Cochrane: A low-cost antiseptic used to cleanse the cord after birth could
help reduce infant death rates in developing countries by 12%, a
systematic review published in the Cochrane Library suggests. Authors of
the review found that when chlorhexidine was used on babies born
outside of a hospital, it reduced the number of newborn babies who died
or suffer from infections.
A third of deaths in newborn babies are
caused by infections. As one of the World Health Organization's
Essential Medicines, chlorhexidine has been used in hospitals and other
medical settings to prevent bacterial infections for many decades. It
can be applied topically as a gel, wash, or powder. In maternity care,
it can be used either as a vaginal disinfectant to prevent the spread of
bacteria from mother to baby, or as a cleansing agent for the newborn
baby's skin or umbilical cord. In some countries with high infant death
rates, using chlorhexidine as a cleansing agent after birth has been
shown to be a cost-effective way to reduce the risk of death from
infection. However, more comprehensive approaches to examining the
evidence are required.
The researchers reviewed data from 12
trials involving over 87,000 newborns. Seven of the trials took place in
South-East Asia, two in Africa, two in Europe and one South America.
Of the 12 trials, the five carried out in community settings, which
involved 72,030 newborns, provided the highest quality evidence. These
trials included home births. They showed that cleansing cords with
chlorhexidine reduced infant deaths by 12% compared to keeping cords
dry. Using chlorhexidine also halved the number of newborn babies that
suffered from omphalitis, swelling of the cord stump commonly caused by
bacterial infections.
"Based on our review, using chlorhexidine to
clean the umbilical cord saves newborn babies’ lives," said lead
researcher Anju Sinha, who is based at the Indian Council of Medical
Research in New Delhi, India.
The authors conclude that further
evidence from African countries is needed to help to support the
findings. "The greatest benefits were seen in the South-East Asian
studies," said Sinha. "The results from African studies are less
convincing, so we would like to see whether the results from ongoing
trials in Zambia and Tanzania can substantiate this evidence."