Abstract
Objective: To determine if cleansing the birth canal with an antiseptic at delivery reduces infections in mothers and babies postnatally. Design: Clinical trial; true months of no intervention were followed by three months of intervention and a final month of no intervention. Setting: Queen Elizabeth Central Hospital (tertiary care urban hospital), Blantyre, Malawi. Subjects: A total of 6965 women giving birth in a six month period and their 7160 babies. Intervention: Manual type of the maternal birth canal with a 0.25% chlorhexidine solution at every vaginal examination before delivery. Babies born during the intervention were also wiped with chlorhexidine. Main outcome measures: Effects of the intervention on neonatal and maternal morbidity and mortality. Results: 3635 women giving birth to 3743 babies were enrolled in the intervention phase and 3330 women giving birth to 3417 babies were enrolled in the non-intervention phase. There were no adverse reactions related to the intervention among the mothers or their children. Among infants born in the intervention phase, overall neonatal admissions were reduced (634/3743 (16.9%) v 661/3417 (19.3%), P <0.01), as were admissions for neonatal sepsis (7.8 v 17.9 per 1000 live births, P <0.0002), overall neonatal mortality (28.6 v 36.9 per 1000 live births, P <0.06), and mortality due to infectious causes (2.4 v 7.3 per 1000 live births, p <0.005). Among mothers receiving the intervention, admissions related to delivery were reduced (29.4 v 40.2 per 1000 deliveries, P <0.02), as were admissions due to postpartum infections (1.7 v 5.1 per 1000 deliveries, P = 0.02) and duration of hospitalisation (Wilcoxon P = 0.008). Conclusions: Cleansing the birth canal with chlorhexidine reduced early neonatal and maternal postpartum infectious problems. The safety, simplicity, and low cost of the procedure suggest that it should be considered as standard care to lower infant and maternal morbidity and mortality.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 216-219 |
| Number of pages | 4 |
| Journal | BMJ (Online) |
| Volume | 315 |
| Issue number | 7102 |
| State | Published - 1997 |
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- Medicine(all)
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Effect of cleansing the birth canal with antiseptic solution on maternal and newborn morbidity and mortality in Malawi : Clinical trial. / Taha, Taha E; Biggar, Robert J.; Broadhead, Robin L.; Mtimavalye, Laban A R; Justesen, Aafke B.; Liomba, George N.; Chiphangwi, John D.; Miotti, Paolo G.
In: BMJ (Online), Vol. 315, No. 7102, 1997, p. 216-219.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effect of cleansing the birth canal with antiseptic solution on maternal and newborn morbidity and mortality in Malawi
T2 - Clinical trial
AU - Taha, Taha E
AU - Biggar, Robert J.
AU - Broadhead, Robin L.
AU - Mtimavalye, Laban A R
AU - Justesen, Aafke B.
AU - Liomba, George N.
AU - Chiphangwi, John D.
AU - Miotti, Paolo G.
PY - 1997
Y1 - 1997
N2 - Objective: To determine if cleansing the birth canal with an antiseptic at delivery reduces infections in mothers and babies postnatally. Design: Clinical trial; true months of no intervention were followed by three months of intervention and a final month of no intervention. Setting: Queen Elizabeth Central Hospital (tertiary care urban hospital), Blantyre, Malawi. Subjects: A total of 6965 women giving birth in a six month period and their 7160 babies. Intervention: Manual type of the maternal birth canal with a 0.25% chlorhexidine solution at every vaginal examination before delivery. Babies born during the intervention were also wiped with chlorhexidine. Main outcome measures: Effects of the intervention on neonatal and maternal morbidity and mortality. Results: 3635 women giving birth to 3743 babies were enrolled in the intervention phase and 3330 women giving birth to 3417 babies were enrolled in the non-intervention phase. There were no adverse reactions related to the intervention among the mothers or their children. Among infants born in the intervention phase, overall neonatal admissions were reduced (634/3743 (16.9%) v 661/3417 (19.3%), P <0.01), as were admissions for neonatal sepsis (7.8 v 17.9 per 1000 live births, P <0.0002), overall neonatal mortality (28.6 v 36.9 per 1000 live births, P <0.06), and mortality due to infectious causes (2.4 v 7.3 per 1000 live births, p <0.005). Among mothers receiving the intervention, admissions related to delivery were reduced (29.4 v 40.2 per 1000 deliveries, P <0.02), as were admissions due to postpartum infections (1.7 v 5.1 per 1000 deliveries, P = 0.02) and duration of hospitalisation (Wilcoxon P = 0.008). Conclusions: Cleansing the birth canal with chlorhexidine reduced early neonatal and maternal postpartum infectious problems. The safety, simplicity, and low cost of the procedure suggest that it should be considered as standard care to lower infant and maternal morbidity and mortality.
AB - Objective: To determine if cleansing the birth canal with an antiseptic at delivery reduces infections in mothers and babies postnatally. Design: Clinical trial; true months of no intervention were followed by three months of intervention and a final month of no intervention. Setting: Queen Elizabeth Central Hospital (tertiary care urban hospital), Blantyre, Malawi. Subjects: A total of 6965 women giving birth in a six month period and their 7160 babies. Intervention: Manual type of the maternal birth canal with a 0.25% chlorhexidine solution at every vaginal examination before delivery. Babies born during the intervention were also wiped with chlorhexidine. Main outcome measures: Effects of the intervention on neonatal and maternal morbidity and mortality. Results: 3635 women giving birth to 3743 babies were enrolled in the intervention phase and 3330 women giving birth to 3417 babies were enrolled in the non-intervention phase. There were no adverse reactions related to the intervention among the mothers or their children. Among infants born in the intervention phase, overall neonatal admissions were reduced (634/3743 (16.9%) v 661/3417 (19.3%), P <0.01), as were admissions for neonatal sepsis (7.8 v 17.9 per 1000 live births, P <0.0002), overall neonatal mortality (28.6 v 36.9 per 1000 live births, P <0.06), and mortality due to infectious causes (2.4 v 7.3 per 1000 live births, p <0.005). Among mothers receiving the intervention, admissions related to delivery were reduced (29.4 v 40.2 per 1000 deliveries, P <0.02), as were admissions due to postpartum infections (1.7 v 5.1 per 1000 deliveries, P = 0.02) and duration of hospitalisation (Wilcoxon P = 0.008). Conclusions: Cleansing the birth canal with chlorhexidine reduced early neonatal and maternal postpartum infectious problems. The safety, simplicity, and low cost of the procedure suggest that it should be considered as standard care to lower infant and maternal morbidity and mortality.
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UR - http://www.scopus.com/inward/citedby.url?scp=0030848317&partnerID=8YFLogxK
M3 - Article
C2 - 9253269
AN - SCOPUS:0030848317
VL - 315
SP - 216
EP - 219
JO - British Medical Journal
JF - British Medical Journal
SN - 0959-8146
IS - 7102
ER -