RHL Commentary by Haroldo Capurro
EVIDENCE SUMMARY
The revised review covers 22 trials involving 8959 subjects. Eleven of these trials are new, and include 2 conducted in a developing country (Thailand). There were no systemic infections or deaths—the primary outcomes of the review —in any of the trials. No differences were found in umbilical cord infection rates when a topical antiseptic was compared with dry cord care or placebo (Relative Risk [RR]: 0.53; 95% confidence interval [CI]: 0.35–1.13). Topical triple dye seemed to be more effective than alcohol (four trials, 1560 infants RR: 0.30; 95% CI: 0.19–0.49) or povidone-iodine (one trial, 183 infants RR: 0.15, 95% CI: 0.07–0.32) in preventing cord infection. Topical triple dye and antibiotics seemed to be associated with longer cord separation times. In one study use of a topical antiseptic was associated with less parental anxiety when compared with dry cord care.
The statistical methods used were appropriate. A subgroup analysis of term versus preterm and developed versus developing country settings would be appropriate if data permit.
The full RHL commentary also includes sections on: Relevance
- Magnitude of the problem
- of the results
- Implementation of the intervention
Research
References
This document should be cited as: Haroldo Capurro. Routine topical umbilical cord care at birth: RHL commentary (last revised: 30 September 2004). The WHO Reproductive Health Library, No 9, Update Software Ltd, Oxford, 2006. www.rhlibrary.com
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