Delayed Cord Clamping and Stem Cell banking

Delayed Cord Clamping and Stem Cell banking

Delayed Cord Clamping: Delayed cord clamping and stem cell banking means waiting a few minutes after the baby’s birth before cutting the umbilical cord. This delay allows blood to transfer from the placenta to the baby, providing significant health benefits such as increased blood volume and improved iron levels.

Benefits of Delayed Cord Clamping:

1. Increased blood volume in the baby, which helps improve circulation.
2. Improved iron levels, reducing the risk of anemia.
3. Enhanced transfer of stem cells and other vital nutrients from the placenta to the baby.

Stem Cell banking: Storing stem cells from the umbilical cord is the process of collecting and preserving the stem cells found in the cord blood after birth. These cells can be used in the future to treat a range of diseases and disorders.

Benefits of delayed cord clamping and Stem Cell banking:

1. Potential use of stem cells in treating blood diseases like leukemia and lymphoma.
2. Ability to use stem cells to regenerate damaged tissues and treat certain genetic conditions.
3. Preservation of stem cells for personal use or donation for medical research.

Considerations:

• Delayed cord clamping and stem cell banking can complement each other but require prior planning.
• It is important to discuss the options with the medical team to ensure the best benefits for the baby and family.
• There are costs associated with storing stem cells in private banks, although some public banks offer this service free of charge to families.
• Delayed cord clamping and stem cell banking can provide valuable opportunities for future treatment and research, and parents should consider these options early in the pregnancy.

Important Considerations: 

Preplanning: It is crucial to discuss options for delaying umbilical cord clamping and stem cell storage with the medical team before childbirth to ensure the best outcomes for the child and the family. 

Costs: Stem cell storage incurs expenses that must be taken into account. 

Medical Compatibility: Ensuring stored stem cells align with future treatment requirements is essential for effective use. 

Comparison Between Delayed Cord Clamping and Stem Cell banking: 

Many parents wonder about the feasibility of combining delayed cord clamping and stem cell storage. In fact, both can be successfully combined but require careful planning. Delaying cord clamping for a few minutes does not prevent collecting enough blood for stem cell storage. 

Studies and Medical Support: 

Clinical Studies: Medical research has affirmed the benefits of delayed cord clamping without adversely affecting the amount of blood that can be collected from the umbilical cord for storage. 

Health Guidelines: Guidelines from the American College of Obstetricians and Gynecologists (ACOG) indicate that delaying cord clamping should not preclude blood collection from the umbilical cord, allowing both practices to be combined for the child’s full health benefits. 

Comparison between delayed and early umbilical cord clamping

Eighteen randomized controlled trials comparing delayed cord clamping and early cord clamping in 2834 infants were reviewed. Most infants assigned to delayed cord clamping experienced delays exceeding 60 seconds. Delayed cord clamping and stem cell banking led to reduced hospital mortality rates, as well as improved health outcomes such as increased hemoglobin levels and reduced need for blood transfusion.

In three trials involving 996 infants ≤ 28 weeks’ gestation, delayed cord clamping, and stem cell banking also reduced hospital mortality rates. Subgroup analyses indicated that delayed cord clamping, and stem cell banking reduced the occurrence of low Apgar scores in the first minute after birth, but not at the fifth minute.

Delayed cord clamping did not significantly affect other health issues such as need for respiratory support, admission temperature, intraventricular hemorrhage, brain injury, chronic lung disease, patent ductus arteriosus, necrotizing enterocolitis, late-onset sepsis, or retinopathy of prematurity.

Among the potential risks associated with delayed cord clamping were increased red blood cell volume and higher incidence of jaundice.

This systematic review provides strong evidence that delayed cord clamping reduces hospital mortality rates, consistent with current guidelines advocating for delayed cord clamping in premature infants. The assessment of delayed cord clamping as another potentially beneficial practice was not conclusively determined in this review. Further analysis of individual patient data from these and other randomized controlled trials will be crucial for accurately evaluating primary secondary outcomes.

Conclusion: 

Delayed cord clamping and stem cell banking are two medical practices that contribute to improving children’s health outcomes and providing valuable medical resources for future disease treatment. Through preplanning and coordination with the medical team, parents can achieve dual benefits from both practices, enhancing the child’s health and offering valuable therapeutic opportunities in the future.

Delayed cord clamping has demonstrated benefits for infants born prematurely as well as at term. However, guidelines for its implementation have varied across different healthcare centers, and there has been a lack of standardized practice in delaying cord clamping. The concept of physiologically based cord clamping has emerged as an alternative approach in clinical practice. In contrast, cord milking, which involves a different physiological mechanism, may pose potential risks, particularly in premature infants.

Comparing umbilical cord milking with delayed cord clamping and stem cell banking reveals that it substantially heightens the risk of severe intraventricular hemorrhage in preterm infants, particularly those born at earlier gestational ages. In contrast to immediate cord clamping, cord milking does decrease the necessity for packed red blood cell transfusions but does not show improvement in overall clinical outcomes. Therefore, based on existing evidence, cord milking cannot be regarded as a reliable strategy for placental transfusion in preterm infants.

References:

https://pubmed.ncbi.nlm.nih.gov/34219673/

https://pubmed.ncbi.nlm.nih.gov/32152192/

https://pubmed.ncbi.nlm.nih.gov/29097178/

https://www.who.int/tools/elena/interventions/cord-clamping

https://www.aap.org/en/community/aap-sections/sonpm/delayed-cord-clamping-in-preterm-infants-is-it-time-to-become-standard-practice/