Impact of topical applications of sunflower seed oil on neonatal mortality and morbidity in southern Nepal

A community-based, cluster-randomised trial

Bibliographic Data

ID21880745
AuthorsJoanne Katz (0000-0002-5997-7823, Johns Hopkins University, corresponding author), Subarna K Khatry (NLR Nepal), Laxman Shrestha (0000-0002-9991-3074, Tribhuvan University), Aimee Summers (0000-0002-6711-8121, Johns Hopkins University), Marty O Visscher (0000-0001-9266-4127, Cincinnati Children's Hospital Medical Center), Jeevan B Sherchand (Tribhuvan University), James M Tielsch (0000-0002-1151-060X, George Washington University), Shiva Subedi (0000-0002-6360-3998, Johns Hopkins University), Seema Subedi (Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA), Steven C Leclerq (Johns Hopkins University), Luke C Mullany (0000-0003-4668-9803, Johns Hopkins University)
Year2024
Volume9
Issue2
Pagese013691
Publication date2024-02-01
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2023-013691
PMID38423547
OpenAlexW4392303097
LanguageEN
References cited20

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)

Cluster randomised controlled trial · Environmental health · Pathology · Randomized controlled trial · Sunflower oil · Medicine · Neonatal Respiratory Health Research · Neonatal skin health care · Preterm Birth and Chorioamnionitis · Internal Medicine

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