In Reply.—We appreciate the letter from Drs Oudesluys-Murphy and de Groot calling our attention to their article. We regret not having had the opportunity to review their data, which corroborate many of the findings in our study, such as the association of cesarean section with delayed separation of the umbilical cord. They report a shorter duration between delivery and cord separation (which is consistent with other data) when no antibiotic or antiseptic procedure is instituted as part of the routine umbilical cord care of the newborn, an observation consistent with other reports, as noted in our original publication.
Their study included all infants admitted to the normal newborn and neonatal intensive care units, while our study specifically excluded infants admitted to the neonatal intensive care unit. Their finding of delayed separation with decreased birth weight and gestational age does not exclude the effects of antibiotics (those infants treated with antibiotics had