TABLE 25.

Maternal Vaginal and Newborn Skin Antisepsis

SourceLocation and Type of TrialInterventionMaternal OutcomePerinatal/Neonatal Outcome
Taha et al428Malawi; urban hospital setting; QT3635 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. Intervention consisted of manual cleansing of the birth canal and cleansing the baby immediately after birth with a 0.25% chlorhexidine gluconate solution.The intervention resulted in reductions in maternal admissions related to delivery (29.4 vs 40.2/1000; P < .02) and serious postnatal maternal infections (1.7/1000 vs 5.1/1000; P = .02).The intervention resulted in a 22% reduction in NMR and a 67% reduction in infection-associated mortality. The intervention reduced serious neonatal illness requiring admission (16.9% vs 19.3%; P < .01), neonatal sepsis (7.8/1000 vs 17.9/1000; P < .0002), overall neonatal mortality (28.6/1000 vs 36.9/1000; P < .06) and mortality due to infections (2.4/1000 vs 7.3/1000; P < .005).
Biggar et al427Malawi; urban hospital setting; RCTThe infection status of infants of 3327 control women (conventional delivery procedures) was compared with that of 3637 infants of intervention-delivered women. Intervention consisted of washing the maternal birth canal and the skin of the newborn with 0.25% chlorhexidine.Among women with rupture of membranes >4 h before delivery, chlorhexidine reduced HIV transmission rate by 40% (OR: 0.6; CI: 0.4–0.9). No significant effect for women with rupture of membranes <4 h before delivery.