Significance statement
Introduction
Methods
Study design
Study participants
Inclusion criteria
Exclusion criteria
Enrollment and cord blood collection
Cord blood processing
Clinical and cord blood cell characteristics data
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BPD was defined as treatment with oxygen > 21% for at least 28 days. Neonates were diagnosed by BPD severity according to the mode of respiratory support administered at a PMA of 36 and 0/7 weeks by using the diagnostic criteria proposed in 2001. No bronchopulmonary dysplasia: no support; mild BPD: nasal cannula≦2 L/min; moderate BPD: nasal cannula > 2 L/min or noninvasive positive airway pressure; and severe BPD: invasive mechanical ventilation. For neonates discharged from the hospital before 36 weeks’ PMA, BPD severity was categorized on the basis of the respiratory support administered at discharge.
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RDS was defined if the infants showed evidence of respiratory symptoms such as grunting and chest retraction, typical chest radiography findings, and/or treatment with surfactant, and the need for assisted ventilation.
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NEC was defined using Bell’s classification, and any stage of NEC was calculated in this study [23].
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LOS was defined if the infants had a positive bacterial culture results after the first 72 h after birth.
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ROP was defined according to the International Classification for Retinopathy of Prematurity [24].
Perinatal factors and UCBMNCs characters
Cord blood MNC characteristics and clinical outcomes
Cord blood MNC characteristics and first peripheral blood cell classification and count after birth
Statistical analysis
Results
Study population
Characters | Total (n = 89) |
---|---|
Birth weight, median, range | 1450(800,2950) |
GA < 30 weeks, n, (%) | 35(39.3) |
GA,median, range | 30.43(26.57,31.86) |
Male,n,% | 43(48.3) |
Preeclampsia,n,% | 11(12.4) |
Gestational hypertension,n,% | 7(7.9) |
Gestational diabetes,n,% | 33(37.1) |
Antenatal glucocorticoids, n, (%) | 38(42.7) |
CS, n, (%) | 44(49.4) |
Apgar Score | |
1min, median (IQR) | 9(4,9) |
5min, median (IQR) | 10(5,10) |
IVH, n, (%) | 30(33.7) |
NEC, n, (%) | 19(21.3) |
ROP, n, (%) | 18(20.2) |
LOS, n, (%) | 4(4.5) |
BPD, n, (%) | 18(20.2) |
Anemia, n, (%) | 48(53.9) |
RDS, n, (%) | 88(98.9) |
Death, n, (%) | 0(0.0) |
Characteristics of cord blood cells
Total (n = 89) | GA < 30 weeks (n = 35) | GA ≥ 30weeks (n = 54) | P | |
---|---|---|---|---|
Volume collected(ml),median, range | 44(8,133) | 44(20,129) | 41(8,133) | 0.311 |
Volume post processing(ml),median,range | 25(16,44) | 25(16,30) | 25(17.44) | 0.239 |
Total cells collected (108),median,range | 2.76(0.22,13.20) | 2.77(0.22,11.10) | 2.75(0.25,13,20) | 0.668 |
Total cells post processing (108),median,range | 2.6(0.21,10.93) | 2.6(0.21,9.48) | 2.45(0.25,10.93) | 0.665 |
Total cells ratio (after/before),median,range | 0.91(0.63,1.00) | 0.91(0.80,0.99) | 0.91(0.63,1.00) | 0.480 |
Cell concentration before processing*106/ml,median,range | 6.13(0.65,32.57) | 6.04(0.65,18.33) | 6.23(0.82,32.57) | 0.775 |
Cell concentration post processing*106/ml,median,range | 9.24(1.03,42.02) | 10.85(1.03,32.70) | .96(1.39,42.02) | 0.486 |
Cell number (107)/kg post processing,median,range | 15.79(1.52,90.29) | 21.98(1.81,90.29) | 13.77(1.52,88.75) | 0.114 |
Cell number < 5 × 107/kg,n,% | 7(7.9) | 2(5.7) | 5(9.3) | 0.757 |
Cell number 5-9.99 × 107/kg,n,% | 22(24.7) | 8(22.9) | 14(25.9) | |
Cell number ≥ 10 × 107/kg,n,% | 60(67.4) | 25(71.4) | 35(64.8) | |
