Safety and feasibility of umbilical cord blood collection from preterm neonates after delayed cord clamping for the use of improving preterm complications

Zhuxiao Ren; Fang Xu; Jianlan Wang; Zhicheng Zhong; Wei Wei; Jiying Wen; Qi Wang; Liu Guocheng; Jie Yang

Safety and feasibility of umbilical cord blood collection from preterm neonates after delayed cord clamping for the use of improving preterm complications

Am J Transl Res. 2021 May 15;13(5):4553-4560. eCollection 2021.

Authors

Zhuxiao Ren¹, Fang Xu², Jianlan Wang², Zhicheng Zhong³, Wei Wei⁴, Jiying Wen⁵, Qi Wang², Liu Guocheng⁵, Jie Yang¹

Affiliations

¹ The First Affiliated Hospital of Jinan University Guangzhou, China.
² Department of Neonatology, Guangdong Women and Children Hospital, Guangzhou Medical University Guangzhou, China.
³ Clinical Genetic Center, Guangdong Women and Children Hospital, Guangzhou Medical University Guangzhou, Guangdong, China.
⁴ Guang Dong Cord Blood and Stem Cell Bank Guangzhou, China.
⁵ Department of Obstetrics, Guangdong Women and Children Hospital Guangzhou, China.

PMID: 34150035
PMCID: PMC8205698

Abstract

Background: Umbilical cord blood (UCB) is a new and convenient source of stem cells reported to be safe and effective in preventing and treating preterm complications. The initial processing step for this therapy involves cord blood collection and isolation of the mononuclear cell (MNC) layer. However, there is limited information regarding the feasibility and safety of cord blood collection in preterm infants, and whether cord blood cell quality and quantity are adequate for treating complications in preterm infants. UCB units from preterm infants are currently discarded due to safety concerns regarding collection and owing to the harvesting of inadequate volumes for banking. This study aimed to investigate the feasibility and safety of UCB collection following delayed cord clamping (DCC) for preventing and treating complications in preterm infants.

Methods and materials: Singleton preterm infants below 35 weeks gestation were assigned to two cohorts: cord blood collection and non-cord blood collection groups. Mortality and preterm complications in the two groups were compared to evaluate the safety of cord blood collection in preterm infants. The characteristics of the cord blood cells in preterm infants were investigated by comparing the cord blood parameters before and after processing with those of term infants born during the same period.

Results: There were 90 preterm infants and 120 term neonates enrolled in this study. Compared to those of the term group, the preterm neonates had significantly less cord blood volume and fewer cell numbers. Nevertheless, the MNC number in the preterm group was 1.92±1.35×10⁸ per kg, which fulfilled the previously reported targeted cell dose (5×10⁷ cells/kg) suitable for application to improve preterm complications. There was no significant difference regarding complications in the preterm neonates with or without cord blood collection.

Conclusions: The collection of UCB after DCC in preterm infants is feasible and safe. The cell numbers and quality fulfill the criteria for use in improving preterm complications. Cord blood MNCs from preterm neonates should be reconsidered as an ideal source for use in stem cell therapy for preterm complications.

Keywords: Cord blood collection; delayed cord clamping; feasibility; preterm infants; safety.