A low-cost antiseptic treatment routinely used in healthcare settings could help reduce the risk of life-threatening infections in newborn babies, according to new research led by scientists at City St George’s.
Published
The study, recently published in JAMA Network Open, evaluated whether applying antiseptic solutions to women during labour and to newborn infants shortly after birth could reduce levels of harmful bacteria that can cause neonatal sepsis.
Neonatal sepsis is responsible for an estimated 680,000 deaths each year in low-income countries. It is often caused by bacteria transferred from the mother to baby during birth, making the development of simple, affordable prevention strategies a global health priority.
The NeoVT-AMR clinical trial involved 149 women in labour and 147 newborns at Zomba Central Hospital in Malawi. Participants were randomly allocated to receive different antiseptic regimens – 1% chlorhexidine, 2% chlorhexidine, an alternative antiseptic (octenidine with phenoxyethanol), or standard care, which involved the application of sterile water for mothers and no cleansing for newborns.
The antiseptics were applied to the mothers either once or every 4 hours, and to the babies either once or every 24 hours. Researchers assessed their effectiveness by measuring how well levels of bacteria on the maternal genital tract and newborn skin changed - a key indicator of infection risk – as well as safety and feasibility in a clinical setting. Mothers and their babies were followed up for 28 days
A single application of 1% chlorhexidine reduced the amount of bacteria in women during labour by around 3,000-fold compared to standard care, and by around 16-fold in newborn babies, demonstrating its potential to significantly reduce early exposure to infection-causing pathogens.
There was no evidence that the higher 2% concentration provided additional benefit, and octenidine with phenoxyethanol was found to be less effective.
The 1% chlorhexidine treatment was also shown to be safe, with no increase in serious adverse events and no evidence of harm such as skin irritation or neonatal hypothermia.
Dr Emily Beales, lead author of the study from the School of Health & Medical Sciences, said:
“Our findings support 1% chlorhexidine as the best antiseptic to take forward into larger trials designed to determine whether this approach can reduce life-threatening infections in newborns and save lives.”
The study highlights the potential of practical, scalable interventions to address major global health challenges. Chlorhexidine is inexpensive and already widely used, so it could be readily incorporated into infection prevention strategies in hospitals, particularly in low- and middle-income countries.
Dr Emily Beales added:
“The use of 1% chlorhexidine is likely to be most effective as part of a broader package of infection control measures, helping to tackle both maternal and neonatal infections.