| Peer-Reviewed

Factors Influencing Separation of Umbilical Cord at Edagahamus Hospital in Eritrea

Received: 26 May 2023    Accepted: 30 June 2023    Published: 11 July 2023
Views:       Downloads:
Abstract

Resource limited settings in the world continue to face neonatal complications at birth like umbilical cord infections which poses a greater risk of neonatal morbidity and mortality. The enormous impact is felt in low-income countries, hence, need for further research. At birth, the neonate is vulnerable due to the delicate skin which can be easily damaged by microorganisms. There are various sources of contamination of the umbilicus by microbes especially bacteria from the birth canal and contact with the caregivers. Facility contamination by microbes for instance, Staphylococcal organisms are inevitably the commonest found to be the leading contaminants. The research team compiled a questionnaire that was used with an estimated period between 12 to 15 minutes. Mothers were allowed to ask any doubts from the questions during the time of data collection and were told to dial the team members on the separation day of the cord. Statistically, p-value of (0.05) was considered and taken as a benchmark for the level of significance. Study participants age extended between 18 to 43 years (mean of 28.4±5.04 years). 80.5% of the mothers were housewives and 97.1 of the mothers reside in the city, 94.6% of them claimed that they have taken tetanus vaccination. Caesarean section has been observed to prolong umbilical cord separation among infants compared to those delivered via other modes. This is attributable to less microbes found on the newborns skin especially through cesarean section. In reference to this study findings, the frequency of umbilicus wetness affects the cord separation, for example bathing the neonate or applying a wet towel to wipe the infant’s body when compared to other studies whereby it was found out that the drier the umbilical cord the faster it separates. This study has been convicted that elimination of wetness on the neonate’s umbilical cord enhances faster detachment as well as control of infections and therefore, recommends the application of the concept dry care as an effective way for cord care.

Published in American Journal of Nursing and Health Sciences (Volume 4, Issue 3)
DOI 10.11648/j.ajnhs.20230403.11
Page(s) 57-61
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Umbilical Cord Separation Time, Newborn, Neonate, Hygienic Umbilical Cord

