse psychosocial effects. There are over 2.6 million stillbirths each year globally and progress in reducing these deaths has been extremely slow. Maternal reporting of decreased fetal movements (DFM) is strongly associated with stillbirth and has been proposed as a simple, inexpensive screening tool for stillbirth. However maternal awareness of DFM and clinical management of women who report DFM is often suboptimal. Preliminary data suggests that interventions to increase awareness of DFM may reduce stillbirth rates. Mobile phone applications are increasingly used as an information source by pregnant women.
The aim of the MBM trial is evaluate the effectiveness of a mobile phone program for women combined with an educational program for clinicians (MBM package) in reducing late gestation stillbirth rates
MBM is a stepped wedge cluster randomised controlled trial with sequential introduction of the intervention into 8 groups of 3-4 hospitals at four month intervals over a total of three years.
Women with a singleton pregnancy without a major fetal abnormality attending for antenatal care and midwives and doctors providing maternity care at 26 maternity hospitals in Australia and New Zealand.
The primary outcome is stillbirth at 28 weeks or more gestation. Secondary outcomes include: a) composite measure of adverse neonatal outcomes; b) health service utilisation measures; c) woman’s psychosocial outcomes and health seeking behaviour and acceptability; and d) clinical intervention for women with DFM aligned with best practice recommendations.
Sample size: 256,700 births over three years
There are numerous opportunities for PhD and masters projects within this large scale trial.
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Investigating the causes of stillbirth
Knowledge of the causes and contributing factors in stillbirth is crucially important to parents to understand why their baby died and is also the cornerstone of future prevention of stillbirths. Contributing factors relating to care are identified in a small, but important, proportion of stillbirths. Currently, data quality to understand the important contributors for stillbirth is often suboptimal due to under-investigation, inadequate classification and clinical audit of the circumstances surrounding the death.
The focus of this work is on developing an evidence-based stillbirth investigation protocol and enhancements to the existing Perinatal Society of Australia and New Zealand stillbirth and neonatal deaths classification system and audit mechanisms.
Please see further details by clicking on the study title.
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Shared decision-making around timing of birth for women with risk factors at term
This specific project is aligned with the fifth element of the 'Safe Baby Bundle' (SBB) and will explore novel strategies to help translate best-evidence into practice for timing of birth for women with risk factors at term. Research shows that women want to engage in their care and that women’s engagement is associated with better outcomes for mothers and babies. Shared decision-making is “an approach where clinicians and patients share the best available evidence when faced with the task of making decisions, and where patients are supported to consider options, to achieve informed preferences. Students working on this project will carry out a research project nested within the SBB initiative. Additionally, a systematic review will be undertaken to summarise the world literature on the value of shared decision making around timing of birth for women with stillbirth risk factors at term.
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Stillbirth Causes Study
The currently high proportion of unexplained stillbirths is a major barrier to identifying strategies to reduce the stillbirth rate. Many stillbirths are under investigated and the unexplained stillbirth represents a heterogeneous population including those missed diagnosis and those that are yet to be explained through future research. The current lack of evidence for recommended testing is a significant barrier to understanding the causes of stillbirth. Students working on this project analyse the data pertaining to detailed examination of causes of death in a cohort of an estimated 650 stillbirths, and the value of recommended stillbirth investigations including autopsy and placental examination according to presenting scenario. The value of the yield from autopsy will be ascertained from the perspective of the clinician and the parent. A systematic review will be undertaken to summarise the world literature on the value of investigations for stillbirths. Further, detailed review of placental findings will inform revisions to the national classification system for stillbirth.
Supervision history
Current supervision
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Doctor Philosophy
Perinatal mortality audit and classification to drive practice change in perinatal death and near-miss
Principal Advisor
Other advisors: Dr Christine Andrews
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Doctor Philosophy
Evaluation of Maternal and Perinatal Death surveillance and Response in Ethiopia: Opportunities and challenges of MPDSR implementation progress
Principal Advisor
Other advisors: Associate Professor Fran Boyle, Dr Christine Andrews
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Doctor Philosophy
Improving the standards of Autopsy and placental pathology in stillbirth investigations in Australia
Associate Advisor
Other advisors: Associate Professor Fran Boyle, Dr Jessica Sexton
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Doctor Philosophy
Smoking cessation referral and uptake of Quitline services for pregnant women
Associate Advisor
Other advisors: Dr Christine Andrews
Completed supervision
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2022
Doctor Philosophy
The impact of asthma on maternal pregnancy complications, stillbirth and other adverse perinatal outcomes
Principal Advisor
Other advisors: Honorary Professor Vicki Clifton, Dr Christine Andrews
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2022
Doctor Philosophy
Epidemiology and prediction of stillbirth in Australia
Principal Advisor
Other advisors: Professor Sailesh Kumar, Dr Scott Lieske
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2019
Doctor Philosophy
Care in pregnancies after stillbirth: generating evidence to inform clinical practice
Principal Advisor
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2019
Doctor Philosophy
Decreased fetal movement and mobile application interventions during pregnancy
Principal Advisor
Other advisors: Associate Professor Fran Boyle, Associate Professor Kristen Gibbons, Professor Sailesh Kumar
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2016
Doctor Philosophy
Preventing stillbirths: Better data to inform interventions in Australia
Principal Advisor
Other advisors: Associate Professor Fran Boyle
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2019
Doctor Philosophy
Maternal and perinatal factors associated with adverse perinatal outcomes at term and the development of a predictive model for identification of at risk pregnancies.
Associate Advisor
Other advisors: Associate Professor Kristen Gibbons, Professor Sailesh Kumar
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2019
Doctor Philosophy
Reducing the risk of fetal distress with sildenafil: The RIDSTRESS pilot study
Associate Advisor
Other advisors: Professor Sailesh Kumar
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2017
Doctor Philosophy
Induction of Labour Using Prostaglandin (PGE2) Vaginal Gel
Associate Advisor
Other advisors: Professor Sailesh Kumar
Media
Enquiries
Contact Honorary Professor Vicki Flenady directly for media enquiries about:
- perinatal mortality audit
- risk factors
- stillbirth
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