Alemu Bekalu Kassie, Wondimagegn Leltework Yismaw, Bazezew Yibelu, Liyeh Tewachew Muche, Muluneh Abebaw Abeje, Mihretie Gedefaye Nibret, Sema Alekaw, Endalifer Melese Linger, Azeze Getnet Gedefaw, Woldeamanuel Gashaw Garedew, Tlaye Kenean Getaneh, Lee Wing Fong, Wang Yao, Wang Chi Chiu
Department of Midwifery, College of Medicine and Health Sciences, Debre Markos University, Debre Markos 269, Ethiopia.
Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China.
Matern Fetal Med. 2024 Oct 11;6(4):203-210. doi: 10.1097/FM9.0000000000000243. eCollection 2024 Oct.
To compare the effects of human breast milk with those of chlorhexidine and the dry method on umbilical cord separation in Ethiopia.
This open-label 3-arm nonrandomized pilot clinical trial was conducted among 45 neonates (15 in each arm) with more than 630 home visits. After a standard cord cut, human breast milk, chlorhexidine, or nothing was applied once per day for 7 days. The primary outcome was the duration of cord separation, while the secondary outcomes were umbilical cord infection, neonatal fever, jaundice, feeding and breathing difficulty, and persistent crying.
There were statistically significant differences in the time-to-cord separation between the human breast milk group and the chlorhexidine ( 0.001) and dry alone ( 0.038) groups. Compared to those of chlorhexidine, the rates of cord separation among human breast milk and the dry-alone group were 16.02, with 95% confidence intervals (3.81, 37.43; < 0.001) and 3.15 (0.99, 10.00; = 0.052), respectively. One (6.7%) cord site infection was observed in the dry-alone groups only.
This community-label study indicated that human breast milk application significantly shortened the length of umbilical cord separation time compared to chlorhexidine and dry methods. A large-scale randomized controlled trial is needed to confirm these results.
PACTR202310902873290; https://pactr.samrc.ac.za.
在埃塞俄比亚比较人乳与洗必泰及干燥法对脐带脱落的影响。
本开放标签的三臂非随机试验性临床试验在45名新生儿（每组15名）中进行，进行了630多次家访。在标准断脐后，每天一次，连续7天应用人乳、洗必泰或不做任何处理。主要结局是脐带脱落的持续时间，次要结局是脐带感染、新生儿发热、黄疸、喂养和呼吸困难以及持续哭闹。
人乳组与洗必泰组（P = 0.001）和单纯干燥组（P = 0.038）在脐带脱落时间上存在统计学显著差异。与人乳组和单纯干燥组相比，洗必泰组的脐带脱落率分别为16.02，95%置信区间为（3.81，37.43；P < 0.001）和3.15（0.99，10.00；P = 0.052）。仅在单纯干燥组观察到1例（6.7%）脐带部位感染。
这项社区标签研究表明，与人乳组和单纯干燥组相比，应用人乳可显著缩短脐带脱落时间。需要进行大规模随机对照试验来证实这些结果。
PACTR202310902873290；https://pactr.samrc.ac.za 。
