Archives of Pediatrics & Adolescent Medicine is a monthly peer-reviewed, primary source journal for pediatricians in office and hospital settings. Archives provides a forum for dialogue on a range of clinical and humanistic issues relevant to the care of pediatric patients, from infancy through young adulthood. ...
Background More than 95% of neonatal deaths occur in developing countries, approximately 50% at home. Few data are available on the impact of hand-washing practices by birth attendants or caretakers on neonatal mortality. Objective To evaluate the relationship between birth attendant and maternal hand-washing practices and neonatal mortality in rural Nepal. Design Observational prospective cohort study. Setting Sarlahi District in rural southern Nepal. Participants Newborn infants were originally enrolled in a community-based trial assessing the effect of skin and/or umbilical cord cleansing with chlorhexidine on neonatal mortality in southern Nepal. A total of 23 662 newborns were enrolled and observed through 28 days of life. Main Exposures Questionnaires were administered to mothers on days 1 and 14 after delivery to identify care practices and risk factors for mortality and infection. Three hand-washing categories were defined: (1) birth attendant hand washing with soap and water before assisting with delivery, (2) maternal hand washing with soap and water or antiseptic before handling the baby, and (3) combined birth attendant and maternal hand washing. Outcome Measures Mortality within the neonatal period. Results Birth attendant hand washing was related to a statistically significant lower mortality rate among neonates (adjusted relative risk [RR] = 0.81; 95% confidence interval [CI], 0.66-0.99), as was maternal hand was ...
Anytime
