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• W2010624938 abstract "Umbilical cord blood (CB) is increasingly used as a source of haematopoietic stem cells for transplantation ( Rubinstein et al, 1998 ). Although CB stem/progenitor cells have been shown to have increased proliferative capacity compared with adult bone marrow ( Hows et al, 1992 ), the amount of cells obtained from a term delivery is limited and many samples do not contain enough cells for successful marrow reconstitution in adults ( Cairo & Wagner, 1997). When collecting CB for unrelated banking purposes, it is therefore important to target deliveries where a high yield of CB may be expected. Recent reports show that obstetric factors may have an impact on cord blood donations ( Shlebak et al, 1998 ; Donaldson et al, 1999 ). However, no information about the influence of post-date gestation compared with term gestation on CB yield is available, despite the fact that post-term pregnancies account for about 10% of all pregnancies ( Resnik, 1994). Our study aimed to assess the influence of post-date gestation on CB available for transplantation. In a prospective study, pregnant women with a gestation > 41 completed weeks (n = 9) and a control group of women with a gestation term between 38 and 40 weeks after an uneventful pregnancy (n = 10) were consecutively included in the study after obtaining informed consent. At birth, CB was collected from the umbilical vein with the placenta in situ, using a closed collection system containing CPDA1, as described previously ( Surbek et al, 1998 ). The volume of CB was measured and the nucleated cell (NC) content was assessed using an automated cell counter (ADVIA-120, Bayer-Technicon, Germany). The number of CD34+ cells was determined using two-colour flow cytometry (FACScan, Becton Dickinson, San Jose, USA) in an aliquot of lysed CB after incubation with anti-CD45-fluorescein isothiocyanate (FITC) and anti-CD34-phycoerythrin (PE) antibodies. A minimum of 75 000 events were acquired and analysed using the cellquest 3.1f software (Becton Dickinson). To assess the proliferative capacity of haematopoietic progenitors in vitro, mononuclear cells (MNCs) were isolated by Ficoll density centrifugation and cryopreserved in liquid nitrogen in a freezing mixture containing RPMI medium, 20% fetal calf serum (FCS) and 10% dimethyl sulphoxide (DMSO). Between 2 and 12 weeks after collection, MNCs were thawed, resuspended in Iscove's modified Dulbecco's medium (IMDM) and allowed to adhere overnight. Non-adherent MNCs were plated onto 1% methylcellulose culture media containing FCS, bovine serum albumin (BSA) and transferrin, supplemented with either erythropoietin (EPO) alone or in combination with granulocyte colony-stimulating factor (G-CSF), granulocyte–macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-3 and stem cell factor (SCF). After 14 d, the number of colony forming units (CFUs)/105 plated MNC was counted. For statistical analysis, SPSS for Windows software package was used to compare continuous non-parametric data of post-dates and controls using the Mann–Whitney U-test and a two-tailed P-value. In Table I, neonatal and cord blood characteristics of post-date pregnancies and term controls are shown. As expected, the mean newborn weight was slightly higher in the post-date group. However, a smaller CB volume, NC count and total number of CD34+ cells were harvested from post-term deliveries. The relative number of CD34+ cells among leucocytes was also smaller, but the difference did not reach statistical significance, probably owing to the wide variation of values within groups. There was no significant difference in the total number of CFUs/105 MNCs from term vs. post-term CB. Recent reports suggest that length of gestation and neonatal weight is positively correlated to CB yield ( Shlebak et al, 1998 ; Donaldson et al, 1999 ). However, these reports failed to compare directly post-term with term gestation, but instead included also preterm deliveries in their analysis. In contrast, the results of our study show a significantly lower CB yield in post-term pregnancies than term controls concerning CB volume, NC count and total CD34+ cell number. One explanation for our findings might be the decrease in circulating fetal–placental blood volume that occurs in post-term neonates as a result of the decline in placental function. Furthermore, the process of rapid clearing of progenitors from the circulation, which normally occurs during the first days after delivery ( Li et al, 1999 ), might have been triggered in utero if the pregnancy is prolonged and the placental function begins to decrease. Because the number of NC and CD34+ cells has been shown to be related to the outcome after CB transplantation, our results might have clinical implications. First, in view of the limited resources, an argument may be made for the exclusion of post-term pregnancies from cord blood banking in order to target optimal CB donations. Second, if CB is to be collected for the transplantation of an affected sibling, a possible decline of CB yield should be taken into account in the obstetrical management of prolonged pregnancy. This work was supported by a grant from the Basel Cord Blood Bank Project Foundation." @default.
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• W2010624938 date "2000-07-01" @default.
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• W2010624938 title "Decreased cord blood yield in post-term pregnancy: a comparative study" @default.
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• W2010624938 doi "https://doi.org/10.1046/j.1365-2141.2000.02072-2.x" @default.
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