Umbilical cord separation time, predictors and healing complications in newborns with dry care

Abstract

The objective of this study was to explore the umbilical cord separation time, predictors, and healing complications from birth until the newborn was one month old. Design A quantitative longitudinal observational analytical study by stratified random sample was adopted. Setting Public health system hospitals in southern Spain and at newborns' homes. Participants Between April 2016 and December 2017, the study included 106 neonates born after 35-42 weeks of gestation whose umbilical cord was cured with water and soap and dried later as well as newborns without umbilical canalisation whose mothers enjoyed a low-risk pregnancy. Methods The data collection procedure comprised two blocks: from birth to the time of separation of the umbilical cord and from cord separation to the first month of life of the newborn. Umbilical cord separation time was measured in minutes; socio-demographic and clinical characteristics were measured by means of questionnaires, and the external diameter of the umbilical cord was measured using an electronic stainless-steel calliper and trailing roller.

Correlations between the Status of the Umbilical Cord and Neonatal Health Status

“…The umbilical cord, which consists of two arteries and one vein, connects the fetus with the placenta for blood circulation and has a significant influence on the development of the fetus [1][2][3]. The umbilical cord contains Wharton's jelly, which is a gelatinous substance composed of mucous polysaccharides that protects the blood vessels.…”

“…Studies have emphasized the importance of observing umbilical cord status through ultrasonography as part of prenatal care and during pregnancy [10], and have pointed out the practicality of using disinfectants or nursing methods for umbilical cord separation [11], but the importance of observing the thickness and status of the umbilical cord is still under-recognized in the clinical setting, to the point that the umbilical cord may not even be measured with a tape measure. The reason for this lack of awareness may be the inaccurate perception that the umbilical cord loses its function when separated from the mother after the neonate is born [3].…”

“…cant difference with respect to the umbilical cord diameter and poor soft tissue status of the umbilical cord; therefore, the soft tissue status of the umbilical cord is closely related to neonatal health status after birth. The importance of umbilical cord care for monitoring newborns after birth has been highlighted in numerous studies [3,22,23]. Disinfecting the umbilical cord was considered important in the past, whereas natural drying is deemed more important at present [3].…”

“…The importance of umbilical cord care for monitoring newborns after birth has been highlighted in numerous studies [3,22,23]. Disinfecting the umbilical cord was considered important in the past, whereas natural drying is deemed more important at present [3]. Monitoring newborns is a delicate task, but it is one that is absolutely vital to a baby's well-being in the first few minutes of life and, in some instances, beyond.…”

Umbilical cord medication in healthy full-term newborns: a before-after uncontrolled quality improvement study

“…We applied Cox regression analysis considering to be dependent variable our primary outcome and as covariates the variables resulted significantly different ( p < 0.05) between the two study groups from univariate analysis and those suggested by the literature such as birth weight, Apgar score at 5 min, spring season (no or yes), type of delivery (vaginal delivery or cesarean section), and group assignment (PRE or POST) [ 8 , 9 ]. In addition, we performed a second Cox regression analysis considering to be covariates the variables resulted marginally different ( p < 0.2) between the two groups from univariate analysis (male sex and primiparity) and variables regarding parents’ status (primiparity, age of the mother, and difficulty of cord medication) that we hypothesize that could have influenced time of cord detachment.…”