References
[1] Maternal and newborn health safe motherhood, division of reproductive health (technical support) family and reproductive health world health organization, Geneva, page 5.
[2] Zupan J, Garner P, Omari AA. Topical umbilical cord care at birth. Cochrane Database of Systematic Reviews. 2004; https://doi.org/10.1002/14651858.CD001057.pub2 PMID: 15266437.
[3] s. Ministry of Health: A guideline for the use of 7.1% delivering 4% chlorhexidine for newborn umbilical cord care in Kenya. MOH Kenya, 2016.
[4] Bugaje MA, McHoney M, Ameh EA, et al.: Omphalitis. Paediatric Surgery: A Comprehensive Text For Africa. 2010; 124–8.
[5] Ca ´mara-Roca L, Bru-Martin C, Rodrı ´guez-Rivero A, Soler-Gaiton M U-PF. La cura en seco del cordo ´n umbilical en el recie ´n nacido: revisio ´n de la evidencia. Matronas Profesio ´n. 2009; 10: 20–24. Available: http://www.federacion-matronas.org/wp-content/uploads/2018/01/vol10n3pag20-24.pdf
[6] WHO. Care of the umbilical cord. A review of the evidence. WHO/RHT/MSM/9 8.4 ed. Geneva: Am J Dis Child 1988; 142: 220-3 Sarwono E, Disse WS, Ousdesluys-Murphy HM, Oosting H, De Groot CJ. Umbilical cord: factors which influence the separation time. Paediatr Indones. 1991 Jul-Aug; 31 (7-8): 179-84.
[7] Liu L, Oza S, Hogan D, et al.: Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet. 2016; 388 (10063): 3027–35.
[8] Mullany LC, Darmstadt GL, Tielsch JM (2003) Role of antimicrobial applications to the umbilical cord in neonates to prevent bacterial colonization and infection: a review of the evidence. Pediatr Infect Dis J 22: 996-1002.
[9] WHO | WHO recommendations on postnatal care of the mother and newborn. (2014). World Health Organization. Geneva, Switzerland: WHO Press. http://www.who.int/maternal_child_adolescent/docu ments/postnatal-care-recommendations/en/
[10] Arifeen S. El Mullany LC, Shah R, Mannan I, Rahman SM, Talukder MRR, et al. The effect of cord cleansing with chlorhexidine on neonatal mortality in rural Bangladesh: a community-based, clusterrandomised trial. The Lancet. 2012; 379 (9820): 10228.
[11] A. M. Oudesluys-Murphy 1, G. A. M. Eilers 2, and C. J. de Groot 1 Eur J Pediatr (1987) 146: 387-389.
[12] Ahn Y, Sohn M, Jun Y, Lee E, Lee S. Two methods of cord care in high-risk newborns: their effects on hydration, temperature, pH, and floras of the cord area. Journal of child health care: for professionals working with children in the hospital and community. England; 2015; 19: 118–129. https://doi.org/10. 1177/1367493513503580 PMID: 24092869.
[13] Lokesha R, Anil Shetty. “A Prospective Study of Factors Influencing the Time of Separation of Umbilical Cord”. Journal of Evolution of Medical and Dental Sciences 2014; Vol. 3, Issue 67, December 04; Page: 14452-14457, DOI: 10.14260/jemds/2014/3939.
[14] Liu M-F, Lee T-Y, Kuo Y-L, Lien M-C. Comparative effects of using alcohol, natural drying, and salicylic sugar powder on umbilical stump detachment of neonates. The Journal of perinatal & neonatal nursing. 2012; 26: 269–74. https://doi.org/10.1097/JPN.0b013e318261ca33 PMID: 22843010.
