Prenatal selection of cord blood donors according to the estimated fetal weight percentile and new approaches; results of a prospective cohort study. Issue 4 (5th December 2020) - Xinxin, Lin
Abstract: Background: Umbilical cord blood (UCB) donation is becoming inefficient and we recently proposed the estimated fetal weight percentile (EFWp) ≥60th as a predictor for a prenatal selection of donors. The aim of this study is to prospectively validate this and to identify new potential prenatal predictive parameters. Study Design and Methods: Prospective cohort study of low‐risk pregnancies undergoing third trimester ultrasound, whose UCB was collected at delivery (2016‐2018) and compared with a historical cohort (2013‐2016, N = 869). Several ultrasound parameters (EFWp, amniotic fluid, Doppler evaluation, placental thickness) were assessed ultrasound and perinatal data were collected. The association with standard of high quality of UCB was assessed by logistic regression analysis. Results: Among 297 cases, 161 (54%) were selected according to the EFWp ≥60th for UCB units' collection. Cellular criteria for banking was achieved in 27 cases (16.8%), with an average increase of 1.7 times compared to the historical cohort (9.8%, P = .009). Selecting donors according to the 60th EFWp resulted in a higher probability of collecting clinical suitable UCB ( P = .025). Among prenatal and perinatal parameters, EFWp, amniotic fluid, umbilical vein (UV) velocity, newborn weight and percentile and placental weight were significantly associated with a higher cellular content. At logistic regression analysis, significant contributors of UCB collection, were EFWp at 37‐38 weeks ultrasound (OR 1.04; 95% CI: 1‐1.08; P = .042) and UV velocity (OR 1.14; 95% CI: 1‐1.29; P = .037). Conclusion: The evaluation of the EFWp equal or above 60 and the increased UV velocity can result in higher efficiency of public UCB donation programs.