Impact of topical applications of sunflower seed oil on neonatal mortality and morbidity in southern Nepal: a community-based, cluster-randomised trial

Authors

Joanne Katz, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA jkatz1@jhu.edu.
Subarna K. Khatry, Nepal Nutrition Intervention Project, Kathmandu, Nepal.
Laxman Shrestha, Institute of Medicine, Tribhuvan University, Kirtipur, Nepal.
Aimee Summers, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Marty O. Visscher, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Jeevan B. Sherchand, Tribhuvan University, Kirtipur, Nepal.
James M. Tielsch, Global Health, George Washington University School of Public Health and Health Services, Washington, District of Columbia, USA.
Seema Subedi, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Steven C. LeClerq, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Luke C. Mullany, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Document Type

Journal Article

Publication Date

2-29-2024

Journal

BMJ global health

Volume

9

Issue

2

DOI

10.1136/bmjgh-2023-013691

Keywords

Child health; Cluster randomized trial; Paediatrics

Abstract

INTRODUCTION: Hospital-based studies have demonstrated topical applications of sunflower seed oil (SSO) to skin of preterm infants can reduce nosocomial infections and improve survival. In South Asia, replacing traditional mustard with SSO might have similar benefits. METHODS: 340 communities in Sarlahi, Nepal were randomised to use mustard oil (MO) or SSO for community practice of daily newborn massage. Women were provided oil in late pregnancy and the first month post partum, and visited daily through the first week of life to encourage massage practice. A separate data collection team visited on days 1, 3, 7, 10, 14, 21 and 28 to record vital status and assess serious bacterial infection. RESULTS: Between November 2010 and January 2017, we enrolled 39 479 pregnancies. 32 114 live births were analysed. Neonatal mortality rates (NMRs) were 31.8/1000 (520 deaths, 16 327 births) and 30.5/1000 (478 deaths, 15 676 births) in control and intervention, respectively (relative risk (RR)=0.95, 95% CI: 0.84, 1.08). Among preterm births, NMR was 90.4/1000 (229 deaths, 2533 births) and 79.2/1000 (188 deaths, 2373 births) in control and intervention, respectively (RR=0.88; 95% CI: 0.74, 1.05). Among preterm births <34 weeks, the RR was 0.83 (95% CI: 0.67, 1.02). No statistically significant differences were observed in incidence of serious bacterial infection. CONCLUSIONS: We did not find any neonatal mortality or morbidity benefit of using SSO instead of MO as emollient therapy in the early neonatal period. Further studies examining whether very preterm babies may benefit are warranted. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT01177111).

APA Citation

Katz, Joanne; Khatry, Subarna K.; Shrestha, Laxman; Summers, Aimee; Visscher, Marty O.; Sherchand, Jeevan B.; Tielsch, James M.; Subedi, Seema; LeClerq, Steven C.; and Mullany, Luke C., "Impact of topical applications of sunflower seed oil on neonatal mortality and morbidity in southern Nepal: a community-based, cluster-randomised trial" (2024). GW Authored Works. Paper 4290.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4290

Department

Global Health