Maternal Knowledge of Umbilical Cord Care and Its Association With Cord Separation Duration: A Cross-Sectional Study in Simalungun Regency

Elv Feedia Mona Saragih; Verawaty Fitrinelda Silaban

doi:10.58222/jkm.v5i1.1963

Authors

Elv Feedia Mona Saragih Universitas Prima Indonesia
Verawaty Fitrinelda Silaban Midwifery Study Programme, Universitas Prima Indonesia

DOI:

https://doi.org/10.58222/jkm.v5i1.1963

Keywords:

Postpartum Maternal Knowledge, Umbilical Cord Care, Cord Separation, Neonate, Simalungun

Abstract

Background: The postnatal period is a critical window for newborn survival, during which umbilical cord care directly influences separation timing and infection risk. Postpartum mothers serve as primary caregivers, yet their understanding of appropriate cord care varies considerably based on education, cultural tradition, and access to health information. Objective: This study examined the association between postpartum maternal knowledge of umbilical cord care and cord separation duration among newborns in Raya Kahean District, Simalungun Regency, alongside selected sociodemographic factors. Methods: An observational analytic cross-sectional study was conducted using total sampling of eligible postpartum mothers in the study area. Knowledge was assessed via a structured, validated questionnaire; cord separation duration was determined through direct observation and caregiver report; and associations between categorical variables were tested using the Chi-Square test. Results: Most mothers were of prime reproductive age with junior secondary education, predominantly identifying as homemakers. Cord care knowledge clustered in the moderate category, while most newborns achieved separation within the physiologically expected timeframe. A markedly strong association was found between maternal knowledge and cord separation duration, with better-informed mothers considerably more likely to experience prompt separation. Educational attainment also showed a significant association with separation outcomes, whereas maternal age and occupational status did not. Conclusion: Postpartum maternal knowledge emerged as the dominant determinant of cord separation timing, substantially outweighing age and occupation, while educational background served as a reinforcing structural enabler. These findings highlight the strategic importance of structured, culturally responsive health education within primary care services in this district.

References

Abdi, G. B., Alemu, B. K., KassaYizengaw, T., & Hussein, B. A. (2025). Umbilical cord care practices and associated factors among mothers who gave birth in the last six months in hetosa district, Arsi zone, Ethiopia 2021: Community-based mixed design. Heliyon, 11(1). https://doi.org/10.1016/j.heliyon.2024.e41133

Alinaitwe, B., Nkunzimaana, F., Kato, C., Uwimbabazi, R., Nakamya, P., McCoy, M., Kaplan, A., Ayebare, E., Winter, J., & Ngabirano, T. D. (2025). Maternal awareness of newborn danger signs before discharge: a secondary analysis of baseline data from a quasi-experimental study in Uganda. Maternal Health, Neonatology and Perinatology, 11(1), 17. https://doi.org/10.1186/s40748-025-00214-x

Balaj, M., York, H. W., Sripada, K., Besnier, E., Vonen, H. D., Aravkin, A., Friedman, J., Griswold, M., Jensen, M. R., Mohammad, T., Mullany, E. C., Solhaug, S., Sorensen, R., Stonkute, D., Tallaksen, A., Whisnant, J., Zheng, P., Gakidou, E., & Eikemo, T. A. (2021). Parental education and inequalities in child mortality: a global systematic review and meta-analysis. Lancet, 398(10300), 608–620. https://doi.org/10.1016/S0140-6736(21)00534-1

Banu, S., & Meera, M. (2025). A Descriptive Study on Attention Regulation, Working Memory Updating, and Cognitive Flexibility Among Young Adults. AIJFR-Advanced International Journal for Research, 6(6).

Coffey, P. S., & Brown, S. C. (2017). Umbilical cord-care practices in low-and middle-income countries: a systematic review. BMC Pregnancy and Childbirth, 17(1), 68.

Dessalegn, N., Dagnaw, Y., Seid, K., & Wolde, A. (2022). Umbilical Cord Care Practices and Associated Factor Among Mothers of Neonates Visiting Mizan-Tepi University Teaching Hospital Southwest Ethiopia 2021. Pediatric Health, Medicine and Therapeutics, 13, 227–

234. https://doi.org/10.2147/PHMT.S363252

Dida, N., Abute, L., Dejene, T., Yadate, T., Geleta, T., Sharma, R., Mon, H. S., Simireta, T., & Addisu, H. (2024). Awareness and healthcare seeking behavior of neonatal danger signs, and predictor variables among mothers/caregivers in four developing regional state of Ethiopia. BMC Pediatrics, 24(1), 188. https://doi.org/10.1186/s12887-024-04656-8

Dinas Kesehatan Kabupaten Simalungun. (2023). Profil Kesehatan Kabupaten Simalungun Tahun 2022. https://portalsatudata.simalungunkab.go.id/gl/dataset/profil-dinas-kesehatan

Ezeogu, J., Kawa, A., Chimah, C. T., & Eke, C. (2026). Harmful traditional cord care practices amongst mothers in south-eastern, Nigeria: a cross sectional study. Discover Public Health, 23(1), 656. https://doi.org/10.1186/s12982-026-02017-7

Filyani, I., & Marika, S. (2025). Health Information-Seeking Behavior on the Internet Among Housewives in Balam Merah Village. PKM-P, 9(2), 427–430.