[15] Gras-Le Guen C, Caille A, Launay E, Boscher C, Godon N, Savagner C, et al. Dry Care Versus Antiseptics for Umbilical Cord Care: A Cluster Randomized Trial. Pediatrics. United States; 2017; 139: e20161857. https://doi.org/10.1542/peds.2016-1857 PMID: 28008096.
[16] Guala A, Pastore G, Garipoli V, Agosti M, Vitali M, Bona G. The time of umbilical cord separation in healthy full-term newborns: a controlled clinical trial of different cord care practices. European journal of pediatrics. Germany; 2003. pp. 350–351. https://doi.org/10.1007/s00431-003-1174-2 PMID: 12692719.
[17] Bhalla JN, Nafis N, Rohatgi P, Singh. Some observations on separation of the umbilical stump in the newborn. Indian journal of pediatrics. India; 1975; 42: 329–334. https://doi.org/10.1007/bf02829329 PMID: 1228101.
[18] Shoaeib FMNE, All SAE-FA, El-Barrawy MA. Alcohol or traditional methods versus natural drying for newborn’s cord care. The Journal of the Egyptian Public Health Association. 2005; 80: 169–201. Available: http://www.ncbi.nlm.nih.gov/pubmed/16922152 PMID: 16922152.
[19] Gurarslan Bas N, Soylemez N, Karatay G. Umbilical Cord Seperation Time and Related Factors. Mid Blac Sea Journal of Health Sci, 2022; 8 (1): 47-54.
[20] Chamnanvanakij S, Decharachakul K, Rasamimaree P, Vanprapar N. A randomized study of 3 umbilical cord care regimens at home in thai neonates: comparison of time to umbilical cord separation, parental satisfaction and bacterial colonization. Journal of the Medical Association of Thailand = Chotmaihet thangphaet. Thailand; 2005; 88: 967–972. Available: https://www.ncbi.nlm.nih.gov/pubmed/?term=16241027 PMID: 16241027.
[21] Covas M del C, Alda E, Medina MS, Ventura S, Pezutti O, Paris de Baeza A, et al. [Alcohol versus bath and natural drying for term newborns’ umbilical cord care: a prospective randomized clinical trial]. Archivos argentinos de pediatria. 2011; 109: 305–13. https://doi.org/10.1590/S0325-00752011000400005 PMID: 21829871.
[22] Aygun C, Subasi A, Kucukoduk S. Timing of umbilical cord separation and neonatal intensive care unit practices. American journal of perinatology. United States; 2005; 22: 249–251. https://doi.org/10.1055/ s-2005-870661 PMID: 16041634.
[23] Scasso S, Laufer J, Rodriguez G, Alonso JG, Sosa CG. Vaginal group B streptococcus status during intrapartum antibiotic prophylaxis. International Journal of Gynecology & Obstetrics. 2015; 129: 9–12. https://doi.org/10.1016/j.ijgo.2014.10.018 PMID: 25577036.
[24] Zareba-Szczudlik J, Romejko-Wolniewicz E, Lewandowski Z, Rozanska H, Malinowska-Polubiec A, Dobrowolska-Redo A, et al. Evaluation of the amoxicillin concentrations in amniotic fluid, placenta, umbilical cord blood and maternal serum two hours after intravenous administration. Neuro endocrinology letters. 2016; 37: 403–409. Available: http://www.ncbi.nlm.nih.gov/pubmed/28231686 PMID: 28231686.
[25] Hershkovich-Shporen C, Bardenstein R, Blickstein I, Shinwell ES, Flidel-Rimon O. Maternal intrapartum antibiotic treatment continues to exert a bactericidal effect on the umbilical cord and peripheral venous blood of newborn infants. Acta paediatrica (Oslo, Norway: 1992). 2017; 106: 1767–1771. https://doi. org/10.1111/apa.13982 PMID: 28695642.
Cite This Article
  • APA Style

