An Observational Study of Umbilical Cord Clamping and Care Practices during Home Deliveries in Central Uganda

Authors

  • Divya Shakti Department of Pediatrics, Children's Hospital of Michigan, 3901 Beaubien St, Detroit, MI 48201, USA
  • Veena Singh Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
  • Gertrude Nakigozi Rakai Health Sciences Program, P.O. Box 279, Kalisizo, Rakai, Uganda
  • Sarah Kiguli Makerere University College of Health Sciences, Kampala, Uganda
  • Deepak Kamat Department of Pediatrics, Children's Hospital of Michigan, 3901 Beaubien St, Detroit, MI 48201, USA

DOI:

https://doi.org/10.6000/1929-4247.2016.05.01.4

Keywords:

Umbilical cord care, umbilical cord clamping, newborn care practices, home childbirth, maternal health services.

Abstract

Delayed umbilical cord clamping and care practices have important implications for infant iron stores and neonatal survival. This is especially important in countries like Uganda, where there is a high prevalence of anemia in women and children coupled with a high newborn mortality rate. This study assesses cord clamping and care practices in home births in a coverage area of 12 health centers in 4 districts near Kampala, Uganda. We interviewed 147 women, most of who had at least primary school education and delivered their babies in the homes of traditional birth attendants. Only 65% of the persons conducting delivery washed hands, and most wore gloves. Most frequent cord ties were threads (86.7%), and glove rims (8.3%). Cords were cut with clean instruments in most (93.1%) deliveries. During cord clamping, newborn was positioned at a higher level than mother in 59%, delayed clamping (≥3mins) was reported in 52%. Combination of delayed clamping and positioning of newborn at mother’s level or lower was reported in only 19%. Substances used for cord care included surgical spirit (42.4%), local herbs (24.5%), powder (22.6%), ash (21.6%), saline water (10.3%), and tea (2.8%). Cord care instructions given most commonly were: cleaning with warm saline water (27%), spirit or antiseptics (25%), and herb application (7%). Awareness regarding cord infections was poor (20%). Mother’s education level, and age were not associated with cord clamping or care practices. Our study indicates scope for interventions to help improve hemoglobin levels in infancy. Education regarding cord care practices may reduce infections.

References

Lozoff B. Iron deficiency and child development. Food Nutr Bull 2007; 28(4 Suppl): S560-71. http://dx.doi.org/10.1542/peds.2005-1156

Chaparro CM, Neufeld LM, Tena Alavez G, Eguia-Liz Cedillo R, Dewey KG. Effect of timing of umbilical cord clamping on iron status in Mexican infants: a randomised controlled trial. Lancet 2006; 367: 1997-2004. http://dx.doi.org/10.1016/S0140-6736(06)68889-2

Ceriani Cernadas JM, Carroli G, Pellegrini L, et al. The effect of timing of cord clamping on neonatal venous hematocrit values and clinical outcome at term: a randomized, controlled trial. Pediatrics 2006; 117: e779-86.

Hutton EK, Hassan ES. Late vs. early clamping of the umbilical cord in full-term neonates: systematic review and meta-analysis of controlled trials. JAMA 2007; 297: 1241-52. http://dx.doi.org/10.1001/jama.297.11.1241

Uganda Bureau of Statistics (UBOS) and ICF International Inc. 2012. Uganda Demographic and Health Survey 2011. Kampala, Uganda: UBOS and Calverton, Maryland:ICF International Inc.

Eregie CO, Ofovwe G. Factors associated with neonatal tetanus mortality in northern Nigeria. East Afr Med J 1995; 72: 507-9.

Faridi MM, Rattan A, Ahmad SH. Omphalitis neonatorum. J Indian Med Assoc 1993; 91: 283-5.

Sawardekar KP. Changing spectrum of neonatal omphalitis. Pediatr Infect Dis J 2004; 23: 22-6. http://dx.doi.org/10.1097/01.inf.0000105200.18110.1e

Gran L. Oxytocic principles of Oldenlandia affinis. Lloydia 1973; 36: 174-8.

Gunasekera S, Daly NL, Anderson MA, Craik DJ. Chemical synthesis and biosynthesis of the cyclotide family of circular proteins. IUBMB Life 2006; 58: 515-24. http://dx.doi.org/10.1080/15216540600889532

World Health Organization. Care of the umbilical cord. Maternal and new born health/safe motherhood. World Health Organization; Geneva, Switzerland 1998.

Capurro H. The WHO Reproductive Health Library. Geneva: World Health Organization; Topical umbilical cord care at birth: RHL practical aspects: RHL practical aspects (last revised: 30 September 2004). The WHO Reprodutive Health Library; Geneva: World Health organization.

Zupan J, Garner P, Omari AA. Topical umbilical cord care at birth. Cochrane Database Syst Rev 2004; (3): CD001057. http://dx.doi.org/10.1002/14651858.cd001057.pub2

Imdad A, Mullany LC, Baqui AH, et al. The effect of umbilical cord cleansing with chlorhexidine on omphalitis and neonatal mortality in community settings in developing countries: a meta-analysis. BMC Public Health 2013; 13(Suppl 3): S15. http://dx.doi.org/10.1186/1471-2458-13-S3-S15

Waiswa P, Peterson S, Tomson G, Pariyo GW. Poor newborn care practices - a population based survey in eastern Uganda. BMC Pregnancy Childbirth 2010; 10: 9. http://dx.doi.org/10.1186/1471-2393-10-9

Waiswa P, Kemigisa M, Kiguli J, Naikoba S, Pariyo GW, Peterson S. Acceptability of evidence-based neonatal care practices in rural Uganda - implications for programming. BMC Pregnancy Childbirth 2008; 8: 21. http://dx.doi.org/10.1186/1471-2393-8-21

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Published

2016-03-14

How to Cite

Shakti, D., Singh, V., Nakigozi, G., Kiguli, S., & Kamat, D. (2016). An Observational Study of Umbilical Cord Clamping and Care Practices during Home Deliveries in Central Uganda. International Journal of Child Health and Nutrition, 5(1), 25–30. https://doi.org/10.6000/1929-4247.2016.05.01.4

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Section

General Articles