Israel, C. E., Attama, K. O., Opara, H. C., Ihudiebube-Splendor, C. N., & Omotola, N. J. (2024). Knowledge and use of chlorhexidine gel in umbilical cord care among postpartum women at Poly General Hospital, Enugu, Southeast Nigeria: a cross-sectional study. International Health, 16(3), 334–343. https://doi.org/10.1093/inthealth/ihad061

Kasadha, N., Namazzi, G., Okuga, M., Wasswa, R., Kananura, R., Kajjo, D., Nanakabirwa, J., & Waiswa, P. (2025). Umbilical Cord Care among Women 15–49 Years in Uganda; a National Cross Sectional Study. MedRxiv, 2025.08.13.25333574.

https://doi.org/10.1101/2025.08.13.25333574

Kementerian Kesehatan Republik Indonesia. (2022). Profil Kesehatan Indonesia 2021.

https://kemkes.go.id/app_asset/file_content_download/Profil-Kesehatan-Indonesia-2021.pdf

Merter, O. S., Karakul, A., Karaarslan, D., & Assistant, R. (2023). The impact of umbilical cord care education given to primiparous mothers on cord separation time: A randomized controlled study. Journal of Pediatric Nursing, 71, e128–e134. https://doi.org/10.1016/j.pedn.2023.05.005

Molina-García, L., Hidalgo-Ruiz, M., Cámara-Jurado, A. M., Fernández-Valero, M. J., Delgado-Rodríguez, M., & Martínez-Galiano, J. M. (2019). Newborn health indicators associated with maternal age during first pregnancy. International Journal of Environmental Research and Public Health, 16(18), 3448.

Moon, R. Y., LoCasale-Crouch, J., Turnbull, K. L. P., Colson, E., Kellams, A., Heeren, T., Kerr, S., Hauck, F. R., & Corwin, M. J. (2020). Investigating mechanisms for maternal education disparities in enacting health-promoting infant care practices. Academic Pediatrics, 20(7), 926–933.

Ningtias, M., Achyar, K., & Kusuma, I. R. (2023). Gambaran Pengetahuan Ibu Nifas Tentang Perawatan Tali Pusat. Jurnal Riset Kesehatan Masyarakat, 3(2). https://doi.org/10.14710/Jrkm.2023.18718

Notoatmodjo, S. (2018). Ilmu perilaku kesehatan (2nd ed.). Rineka Cipta.

Nursalam. (2020). Metodologi penelitian ilmu keperawatan: Pendekatan praktis (5th ed.). Salemba Medika.

Obeagu, E. I., & Obeagu, G. U. (2024). An update on factors affecting umbilical cord care among mothers: A review. Medicine, 103(28), e38945. https://doi.org/10.1097/MD.0000000000038945

Sari, A. P., Silaban, T. D. S., & Romlah, R. (2025). Hubungan Cara Perawatan Tali Pusat Dengan Lamanya Waktu Pelepasan Tali Pusat. Jurnal Berita Kesehatan, 18(1), 131–136.

Savitri, W., Baskah, D., & Nugraheni, D. (2023). Pengaruh Penggunaan Aplikasi Bidan-ku Berbasis Android Terhadap Kesiapan Ibu Hamil untuk Bersalin di PMB Kota Bengkulu. Journal of Nursing and Public Health, 11(2). https://doi.org/10.37676/jnph.v11i2.5184

Sidabutar, M. Y., Manik, R. M., & Manik, R. M. (2022). Tingkat pengetahuan ibu nifas tentang perawatan tali pusat pada bayi baru lahir di Klinik Bidan Kristina Perumnas Kalsim Kota Sidikalang tahun 2021. Journal of Healthcare Technology and Medicine, 7(2).

Singh, D. R., Harvey, C. M., Bohara, P., Nath, D., Singh, S., Szabo, S., & Karki, K. (2019). Factors associated with newborn care knowledge and practices in the upper Himalayas. PLoS ONE, 14(9), e0222582. https://doi.org/10.1371/journal.pone.0222582

Sofya, A., Novita, N. C., Afgani, M. W., Isnaini, M., Islam, U., Raden, N., & Palembang, F. (2024). Metode Survey: Explanatory Survey dan Cross Sectional dalam Penelitian Kuantitatif. Edu Society: Jurnal Pendidikan, Ilmu Sosial, Dan Pengabdian Kepada Masyarakat, 4(3), 1695–1708.

Tong, K., Fu, X., Hoo, N. P., Kean Mun, L., Vassiliu, C., Langley, C., Sahakian, B. J., & Leong, V. (2024). The development of cognitive flexibility and its implications for mental health disorders. Psychological Medicine, 54(12), 3203–3209. https://doi.org/10.1017/S0033291724001508

World Health Organization. (2020). Every newborn action plan: Every Newborn progress report. https://www.who.int/initiatives/every-newborn-action-plan

Yohannes, D., Manilal, A., Woldemariam, M., Aklilu, A., Zakir, A., Batire, S., Negede, B., Alodaini,

H. A., & Idhayadhulla, A. (2025). Bacterial profile, antibiotic susceptibility patterns and associated factors among neonates suspected of omphalitis in Arba Minch, Southern Ethiopia. Scientific Reports, 15(1), 14404. https://doi.org/10.1038/s41598-025-98350-z

Zeyneloglu, S., & Kisa, S. (2018). Traditional practices for maternal and newborn care among Turkish postpartum women. Applied Nursing Research, 39, 148–153. https://doi.org/10.1016/j.apnr.2017.11.018