Therapist Unlimited Blog

Mothers who are using microbicide-soaked vaginal and infant wipes to protect their babies from neonatal sepsis are in for a nightmare.
A recent medical study has shown that  microbicide-soaked vaginal and infant wipes to protect their babies from neonatal sepsis or transmission of disease-causing bacteria.
With this finding, medical experts suggested that other interventions are needed to target child mortality.
It is said that 900 000 sepsis-associated neonatal deaths per year arise in developing countries, mainly in the first week of life.
Early-onset sepsis poses unique opportunities for prevention because of intrapartum, vertical transmission of bacteria to newborn babies. For example, widespread use of targeted prophylaxis with intrapartum antibiotics in the USA coincided with a 70% reduction in early-onset group B streptococcal disease. Logistical and resource limitations, however, prevent use of intrapartum antibiotics in developing countries.In this randomised controlled trial, the authors (led by Dr Clare L Cutland, Vaccine Preventable Diseases and Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, South Africa) assessed the efficacy of intrapartum and neonatal chlorhexidine coated-wipes in reducing early-onset neonatal sepsis and vertical transmission of group B streptococcus.

Mothers seeking to protect their babies from neonatal sepsis could not find relief from microbicide-soaked vaginal and infant wipes.

The trial took place in Soweto, South Africa, and 8,011 women (aged 12-51 years) were randomly assigned in a 1:1 ratio to chlorhexidine vaginal wipes or external genitalia water wipes during active labour, and their 8,129 newborn babies were assigned to chlorhexidine full-body (intervention group) or foot (control group) washes with chlorhexidine at birth, respectively. In a subset of mothers (n=5144 lower vaginal swabs and neonatal skin swabs were gathered after delivery to assess colonisation with potentially pathogenic bacteria. Primary outcomes were neonatal sepsis in the first 3 days of life and vertical transmission of group B streptococcus.
The researchers found that rates of neonatal sepsis did not differ between the groups (chlorhexidine 3% vs 4%). Rates of colonisation with group B streptococcus in newborn babies born to mothers in the chlorhexidine (54%) and control groups (55%) did not differ.
The authors say: "Use of maternal and neonatal chlorhexidine wipes did not prevent the occurrence of early-onset sepsis. This absence of benefit was corroborated by the lack of effect on vertical transmission of the main sepsis-causing pathogens, and on serious maternal post-partum sepsis."
They conclude: "Although several trials have raised hopes that chlorhexidine vaginal and neonatal cleansing would be beneficial in saving the lives of newborn babies, the results from our trial suggest that use of chlorhexidine wipes is unlikely to reduce neonatal mortality from vertically acquired sepsis. Other neonatal interventions are needed to achieve the Millennium Developmental Goal of reduction in childhood mortality."