Obstetrical and neonatal factors associated with optimal public banking of umbilical cord blood in the context of delayed cord clamping.

Purpose: To assess the association of specific newborn and maternal factors with indicators of increased blood-forming capacity in umbilical cord blood to inform strategic collection strategies that could augment the quality of units in public cord blood banks. Methods: Data regarding 268 consecutive cord blood units (CBUs) banked by Canadian Blood Services were analyzed. Multivariate analysis was performed to identify factors associated with markers of hematopoietic potency and likelihood of utilization. Results: Delayed clamping of the cord beyond 60 s was associated with reduced volume collected. Any delay in clamping of the cord was associated with reduced total nucleated cell counts. Newborn weight >4,000 g was also associated with greater blood volume in the collection but not with other measures of hematopoietic potency. Cord blood acidosis at birth (pH < 7.17) and pregnancy-associated hypertension were associated with increased numbers of CD34+ cells and colony-forming units, whereas other maternal and neonatal factors (gestation number, APGAR scores, baby sex, method of delivery and gestational age) did not correlate with measures of hematopoietic potency. Cord blood acidosis and pregnancy-associated maternal hypertension occurred more often when there was no delay in cord clamping and correlated with enrichment of hematopoietic progenitors in banked CBUs. Conclusion: Hypertension during pregnancy and low cord blood pH, indicators of physiologic stress of placental vasculature, were associated with greater enrichment of hematopoietic progenitors in CBUs. Collection of CBUs in these cases should not be overlooked and may represent ideal conditions for banking.