J Zupan1, P Garner. 1. Division of Reproductive Health, World Health Organisation, 20 Avenue Appia, 1211 Geneva 27, Switzerland. zupanj@who.ch
Abstract
BACKGROUND: Umbilical cord infection caused many neonatal deaths before aseptic techniques were used. OBJECTIVES: The objective of this review was to assess the effects of topical cord care in preventing cord infection, illness and death. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Controlled Trials Register (Cochrane Library issue 4, 1997) and Medline. We also contacted experts in the field. SELECTION CRITERIA: Randomised and quasi-randomised trials of topical cord care compared with no routine care, and comparisons between different forms of care. DATA COLLECTION AND ANALYSIS: Two reviewers assessed trial quality and extracted data. MAIN RESULTS: Ten studies were included, all from developed countries. No systemic infections or deaths were observed in any of the studies reviewed. Cord and other skin infections within six weeks of observation were not affected by use of antiseptics. There was a trend to reduced colonization with antibiotics compared to antiseptics and no treatment. Antiseptics prolonged the time to cord separation. Use of antiseptics was associated with a reduction in maternal concern about the cord. REVIEWER'S CONCLUSIONS: Simply keeping the cord clean appears to be as effective and safe as using antibiotics or antiseptics.
BACKGROUND: Umbilical cord infection caused many neonatal deaths before aseptic techniques were used. OBJECTIVES: The objective of this review was to assess the effects of topical cord care in preventing cord infection, illness and death. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Controlled Trials Register (Cochrane Library issue 4, 1997) and Medline. We also contacted experts in the field. SELECTION CRITERIA: Randomised and quasi-randomised trials of topical cord care compared with no routine care, and comparisons between different forms of care. DATA COLLECTION AND ANALYSIS: Two reviewers assessed trial quality and extracted data. MAIN RESULTS: Ten studies were included, all from developed countries. No systemic infections or deaths were observed in any of the studies reviewed. Cord and other skin infections within six weeks of observation were not affected by use of antiseptics. There was a trend to reduced colonization with antibiotics compared to antiseptics and no treatment. Antiseptics prolonged the time to cord separation. Use of antiseptics was associated with a reduction in maternal concern about the cord. REVIEWER'S CONCLUSIONS: Simply keeping the cord clean appears to be as effective and safe as using antibiotics or antiseptics.