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. When the broad-spectrum antiseptic agent chlorhexidine was used on babies born outside of a hospital, the number of newborns who died or experienced infections was reduced.
A third of deaths in newborn babies are caused by infections. 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 mortality rates, the use of chlorhexidine as a cleansing agent after birth has been 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 in 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 with keeping cords dry. Using chlorhexidine also halved the number of newborn babies with 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, in a press release.
The authors concluded 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."