Emollient therapy for preterm newborn infants--evidence from the developing world

Rehana A Salam, Jai K Das, Gary L Darmstadt, Zulfiqar A Bhutta, Rehana A Salam, Jai K Das, Gary L Darmstadt, Zulfiqar A Bhutta

Abstract

Introduction: Application of emollients is a widespread traditional newborn care practice in many low and middle-income countries (LMICs) and may have the potential to decrease infection and consequent mortality in preterm neonates.

Methods: We systematically reviewed literature published up to December 2012 to identify studies describing the effectiveness of emollient therapy. We used a standardized abstraction and grading format to estimate the effect of emollient therapy by applying the standard Child Health Epidemiology Reference Group (CHERG) rules.

Results: We included seven studies and one unpublished trial in this review. Topical emollient therapy significantly reduced neonatal mortality by 27% (RR: 0.73, 95% CI: 0.56, 0.94) and hospital acquired infection by 50% (RR: 0.50, 95% CI: 0.36, 0.71). There were significant increases in weight (g) (MD: 98.04, 95% CI: 42.64, 153.45) and weight gain (g/kg/day) (MD: 1.57, 95% CI: 0.79, 2.36), whereas the impacts were non-significant for length and head circumference.

Conclusion: Emollient therapy is associated with improved weight gain, reduced risk of infection and associated newborn mortality in preterm neonates and is a potentially promising intervention for use in low resource settings. Large scale effectiveness trials are required to further assess the impact of this intervention.

Figures

Figure 1
Figure 1
Search flow diagram
Figure 2
Figure 2
Forest plot for the impact of emollient therapy on neonatal mortality
Figure 3
Figure 3
Forest plot for the impact of emollient therapy on hospital acquired infection
Figure 4
Figure 4
Forest plot for the impact of emollient on weight

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Source: PubMed

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