The care of the umbilical cord in newborns

Omphalitis is defined as a periumbilical acute bacterial infection with induration, erythema, bad smell, pain, and presenting or not association with purulent exudate at the base of the navel. It is peculiar at the neonatal period, and the average age for its incidence is the third or fourth day of life.

It is an important cause of neonatal mortality and its prevention is of great importance for public health. An investigation is being carried out, as a doctoral thesis project, on “The process of umbilical cord fall in newborns in the Andalusian public health system in the province of Jaén” conducted by Mª Dolores López Medina, under the supervision of Prof. Manuel Linares and Prof. Isabel Mª López Medina. As a part os this study, they have recently carried out a systematic review with meta-analysis to compare the effect of dry care and the application of chlorhexidine to the umbilical cord of newborns at risk of developing omphalitis.

The joint analysis of the studies shows a significant decrease in the risk of omphalitis in the chlorhexidine group compared to the dry care group. However, in the analysis by subgroups, chlorhexidine umbilical cord care did not reduce the risk of omphalitis in hospital births in countries with a low infant mortality rate, or at chlorhexidine concentrations below 4%.

Findings indicate that dry cord care is effective in countries with low infant mortality rate and in hospital births. However, 4% chlorhexidine for umbilical cord care protects against omphalitis in home births, in countries with a high infant mortality rate.

The full text is available at: López-Medina MD, Linares-Abad M, López-Araque AB, López-Medina IM. Dry care versus chlorhexidine cord care for prevention of omphalitis. Systematic review with meta-analysis. Rev. Latino-Am. Enfermagem. 2019;27:e3106.

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