Trial reportPediatrics2007
Impact of newborn skin-cleansing with chlorhexidine on neonatal mortality in southern Nepal: a community-based, cluster-randomized trial.
Trial report in Pediatrics, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00109616 (Newborn Antiseptic Washing and Neonatal Mortality-Nepal), which is not on this map. Cited by 75 papers, 14 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Newborn Antiseptic Washing and Neonatal Mortality-Nepal
Who cites it
75 citing papers in PubMed, 14 syntheses or guidelines pooled it, 122 citations in OpenAlex.
- Prevention and Treatment of Neonatal Infections in Facility and Community Settings of Low- and Middle-Income Countries: A Descriptive Review.Neonatology · 2025Pooled it
- Skin care interventions in infants for preventing eczema and food allergy.The Cochrane database of systematic reviews · 2022Pooled it
- Skin care interventions in infants for preventing eczema and food allergy.The Cochrane database of systematic reviews · 2021Pooled it
- Evidence-based interventions to reduce mortality among preterm and low-birthweight neonates in low-income and middle-income countries: a systematic review and meta-analysis.BMJ global health · 2021Pooled it
- Home-based neonatal care by community health workers for preventing mortality in neonates in low- and middle-income countries: a systematic review.Journal of perinatology : official journal of the California Perinatal Association · 2016Pooled it
- A systematic review of community-to-facility neonatal referral completion rates in Africa and Asia.BMC public health · 2015Pooled it
- Chlorhexidine skin or cord care for prevention of mortality and infections in neonates.The Cochrane database of systematic reviews · 2015Pooled it
- Estimates of possible severe bacterial infection in neonates in sub-Saharan Africa, south Asia, and Latin America for 2012: a systematic review and meta-analysis.The Lancet. Infectious diseases · 2014Pooled it
- Risk of childhood undernutrition related to small-for-gestational age and preterm birth in low- and middle-income countries.International journal of epidemiology · 2013Pooled it
- Umbilical cord antiseptics for preventing sepsis and death among newborns.The Cochrane database of systematic reviews · 2013Pooled it
- The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis.BMC public health · 2013Pooled it
- Time to initiation of breastfeeding and neonatal mortality and morbidity: a systematic review.BMC public health · 2013Pooled it
- Clean birth and postnatal care practices to reduce neonatal deaths from sepsis and tetanus: a systematic review and Delphi estimation of mortality effect.BMC public health · 2011Pooled it
- A systematic review of the reporting of Data Monitoring Committees' roles, interim analysis and early termination in pediatric clinical trials.BMC pediatrics · 2009Pooled it
- Antiseptic Cleansing to Reduce Vertical Transmission of Pathogens to Neonates: The NeoVT-AMR Randomized Clinical Trial.JAMA network open · 2026Trial
- "We have to clean ourselves to ensure that our children are healthy and beautiful": findings from a qualitative assessment of a hand hygiene poster in rural Uganda.BMC public health · 2019Trial
- Year-round influenza immunisation during pregnancy in Nepal: a phase 4, randomised, placebo-controlled trial.The Lancet. Infectious diseases · 2017Trial
- Clinical Presentation and Birth Outcomes Associated with Respiratory Syncytial Virus Infection in Pregnancy.PloS one · 2016Trial
- Sex differences in morbidity and care-seeking during the neonatal period in rural southern Nepal.Journal of health, population, and nutrition · 2015Trial
- Designs of two randomized, community-based trials to assess the impact of influenza immunization during pregnancy on respiratory illness among pregnant women and their infants and reproductive outcomes in rural Nepal.BMC pregnancy and childbirth · 2015Trial
15 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveHospital-based data from Africa suggest that newborn skin-cleansing with chlorhexidine may reduce neonatal mortality. Evaluation of this intervention in the communities where most births occur in the home has not been done. Our objective was to assess the efficacy of a 1-time skin-cleansing of newborn infants with 0.25% chlorhexidine on neonatal mortality.
methodsThe design was a community-based, placebo-controlled, cluster-randomized trial in Sarlahi District in southern Nepal. Newborn infants were cleansed with infant wipes that contained 0.25% chlorhexidine or placebo solution as soon as possible after delivery in the home (median: 5.8 hours). The primary outcome was all-cause mortality by 28 days. After the completion of the randomized phase, all newborns in study clusters were converted to chlorhexidine treatment for the subsequent 9 months.
resultsA total of 17,530 live births occurred in the enrolled sectors, 8650 and 8880 in the chlorhexidine and placebo groups, respectively. Baseline characteristics were similar in the treatment groups. Intention-to-treat analysis among all live births showed no impact of the intervention on neonatal mortality. Among live-born infants who actually received their assigned treatment (98.7%), there was a nonsignificant 11% lower neonatal mortality rate among those who were treated with chlorhexidine compared with placebo. Low birth weight infants had a statistically significant 28% reduction in neonatal mortality; there was no significant difference among infants who were born weighing > or = 2500 g. After conversion to active treatment in the placebo clusters, there was a 37% reduction in mortality among low birth weight infants in the placebo clusters versus no change in the chlorhexidine clusters.
conclusionsNewborn skin-wiping with chlorhexidine solution once, soon after birth, reduced neonatal mortality only among low birth weight infants. Evidence from additional trials is needed to determine whether this inexpensive and simple intervention could improve survival significantly among low birth weight infants in settings where home delivery is common and hygiene practices are poor.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.