Association of stress-related perinatal factors and cord blood unit hematopoietic progenitors is dependent on delivery mode.

BACKGROUND

Perinatal characteristics, variably utilized in cord blood (CB) selection for banking, affect CB hematopoietic progenitor cells (HPCs). The association between perinatal stress factors and CB unit HPCs was evaluated.

STUDY DESIGN AND METHODS

Umbilical arterial (UA) pH, absolute and relative birth weight (BW) and placental weight (PW), and PW/BW ratio of 167 healthy, full-term infants were compared with CB unit prefreeze total nucleated cells (TNCs), total CD34+ (TCD34+) cells, and total colony-forming unit (CFU-TOT) number. Cesarean section (C-section, n = 104) and vaginal delivery subgroups were also analyzed.

RESULTS

UA pH (median, 7.28; range, 7.04-7.40) correlated with CB unit CFU-TOT number (n = 166; r = -0.32, p < 0.0001), TCD34+ cells (r = -0.31, p < 0.0001), and TNCs (r = -0.29, p = 0.0002). Similarly, BW, PW, and PW/BW ratio correlated with HPCs. In multiple linear regression analysis, CFU-TOT number was predicted by collected CB TNCs and UA pH in vaginal deliveries (R(2) = 0.53), in contrast with TNCs, PW, and BW in C-sections (R(2) = 0.37). TCD34+ cells were predicted by adding UA pH (vaginal deliveries, R(2) = 0.75) or PW (C-sections, R(2) = 0.36) to collected CB TNCs.

CONCLUSIONS

Stress-related perinatal factors, particularly UA pH, are associated with CB unit HPCs and may improve unit selection. Multiple linear regression models may prove useful for predicting HPCs. Mode of delivery affects model choice; UA pH has a strong effect on HPCs in vaginal deliveries.