100\u2005Comparision of effect of dry cord care versus chlorhexidine cord care on cord separation time in healthy newborns

Abstract

Background Umbilical cord infection (omphalitis) is a major cause of neonatal mortality and morbidity in developing country like Nepal. Detached umbilical stump is an important colonizing site for different types of bacteria and it also provides direct access to blood stream. Inadequate cord care may lead to omphalitis as well as neonatal sepsis. This study compares 2 cord care regimens. Objectives General: To compare two different cord care regimens (dry cord care vs chlorhexidine) Specific: • To evaluate the cord separation time in both regimens. • To find out the incidence of omphalitis Methods Comparative observational study carried out in over a three month period of August 2019 to October 2019 in a tertiary hospital after receiving ethical clearance. Study population consisted of healthy neonates born between 37 -42 weeks. Consent was taken from parents. Babies admitted to NICU, with any umbilical disorders or requiring umbilical catheterization were excluded. Babies were randomized in two groups dry cord care (group I) and chlorhexidine care (group II) via computer generated numbers. In group I after delivery, umbilical cord was kept dry and nothing was applied. In group II 4% chlorhexidine gluconate gel was applied once on the umbilical cord immediately after cutting. In both the groups parents were counseled to avoid unhygienic cord care practices. Sample size : 280 Personal data of the mother and the newborn’s were recorded. A questionnaire was administered on regular neonatal follow up at well baby clinic or by phone on 15 days of life. 256 babies enrolled in group I as 24 babies did not follow up and 258 babies were enrolled in group II as 22 babies were lost to follow up. Results 730 babies were delivered over three months period and 514 babies were enrolled. Among them 313 (60%) males. Mean birth weight - 3057±443 grams, mean gestational age - 38.63±1.0 weeks, Mean maternal age - 27.2 years. The key clinical and epidemiologic features of the two study groups are shown in table 1. Both groups were comparable. mean cord separation time in dry cord care group was 7.70±1.2 days, and in chlorhexidine group it was 7.77±1.4 days. There was no significant difference between these two regimens. None of the newborns developed umbilical sepsis. Conclusions There was no significant difference between the cord separation times in both cord care regimens. Both dry cord care and chlorhexidine cord care regimens were found to be safe and effective.