Antiseptic Cleansing Prevents Deaths in Newborns

A new review concludes that using a low-cost antiseptic to cleanse the umbilical cord after birth could help reduce infant death rates in developing countries by 12%.

Researchers at the Indian Council of Medical Research (New Delhi, India), Kasturba Hospital (Delhi, India), and other institutions conducted a systemic review of 12 trials involving chlorhexidine cleansing in over 87,000 newborns worldwide. Seven of the trials took place in South-East Asia, two in Africa, two in Europe, and one South America. Of the 12 trials, the five carried out in community settings, which involved 72,030 newborns (including home births), provided the highest quality evidence.

The results showed that cleansing umbilical cords with chlorhexidine reduced infant deaths by 12%, compared to keeping cords dry. Using chlorhexidine also halved the number of newborn babies that suffered from omphalitis, a swelling of the cord stump commonly caused by bacterial infections. The results also revealed, however, that maternal vaginal chlorhexidine use probably leads to no difference in neonatal mortality or risk of infections in the hospital setting. The review was published in the March 2015 issue of the Cochrane Library.

“The greatest benefits were seen in the South-East Asian studies. The results from African studies are less convincing, so we would like to see whether the results from ongoing trials in Zambia and Tanzania can substantiate this evidence,” said lead author Anju Sinha, MD, of the Indian Council of Medical Research. “Based on our review, using chlorhexidine to clean the umbilical cord saves newborn babies lives.”

Chlorhexidine salts dissociate and release the positively charged chlorhexidine cation molecule, which causes a bactericidal effect by binding to negatively charged cell walls. At low concentrations, a bacteriostatic effect occurs; at high concentrations, membrane disruption results in cell death. It can be applied topically as a gel, wash, or powder. In maternity care, it can be used either as a vaginal disinfectant to prevent the spread of bacteria from mother to baby, or as a cleansing agent for the newborn baby's skin or umbilical cord.

Related Links:
Indian Council of Medical Research
Kasturba Hospital