Timing of Umbilical Cord Separation and Neonatal Intensive Care Unit Practices

ABSTRACT

We investigated the effects of antibiotic and corticosteroid treatment of the mother close to birth and postnatal neonatal intensive care unit (NICU) practices such as phototherapy, parenteral nutrition, and antibiotic treatment of the infant on umbilical cord detachment time. The impact of dry cord care on risk of omphalitis in NICU patients was also investigated. Cord separation time was longer in preterm babies. Antenatal antibiotic and corticosteroid use did not affect cord detachment time. The use of postpartum antibiotics, parenteral nutrition, and phototherapy delayed cord separation. Among these, antibiotic treatment was the most effective factor. Dry cord care did not increase the risk of omphalitis in NICU patients in our series.

KEYWORDS

Umbilical cord - separation - affecting factors

REFERENCES

• 1 Berseth C L. Disorders of the umbilical cord, abdominal wall, urachus and omphalomesenteric duct. In: Taeusch HW, Ballard RA Avery's Diseases of the Newborn, 7th ed. Philadelphia; WB Saunders 1998: 933
• 2 Oudesluys-Murphy A M, den Hollander J C. Separation of the umbilical cord: histological findings.  Biol Neonate. 1990;  58 54-56
• 3 Akbari H, Zadeh M M. Leucocyte adhesion deficiency.  Indian J Pediatr. 2001;  68 77-79
• 4 Razvi S, Murphy R, Shlasko E, Cunnigham-Rundles C. Delayed separation of the umbilical cord attributable to urachal anomalies.  Pediatrics. 2001;  108 493-494
• 5 Oudesluys-Murphy A M, den Hollander J C, Hop W CJ. Umbilical cord separation: histological findings and perinatal factors.  Biol Neonate. 1990;  58 236-240
• 6 Oudesluys-Murphy A M, Eilers G AM, Groot C J. The time of separation of the umbilical cord.  Eur J Pediatr. 1987;  146 387-389
• 7 Novack A H, Mueller B, Ochs H. Umbilical cord separation in the normal newborn.  Am J Dis Child. 1988;  142 220-223
• 8 Hsu C F, Wang C C, Yuh Y S et al.. The effectiveness of single and multiple applications of triple dye on umbilical cord separation time.  Eur J Pediatr. 1999;  158 144-146
• 9 World Health Organisation .Care of the Umbilical Cord: WHO/FHE/MSM-Cord Care. Geneva; WHO 1998
• 10 Mullany L C, Darmstadt G L, Tielsch J M. Role of antimicrobial applications to the umbilical cord in neonates to prevent bacterial colonisation and infection: a review of the evidence.  Pediatr Infect Dis J. 2003;  22 996-1002