Abstract
Inadequate cord care in neonates is an important modifiable risk factor of cord stump infection, sepsis, and neonatal death, particularly in countries with limited resources. Dry cord care and alcohol 70% are commonly used in multiple developing countries. There is a need to investigate the efficacy and safety of both the cord care to achieve the best outcomes in neonates during this critical period of life. The objective of the study was to compare between dry cord care and topical application of alcohol 70% for cord care in newborn infants in terms of cord separation time (CST) as well as the incidence of omphalitis, sepsis, and neonatal mortality. The analysis was conducted up to April 2019 in MEDLINE, Cochrane Library, Embase, Scopus, and Google Scholar to include randomized clinical trials (RCTs) and quasi-experiments which investigated at least two infant groups receiving either dry cord care or alcohol 70%. Mean differences (MDs) and 95% confidence intervals (CIs) were used to analyze continuous data, while risk ratios (RRs) and 95% CIs were used to analyze dichotomous variables. A total of 13 articles were included (4967 infants, 50.35% females, six RCTs). Alcohol application was significantly associated with longer CST (MD = 1.93 days, 95% CI: 0.80, 3.06) with significant heterogeneity among studies (I2 = 97%) while no significant differences were found in the risk of omphalitis. On the other hand, dry cord care was associated with the risk of foul odor at the cord/surrounding tissues (RR = 0.49, 95% CI: 0.28, 0.85) and increased risk of E-coli colonization (RR = 0.75, 95% CI: 0.57, 0.98). Dry cord care is a simple and effective way to shorten CST, particularly in countries with limited resources. However, in light of the limitations of the included studies, future RCTs with higher methodological quality are warranted. The significant heterogeneity among studies is the limitations of the included studies.
Highlights
Newborns face one of the greatest physiological challenges during the transition from fetal to neonatal life
The newborn becomes independent once the umbilical cord is cut and the subsequent care of the cord stump represents an important stage until its detachment up to two weeks after birth [1]
The umbilical cord remains one of the significant portals of entry of pathogenic bacteria, which might be associated with clinical signs of omphalitis [5]
Summary
Newborns face one of the greatest physiological challenges during the transition from fetal to neonatal life. The newborn becomes independent once the umbilical cord is cut and the subsequent care of the cord stump represents an important stage until its detachment up to two weeks after birth [1] This is because different types of bacteria colonize the devitalized tissues of the stump, including gram-positive bacteria, which could be followed by many enteric microorganisms [2]. The umbilical cord remains one of the significant portals of entry of pathogenic bacteria, which might be associated with clinical signs of omphalitis [5] The latter is defined as a bacterial infection of the umbilical stump and/or surrounding tissues occurring mostly at an average age of three days and rarely reported outside of the neonatal period
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
