Optimizing donor selection in order to establish a cord blood banking facility: maternal and obstetric factors impact

Abstract

<jats:title>Abstract</jats:title><jats:p>In this study, we analyzed the obstetric factors affecting total nucleated cells (TNC) content of cord blood units to establish the criteria for umbilical cord blood (UCB) donor selection in our geographic area.</jats:p><jats:p>UCB was collected from normal uncomplicated pregnancies. In every case, following data were recorded: (1) gestation length; (2) type of delivery (cesarean or vaginal); and (3) newborn characteristics: weight and sex. For each sample, TNC content, percentage and number of CD34+ cells, and viability were analyzed.</jats:p><jats:p>The results showed that TNC content increases with cord blood volume, gestational length and newborn weight. The mean blood volume and the mean TNC per unit were 42.37 ± 13.5 ml and 55.49 ± 19.4 × 107, respectively. Stepwise regression analysis revealed a positive and significant correlation (r= 0.89) between these two variables. Meanwhile the CD34+ cell content remains unchanged in deliveries at 32–40 weeks of gestation. The mean CD34+ percentage obtained was 0.37 ± 0.06, and the total number of CD34+ cells was 4.827 ± 0.8204 × 104 / mL UCB.</jats:p><jats:p>Concluding, the maternal and obstetric factors have a significant impact on UCB cell quantity and quality. The main criteria for UCB collection and storage resulted to be: a gestational age higher than 36–40 weeks and newborn weight &gt; 3200g; gestation number ≤ 2 and placental weight &gt; 700g can be added to the standard criteria to improve the bank efficiency. Our results have also become helpful in evaluating stored UCB units to establish the adequacy for clinical transplant utilization.</jats:p>

The effect of maternal and infant factors on cord blood yield

“…A longer gestational period was associated with a higher TNC count . It has been shown that each additional week of gestation is associated with a 3% increase in TNC .…”

“…Chivu et al. found that maternal age inversely influenced the TNC count . However, several studies have indicated that maternal age has no effect on laboratory parameters of CB …”

“…It has been shown that each additional week of gestation is associated with a 3% increase in TNC . Some studies have reported that babies born between 38 and 40 weeks, over 40 weeks, over 41 weeks, and 36–40 week gestation have higher umbilical CB (UCB) volumes and TNC than babies born at earlier gestational ages. Clearly, progressive gestation age is associated with increased placenta weight as well as TNC.…”

“…Several studies have shown that gestational age has a negative effect on the CD34 + cell concentration and the percentage of CD34 + CB cells decreases during pregnancy . Premature infants have a higher CD34 + cell count as compared to full‐term infants .…”

“…Because cesarian section is usually performed a few weeks earlier than vaginal delivery, the CB contains more stem cells. A number of studies have shown that the mode of delivery has no significant effect on the CD34 + cell count, CFU count, or any CB laboratory parameter …”