Volumes/kg required for infusing 1 × 107 cells/kg,median,range | 1.08(0.24,9.71) | 0.92(0.31,9.71) | 1.12(0.24,7.19) | 0.486 |
Infused volumes > 20ml/kg required for 1 × 107 cells/kg,n,% | 0% | 0% | 0% | 1.000 |
Volumes/kg required for infusing 5 × 107 cells/kg,median,range | 5.42(1.19,48.54) | 4.61(1.53,48.54) | 5.58(1.19,35.97) | 0.486 |
Infused volumes > 20ml/kg required for 5 × 107 cells/kg,n,% | 3(3.4) | 2(5.7) | 1(1.9) | 0.559 |
Volumes/kg required for infusing 10 × 107 cells/kg,median,range | 10.82(2.38,97.09) | 0.22(3.05,97.09) | 11.16(2.38,71.94) | 0.486 |
Infused volumes > 20ml/kg required for 10 × 107 cells/kg,n,% | 23(25.8) | 9(25.7) | 14(25.9) | 1.000 |
Cell viability after processing(%),median, range | 96.73(90.37,98.79) | 96.74(90.37,98.54) | 96.51(90.47,98.79) | 1.000 |
CD34 + cells proportion after processing(%),median, range | 0.57(0.09,1.87) | 0.66(0.15,1.50) | 0.51(0.09,1.87) | 0.225 |
CFU-GM number/105MNCs,median, range | 7.33(0.21,241) | 7.75(0.91,219) | 6.8(0.21.241) | 0.480 |
Perinatal factors and cord blood cell parameters
Cord blood cells characteristics | Cell concentration before processing*106/ml | Cord blood volume, ml | Cell viability,% | CD34% in MNCs | CFU-GM number/105 MNCs |
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P Value, OR (95% CI) | |||||
Antenatal glucocorticoids | 0.005,-3.144(-5.312,-0.976) | 0.493,-4.382,(-14.886,7.231) | 0.073,-0.877(-1.837,0.083) | 0.076,0.132(-0.014,0.277) | 0.000,87.243(61.933,112.493) |
Preeclampsia | 0.007,-5.112(-8.781,-1.442) | 0.954,0.546(-18.169,19.260) | 0.512,-0.537(-2.162,1.088) | 0.373,-0.111(-0.358,0.136) | 0.188,-28.481(-71.213,14.251) |
GA(weeks) | 0.382,0.339(-0.429,1.108) | 0.822,0.445(-3.475,4.365) | 0.376,-0.152(-0.492,0.188) | 0.030,-0.057(-0.109,-0.006) | 0.032,-9.838(-18.789,-0.887) |
Cord blood cell parameters and outcomes
UCBMNCs characters | Cell concentration before processing*106/ml | CD34% in MNCs | Cell viability,% | Cord blood volume before processing, ml | CFU-GM number/105 MNCs |
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BPD | |||||
P | 0.25 | 0.274 | 0.721 | 0.98 | 0.359 |
OR, 95% CI | 1.056,0.963–1.158 | 0.389(0.072,2.112) | 1.045(0.821,1.330) | 1(0.979,1.002) | 0.996(0.998,1.004) |
NEC | |||||
P | 0.565 | 0.311 | 0.904 | 0.198 | 0.319 |
OR, 95% CI | 1.025,0.943–1.114 | 2.315(0.492,9.256) | 0.986(0.786,1.003) | 0.983(0.958,1.009) | 1.003(0.997,1.010) |
LOS | |||||
P | 0.203 | 0.561 | 0.051 | 0.784 | 0.238 |
OR, 95% CI | 0.788,0.546–1.137 | 1.27(0.567,2.843) | 0.567(0.321,0.883) | 1.005(0.967,1.046) | 1.007(0.995,1.020) |
IVH | |||||
P | 0.565 | 0.072 | 0.390 | 0.736 | 0.189 |
OR, 95% CI | 1.025,0.943,1.114 | 3.529(0.893,13,943) | 0.918(0.756,1.116) | 0.997(0.978,1.016) | 1.004(0.998,1.010) |
ROP | |||||
P | 0.411 | 0.231 | 0.424 | 0.124 | 0.060 |
OR, 95% CI | 0.952,0.847–1.070 | 2.501(0.559.11.191) | 1.109(0.860,1.431) | 1.016(0.996,1.037) | 1.006(1.000,1.013) |
RDS | |||||
P | 0.159 | 0.252 | 0.986 | 0.893 | 0.672 |
OR, 95% CI | 0.862,0.700–1.060 | 0.034(0.000,11.014) | 0.992(0.404,2.433) | 0.995(0.922,1.074) | 1.010(0.963,1.061) |
Anemia | |||||
P | 0.366 | 0.164 | 0.374 | 0.598 | 0.161 |
OR, 95% CI | 1.042,0.953–1.139 | 2.997(0.639,14.063) | 0.914(0.749,1.115) | 1.005(0.987,1.024) | 1.005(0.998,1.011) |
White blood cells (109/l) | |||||
P, R | 0.000,0.862 | ||||
OR, 95% CI | 1.229,1.073–1.385 | ||||
Neutrophile(109/l) | |||||
P, R | 0.000,0.834 | ||||
OR, 95% CI | 0.992,0.851–1.134 | ||||
Lymphocyte(109/l) | |||||
P, R | 0.000,0.369 | ||||
OR, 95% CI | 0.119,0.055–0.184 | ||||
PLT(109/l) | |||||
P, R | 0.010,0.273 | ||||
OR, 95% CI | 3.294,0.791–5.776 | ||||
HB(g/l) | |||||
P, R | 0.090,0.183 | ||||
OR, 95% CI | -0.803,-1.736–0.129 | ||||
CRP(mg/l) | |||||
P, R | 0.113.0.171 | ||||
OR, 95% CI | 0.096,-0.023–0.216 |