Chlorhexidine to Umbilical Cord Stump Reduces Newborn Mortality
(HealthDay News) – Cleaning the umbilical cord with chlorhexidine after birth significantly reduces newborn mortality and infection in rural Bangladesh and Pakistan, according to two studies published online Feb. 8 in The Lancet.
In the first study, Shams El Arifeen, DrPH, from the International Centre for Diarrhoeal Disease Research in Dhaka, Bangladesh, and colleagues randomly assigned 29,760 newborn babies in rural Bangladesh to either a single cleansing of the umbilical cord with 4% chlorhexidine at birth, daily cleansing of the umbilical cord with chlorhexidine for seven days after birth, or promotion of dry cord care as a control. They found that a single cleansing significantly reduced neonatal mortality compared with dry cord care (relative risk, 0.8), while multiple cleansing had no significant effect. Multiple cord cleansing significantly reduced the occurrence of severe cord infection (relative risk, 0.35), while a single cleansing had no significant effect.
In the second study, Sajid Soofi, FCPS, from Aga Khan University in Karachi, Pakistan, and colleagues randomly assigned 9,741 newborns in rural Pakistan to either cleansing of the umbilical cord with 4% chlorhexidine at birth and daily for up to fourteen days along with antiseptic soap and promotion of hand washing, cleansing with chlorhexidine only, hand washing only, or standard dry cord care as a control. They found that chlorhexidine significantly reduced neonatal mortality (risk ratio, 0.62) and omphalitis (risk ratio 0.58), while hand washing had no effect.
"On balance, we think that sufficient evidence has accrued to claim proof-of-principle that application of 4% chlorhexidine to the cord stump can prevent omphalitis and neonatal mortality in high-mortality settings," David Osrin, PhD, and Zelee Elizabeth Hill, PhD, from the University College London Institute for Global Health write in an accompanying editorial.