## Core Concept
Tetanus neonatorum, also known as neonatal tetanus, is a form of generalized tetanus that occurs in newborn infants, typically within the first few weeks of life. It is caused by *Clostridium tetani*, which enters the body through the umbilical stump, often due to poor cord care in a non-immunized mother. The prevention of tetanus neonatorum primarily focuses on immunizing the mother.

## Why the Correct Answer is Right
The correct answer, **D. Tetanus toxoid to pregnant women**, is the best preventive measure against tetanus neonatorum. Immunizing pregnant women with tetanus toxoid provides passive immunity to the newborn through the placenta. This immunity helps protect the newborn against tetanus infection until the infant can receive active immunization. The World Health Organization (WHO) recommends that all pregnant women receive tetanus toxoid-containing vaccine as part of their antenatal care to prevent maternal and neonatal tetanus.

## Why Each Wrong Option is Incorrect
- **Option A: Administration of tetanus immunoglobulin to newborns** - While tetanus immunoglobulin can provide immediate, short-term protection against tetanus, it is not the most effective or practical preventive measure for tetanus neonatorum on a large scale compared to maternal immunization.
- **Option B: Cleaning of the umbilical stump with antiseptics** - Although good cord care can reduce the risk of tetanus infection, it is not as effective in preventing tetanus neonatorum as immunizing the mother, especially in areas with poor hygiene.
- **Option C: Giving tetanus toxoid to the newborn** - Tetanus toxoid given to newborns would not provide immediate protection since it takes time to induce immunity. Newborns are most vulnerable in the first few weeks of life.

## Clinical Pearl / High-Yield Fact
A key point to remember is that maternal immunization with tetanus toxoid not only protects the mother but also provides immunity to the newborn, significantly reducing the risk of neonatal tetanus. This strategy is part of the global effort to eliminate maternal and neonatal tetanus.

## Correct Answer: D. Tetanus toxoid to pregnant women