A Review of Studies with Chlorhexidine Applied Directly to the Umbilical Cord

Robert L. Goldenberg; Elizabeth M. McClure; Sarah Saleem

doi:10.1055/s-0032-1329695

American Journal of Perinatology, Table of Contents

Am J Perinatol 2013; 30(08): 699-702
DOI: 10.1055/s-0032-1329695

Commentary

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Review of Studies with Chlorhexidine Applied Directly to the Umbilical Cord

Contributor(s):

Robert L. Goldenberg

¹Department of Obstetrics and Gynecology, Columbia University, School of Medicine, New York

,

Elizabeth M. McClure

²Social, Statistical and Environmental Sciences, Research Triangle Institute, Durham, North Carolina

,

Sarah Saleem

³Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan

› Author Affiliations

Abstract

Infection-related neonatal mortality due to omphalitis in developing country home births is an important public health problem. Three cluster randomized trials of 4% chlorhexidine applied to the umbilical cord stump from once to multiple times in the days following a home birth have evaluated this intervention compared with other types of cord care on the development of omphalitis and neonatal mortality. Each of the three studies showed significant reductions in either omphalitis, neonatal mortality, or both with the 4% chlorhexidine. However, the optimal dosing schedule remains uncertain. Although further studies are needed to clarify this issue, from the three studies it is now clear that with a minimum of one application of 4% chlorhexidine to the umbilical cord stump following delivery, the incidence of omphalitis and neonatal mortality can be reduced, especially in preterm newborns. This intervention, which is safe and inexpensive and requires minimal training and skill, should strongly be considered for adoption wherever home births occur.

Keywords

chlorhexidine - neonatal mortality - cord care - developing countries

Full Text

References

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