Amponsah-Kodua Gloria, Agyei-Baffour Peter, Okyere Paul, Acheampong Princess Ruhama, Karikari Julius Kwabena, Akohene-Mensah Kofi, Tagoe Nadia, Ti-Baliania Justine Naab, Owusu-Dabo Ellis
Kwame Nkrumah University of Science and Technology.
University Hospital, Kwame Nkrumah University of Science and Technology.
Res Sq. 2025 May 12:rs.3.rs-6401569. doi: 10.21203/rs.3.rs-6401569/v1.
Neonatal mortality is still high in Ghana and Sub-Saharan Africa though great strides have been made in other parts of the world. Neonatal infection causes a third of neonatal deaths. The umbilical stump can be an entry point for bacteria if not properly cared for, leading to omphalitis and sepsis. The World Health Organisation and Ghana Health Service recommend using 7.1% chlorhexidine digluconate for cord care to reduce the incidence of cord complications. There is however inadequate data on its usage and cord outcomes compared to other cord care methods. This study aimed to assess the risk of cord complications with the various cord care practices in two referral facilities in the Ashanti region, Ghana.
A cross-sectional study with a quantitative approach was conducted from June to December 2023. Simple random sampling was used to select 453 caregivers. We collected data on cord care practices and outcomes using a questionnaire. Stata/SE Version 17.0 was used to analyse the data.
Antenatal clinic attendance significantly reduced the odds of cord infection (aOR = 0.03, p-value = 0.018). Babies of caregivers who washed their hands before cord care were at a decreased odds of getting cord infection (aOR = 0.20, p-value = 0.047). Babies were at increased odds (aOR = 42, p-value = 0.010) of cord bleeding if their caregivers received recommendation on cord care from people other than health workers. There was no statistically significant difference in cord complications (i.e. cord bleeding, cord granuloma and cord infection) in the chlorhexidine and the methylated spirit group (p-value > 0.05). Recall bias was a limitation of the study since caregivers of children between one week and one year were required to report cord practices and outcomes in the first few weeks of their babies' lives.
The cord outcome differs with the various cord care practices. Antenatal clinic attendance should be encouraged and education on proper cord care practices should be intensified among caregivers. Randomized control trials or cohort studies should be done to compare the cord outcome in chlorhexidine and methylated spirit.
尽管世界其他地区已取得巨大进展，但加纳和撒哈拉以南非洲的新生儿死亡率仍然很高。新生儿感染导致三分之一的新生儿死亡。如果脐残端护理不当，可能成为细菌的侵入点，导致脐炎和败血症。世界卫生组织和加纳卫生服务局建议使用7.1%葡萄糖酸氯己定进行脐带护理，以降低脐带并发症的发生率。然而，与其他脐带护理方法相比，关于其使用情况和脐带护理结果的数据不足。本研究旨在评估加纳阿散蒂地区两家转诊机构中各种脐带护理方法导致脐带并发症的风险。
2023年6月至12月进行了一项采用定量方法的横断面研究。采用简单随机抽样方法选取453名护理人员。我们使用问卷收集了脐带护理方法和护理结果的数据。使用Stata/SE 17.0版本分析数据。
产前门诊就诊显著降低了脐带感染的几率（调整后比值比[aOR]=0.03，p值=0.018）。在进行脐带护理前洗手的护理人员所照顾的婴儿发生脐带感染的几率降低（aOR=0.20，p值=0.047）。如果护理人员从非卫生工作者那里获得脐带护理建议，婴儿发生脐带出血的几率会增加（aOR=42，p值=0.010）。葡萄糖酸氯己定组和甲基化酒精组在脐带并发症（即脐带出血、脐带肉芽肿和脐带感染）方面没有统计学上的显著差异（p值>0.05）。回忆偏倚是本研究的一个局限性，因为要求1周至1岁儿童的护理人员报告其婴儿出生后头几周的脐带护理情况和护理结果。
不同的脐带护理方法会导致不同的脐带护理结果。应鼓励孕妇前往产前门诊就诊，并加强对护理人员进行正确脐带护理方法的教育。应开展随机对照试验或队列研究，以比较葡萄糖酸氯己定和甲基化酒精的脐带护理结果。
