Cord blood, collected from the umbilical cord and placenta after childbirth, is a rich source of hematopoietic stem cells, which can develop into various types of blood cells. These stem cells are invaluable in treating a range of diseases, including leukemia, lymphoma, and other blood disorders. Cord blood transplants offer a viable alternative to bone marrow transplants, with the advantage of being more readily available and having a lower risk of graft-versus-host disease. As a result, cord blood is increasingly recognized as a critical resource in transplant medicine, offering hope for patients requiring life-saving treatments.
- Cord blood is rich in hematopoietic stem cells.
- It can treat diseases like leukemia, lymphoma, and other blood disorders.
- Cord blood transplants are an alternative to bone marrow transplants.
- More readily available and easier to match than bone marrow.
- Lower risk of graft-versus-host disease.
“We made several attempts to explain this finding. A direct vaccine effect is unlikely. Previous studies have shown that the vaccine does not cross the placenta and that it cannot be found in umbilical cord blood,” says Mikael Norman, professor of pediatrics and neonatology at the Department of Clinical Science, Intervention and Technology, Karolinska Institutet and first author of the study.
Instead, the researchers have adjusted for several background factors that were unevenly distributed in the two groups of women. They also conducted seven different subgroup analyses of women and newborns.
“No matter how we look at it, the finding remains and therefore, we cannot say what the lower risk of death among infants of vaccinated women relates to,” says Mikael Norman.
The researchers used national registers in both countries and included 98% of all newborn babies of women who became pregnant after the vaccines became available. All births from gestational week 22 and onward were included in the study. The first baby was born in June 2021 and the last one in January 2023. All babies were followed up for at least one month or as long as they were admitted to a neonatal unit.
While the World Health Organization recommends that newborns, including preterm babies who do not require positive pressure ventilation should not have their cord clamped earlier than one minute after birth this has not always been consistently applied.
Next steps
“Midwives welcome this research—delaying cord clamping ensures that the physiological changes happening at the time of birth can happen and there are clearly very good outcomes especially for premature babies. We can all do this and now we know we should,” said Professor Caroline Homer, President of the Perinatal Society of Australia and New Zealand and past President of the Australian College of Midwives.
“Moving forward it’s vital that perinatal professionals record the time of first breath and cord clamping to the second during births to allow for robust, large-scale data to further our work in this area,” said co-author Professor Jonathan Morris, Professor of Obstetrics and Gynaecology at the University of Sydney and Director of Women and Babies Research at The Kolling Institute.
“Intensive staff training in the new protocols will also be vital as it can be daunting to delay treatment in very early and sick babies, but the evidence suggests this results in the best outcomes for these children.”
The ALPHA Collaboration (Advancing Large collectively Prioritised trials for Health outcomes Assessment) will be vital to taking this research forward. They are an international collaboration of perinatal researchers, professionals, parents and policymakers that work with organisations and individuals worldwide to ensure that trials like this can, in the future, run at least ten times larger and faster, in a new era of increased international collaboration.
Co-author Associate Professor Brad Zhang, also from Curtin’s School of Public Health, said the research examined 349 Mozambican pregnant women and their newborn babies up to two years of age.
“The study could have significant implications for future vaccine design techniques that could assist with the prevention of malaria in high-risk countries such as Mozambique,” Associate Professor Zhang said.
“Further research is needed to investigate how IL-12 could protect infants from childhood malaria, but the findings suggest that there is a strong link between levels of this particular protein obtained from the umbilical cord blood and the development of malaria in early childhood.”
Expectant mothers often face a dilemma about whether to take medication when they fall ill due to fears it might harm their unborn baby, but new research is unravelling which drugs are safe to take during pregnancy.
Pregnant women are excluded from trials of new medications for ethical reasons, which has led to growing uncertainty around the effects of drugs on the foetus. The thalidomide scandal of the 1950s and 1960s, when doctors prescribed the sedative to pregnant women to quell their morning sickness, has also highlighted the dangers of taking medications during pregnancy: thousands of women miscarried after taking thalidomide and tens of thousands of children were born with birth defects.
Studies now indicate that pregnant women tend to steer clear of medicines as much as possible.
‘We see women suffering with pain or conditions that should be treated,’ said Professor Hedvig Nordeng from the school of pharmacy at the University of Oslo, Norway. ‘Non-adherence to needed treatment is a major problem during pregnancy.’
But some women may be taking drugs in the early weeks of pregnancy before they realise they are expecting, while others can have serious conditions that mean they cannot avoid medication. For them, the lack of information about the impact this might have on their child can be a source of great anxiety.
In an attempt to tackle this uncertainty, researchers like Prof. Nordeng are turning to databases of medical information and long-term studies to probe how treatments taken by mothers might affect their children’s development over time.
Cord blood
In 1999, the Norwegian Institute of Public Health invited families to participate in a long-term study that collected details about pregnant women, fathers, and the children who were born later. It now includes data on more than 100,000 individuals and provides a wealth of information for scientists wanting to analyse the effects of pharmaceuticals over time.