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Meta-Analysis
. 2004;2004(3):CD001057.
doi: 10.1002/14651858.CD001057.pub2.

Topical umbilical cord care at birth

J Zupan  1 , P Garner, A A A Omari
Affiliations
Meta-Analysis

Topical umbilical cord care at birth

J Zupan et al. Cochrane Database Syst Rev. 2004.

Abstract

Background: Umbilical cord infection caused many neonatal deaths before aseptic techniques were used.

Objectives: 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 (September 2003) and the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 2, 2003). We also contacted experts in the field.

Selection criteria: Randomized and quasi-randomized trials of topical cord care compared with no topical care, and comparisons between different forms of care.

Data collection and analysis: Two reviewers assessed trial quality and extracted data.

Main results: Twenty-one studies (8959 participants) were included, the majority of which were from high-income countries. No systemic infections or deaths were observed in any of the studies reviewed. No difference was demonstrated between cords treated with antiseptics compared with dry cord care or placebo. There was a trend to reduced colonization with antibiotics compared to topical 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.

Reviewers' conclusions: Good trials in low-income settings are warranted. In high-income settings, there is limited research which has not shown an advantage of antibiotics or antiseptics over simply keeping the cord clean. Quality of evidence is low.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1.1
1.1. Analysis
Comparison 1 Antiseptic vs dry cord care/placebo, Outcome 1 Cord infection.
1.2
1.2. Analysis
Comparison 1 Antiseptic vs dry cord care/placebo, Outcome 2 Bacterial colonization ‐ Staphylococcus aureus.
1.3
1.3. Analysis
Comparison 1 Antiseptic vs dry cord care/placebo, Outcome 3 Bacterial colonization ‐ Streptococci.
1.4
1.4. Analysis
Comparison 1 Antiseptic vs dry cord care/placebo, Outcome 4 Bacterial colonization ‐ E.coli.
1.5
1.5. Analysis
Comparison 1 Antiseptic vs dry cord care/placebo, Outcome 5 Parental satisfaction.
2.1
2.1. Analysis
Comparison 2 Antiseptic vs dry cord care/placebo [continuous data], Outcome 1 Time to cord separation.
3.1
3.1. Analysis
Comparison 3 Antiseptic vs antibiotic, Outcome 1 Bacterial colonization ‐ Staphylococcus aureus.
4.1
4.1. Analysis
Comparison 4 Antiseptic vs antibiotic [continuous data], Outcome 1 Time to cord separation.
5.1
5.1. Analysis
Comparison 5 Antiseptic vs antiseptic, Outcome 1 Cord infection.
5.2
5.2. Analysis
Comparison 5 Antiseptic vs antiseptic, Outcome 2 Bacterial colonization ‐ Staphylococcus aureus.
5.3
5.3. Analysis
Comparison 5 Antiseptic vs antiseptic, Outcome 3 Bacterial colonization ‐ Streptococci.
5.4
5.4. Analysis
Comparison 5 Antiseptic vs antiseptic, Outcome 4 Bacterial colonization ‐ E.coli.
6.1
6.1. Analysis
Comparison 6 Antiseptic vs antiseptic [continuous data], Outcome 1 Time to cord separation.
7.1
7.1. Analysis
Comparison 7 Single vs multiple applications [continuous data], Outcome 1 Time to cord separation.
8.1
8.1. Analysis
Comparison 8 Washing cord vs dry cord care, Outcome 1 Bacterial colonization ‐ Staphylococcus aureus.
9.1
9.1. Analysis
Comparison 9 Antiseptic‐aqueous based vs powder [Subgroup analysis], Outcome 1 Cord separation.
10.1
10.1. Analysis
Comparison 10 Antiseptic‐alcohol based vs powder [Subgroup analysis], Outcome 1 Cord separation.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

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