February 20, 2012
Chlorhexidine umbilical cord care can save newborn lives
Cleansing a newborn’s umbilical cord with chlorhexidine can reduce his risk of infection and death during the first weeks of life by as much as 20 percent, according to a study led by researchers at the Johns Hopkins Bloomberg School of Public Health.
The study, conducted in rural Bangladesh in partnership with ICDDR,B and Bangladeshi NGO Shimantik, and funded by the United States Agency for International Development and Save the Children’s Saving Newborn Lives program, is the latest in a series of studies showing that umbilical cord cleansing with chlorhexidine can save lives. The new findings were published online Feb. 8 by The Lancet.
For the study, Johns Hopkins researchers and colleagues in Bangladesh enrolled more than 29,000 newborns in a randomized trial to determine the effectiveness of single or seven-day cleansing with 4 percent chlorhexidine as compared to the standard dry cord care. According to the study, infants who received a single cleansing with chlorhexidine were 20 percent less likely to die compared with infants who received the standard dry cord care. Reductions in mortality were not statistically significant among the seven-day cleansing group compared to dry care, but the infants did have fewer signs of cord infection.
“Chlorhexidine cord cleansing is a simple, safe, effective and inexpensive intervention. Large-scale implementation of this intervention with universal coverage has the potential to avert an estimated half a million neonatal deaths per year,” said Abdullah Baqui, senior author and principal investigator of the study and a professor in the Bloomberg School’s Department of International Health.
An early study conducted by Johns Hopkins researchers in Nepal showed that cleansing the umbilical cord with chlorhexidine for seven of the first 10 days of life resulted in a 24 percent decrease in mortality compared to children who received dry cord care. A separate study by researchers from Aga Khan University in Pakistan, which also appears in the current issue of The Lancet, found that cord cleansing with chlorhexidine reduced infant mortality by 38 percent and infections by 42 percent.
“Giving birth and a child’s first week are risky times for a mother and her newborn,” said Rajiv Shah, administrator of USAID. “These studies provide evidence of a simple, low-cost technology that can prevent illness and death for the most vulnerable children. USAID is committed to transforming research into better results and access to lifesaving interventions.”
Neonatal deaths account for more than 40 percent of the estimated 8.8 million deaths of children under the age of 5 each year worldwide. In high-mortality settings, more than half of those neonate deaths are the result of serious infection.
Authors of the study, in addition to Baqui, are Shams El Arifeen, Luke C. Mullany, Rasheduzzaman Shah, Ishtiaq Mannan, Syed M. Rahman, M. Radwanur R. Talukder, Nazma Begum, Ahmed Al-Kabir, Gary L. Darmstadt, Mathuram Santosham and Robert E. Black.