    Afewerki Ghebregziabher Habtemichael, Haben Berhane Embaye, Feven Beletse Negash, Feven Misghina, Laban Lebahati Simel, et al. (2023). Factors Influencing Separation of Umbilical Cord at Edagahamus Hospital in Eritrea. American Journal of Nursing and Health Sciences, 4(3), 57-61. https://doi.org/10.11648/j.ajnhs.20230403.11

    Copy | Download

    ACS Style

    Afewerki Ghebregziabher Habtemichael; Haben Berhane Embaye; Feven Beletse Negash; Feven Misghina; Laban Lebahati Simel, et al. Factors Influencing Separation of Umbilical Cord at Edagahamus Hospital in Eritrea. Am. J. Nurs. Health Sci. 2023, 4(3), 57-61. doi: 10.11648/j.ajnhs.20230403.11

    Copy | Download

    AMA Style

    Afewerki Ghebregziabher Habtemichael, Haben Berhane Embaye, Feven Beletse Negash, Feven Misghina, Laban Lebahati Simel, et al. Factors Influencing Separation of Umbilical Cord at Edagahamus Hospital in Eritrea. Am J Nurs Health Sci. 2023;4(3):57-61. doi: 10.11648/j.ajnhs.20230403.11

    Copy | Download

  • @article{10.11648/j.ajnhs.20230403.11,
      author = {Afewerki Ghebregziabher Habtemichael and Haben Berhane Embaye and Feven Beletse Negash and Feven Misghina and Laban Lebahati Simel and Kifleyesus Tedla},
      title = {Factors Influencing Separation of Umbilical Cord at Edagahamus Hospital in Eritrea},
      journal = {American Journal of Nursing and Health Sciences},
      volume = {4},
      number = {3},
      pages = {57-61},
      doi = {10.11648/j.ajnhs.20230403.11},
      url = {https://doi.org/10.11648/j.ajnhs.20230403.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajnhs.20230403.11},
      abstract = {Resource limited settings in the world continue to face neonatal complications at birth like umbilical cord infections which poses a greater risk of neonatal morbidity and mortality. The enormous impact is felt in low-income countries, hence, need for further research. At birth, the neonate is vulnerable due to the delicate skin which can be easily damaged by microorganisms. There are various sources of contamination of the umbilicus by microbes especially bacteria from the birth canal and contact with the caregivers. Facility contamination by microbes for instance, Staphylococcal organisms are inevitably the commonest found to be the leading contaminants. The research team compiled a questionnaire that was used with an estimated period between 12 to 15 minutes. Mothers were allowed to ask any doubts from the questions during the time of data collection and were told to dial the team members on the separation day of the cord. Statistically, p-value of (0.05) was considered and taken as a benchmark for the level of significance. Study participants age extended between 18 to 43 years (mean of 28.4±5.04 years). 80.5% of the mothers were housewives and 97.1 of the mothers reside in the city, 94.6% of them claimed that they have taken tetanus vaccination. Caesarean section has been observed to prolong umbilical cord separation among infants compared to those delivered via other modes. This is attributable to less microbes found on the newborns skin especially through cesarean section. In reference to this study findings, the frequency of umbilicus wetness affects the cord separation, for example bathing the neonate or applying a wet towel to wipe the infant’s body when compared to other studies whereby it was found out that the drier the umbilical cord the faster it separates. This study has been convicted that elimination of wetness on the neonate’s umbilical cord enhances faster detachment as well as control of infections and therefore, recommends the application of the concept dry care as an effective way for cord care.},
     year = {2023}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Factors Influencing Separation of Umbilical Cord at Edagahamus Hospital in Eritrea
    AU  - Afewerki Ghebregziabher Habtemichael
    AU  - Haben Berhane Embaye
    AU  - Feven Beletse Negash
    AU  - Feven Misghina
    AU  - Laban Lebahati Simel
    AU  - Kifleyesus Tedla
    Y1  - 2023/07/11
    PY  - 2023
    N1  - https://doi.org/10.11648/j.ajnhs.20230403.11
    DO  - 10.11648/j.ajnhs.20230403.11
    T2  - American Journal of Nursing and Health Sciences
    JF  - American Journal of Nursing and Health Sciences
    JO  - American Journal of Nursing and Health Sciences
    SP  - 57
    EP  - 61
    PB  - Science Publishing Group
    SN  - 2994-7227
    UR  - https://doi.org/10.11648/j.ajnhs.20230403.11
    AB  - Resource limited settings in the world continue to face neonatal complications at birth like umbilical cord infections which poses a greater risk of neonatal morbidity and mortality. The enormous impact is felt in low-income countries, hence, need for further research. At birth, the neonate is vulnerable due to the delicate skin which can be easily damaged by microorganisms. There are various sources of contamination of the umbilicus by microbes especially bacteria from the birth canal and contact with the caregivers. Facility contamination by microbes for instance, Staphylococcal organisms are inevitably the commonest found to be the leading contaminants. The research team compiled a questionnaire that was used with an estimated period between 12 to 15 minutes. Mothers were allowed to ask any doubts from the questions during the time of data collection and were told to dial the team members on the separation day of the cord. Statistically, p-value of (0.05) was considered and taken as a benchmark for the level of significance. Study participants age extended between 18 to 43 years (mean of 28.4±5.04 years). 80.5% of the mothers were housewives and 97.1 of the mothers reside in the city, 94.6% of them claimed that they have taken tetanus vaccination. Caesarean section has been observed to prolong umbilical cord separation among infants compared to those delivered via other modes. This is attributable to less microbes found on the newborns skin especially through cesarean section. In reference to this study findings, the frequency of umbilicus wetness affects the cord separation, for example bathing the neonate or applying a wet towel to wipe the infant’s body when compared to other studies whereby it was found out that the drier the umbilical cord the faster it separates. This study has been convicted that elimination of wetness on the neonate’s umbilical cord enhances faster detachment as well as control of infections and therefore, recommends the application of the concept dry care as an effective way for cord care.
    VL  - 4
    IS  - 3
    ER  - 

    Copy | Download

Author Information
  • Affiliated to Department of Public Health, College of Health Sciences, Asmara, Eritrea

  • Affiliated to Department of Public Health, College of Health Sciences, Asmara, Eritrea

  • Affiliated to Department of Public Health, College of Health Sciences, Asmara, Eritrea

  • Affiliated to Department of Public Health, College of Health Sciences, Asmara, Eritrea

  • Department of Community Medicine and Primary Health, College of Medicine and Health Sciences, Asmara, Eritrea

  • Department of Gynaecology, Edagahamus Hospital, Asmara, Eritrea

  • Sections