Placental blood collection: effects on newborns.

Human placental blood (PB) is increasingly used as a source of hematopoietic stem cells for transplantation. Since the first successful transplant in 1988, more than 50 pediatric patients have been engrafted by means of PB collected at the birth of full-term newborns.’ and large PB banking programs are arising both in the United States and in Europe.’ In this regard, concern has been raised about risks for the newborn associated to PB collection procedures because clamping of the umbilical cord “too early’’ could “deprive the baby of blood”.’-5 To clarify this issue, we evaluated hemoglobin and bilirubin values during the first 4 days of life in 131 full-term newborns who had their PB collected and stored in our PB bank, established in Milan, Italy in 1993. The procedure was performed after vaginal delivery or cesarean section by an on-call staff from the blood bank. PB was collected by gravity in a blood collection bag containing 18 mL citrate-phosphate-dextrose by venepuncturing the free end of the umbilical cord. On 59 occasions, the umbilical cord was clamped within 30 seconds after delivery, and 76 2 22 mL PB was collected. When the umbilical cord clamping was delayed (35180 seconds, n = 72). 39 2 17 mL PB was collected. As a control, hemoglobin and bilirubin values were evaluated in 75 full-term newborns who did not undergo PB collection. In the latter cases, the umbilical cord was clamped 20 to 120 seconds after collection. As shown in Table I , hemoglobin values were 17.4 t 1.3 g/dL in newborns who had the PB collected after delayed clamping and 17.2 2 I .S g/dL in control subjects who had no PB collected. When the umbilical cord was clamped within 30 seconds and the PB collected, the hemoglobin value was 16.0 f 1.1 g/dL ( P < .01 versus controls and newborns who had a delayed clamping of the cord. determined by unpaired Student’s t-test). A weak negative relationship was found between the volume of PB collected and the newborn’s hemoglobin value ( r = -.42, P = .01). Length of hospital