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母婴因素对脐血CD34+造血干/祖细胞的影响
Influence of maternal and infant factors on CD34+ hematopoietic stem/progenitor cells in umbilical cord blood
目的 比较不同母婴因素与脐血有核细胞总数及CD34+造血干/祖细胞数量的关系，为脐血库合理选择脐血提供参考。方法 前瞻性收集130例2019年6月至2020年1月期间于大连市妇女儿童医疗中心分娩的新生儿脐血标本，男女比例为1：1。收集围生期相关信息：孕母年龄及血型，有/无妊娠糖尿病、妊娠高血压，妊娠方式、分娩方式、单胎/双胎，新生儿体重、性别、生后Apgar评分，以及胎盘、羊水、脐带情况。结果 根据孕母血型、妊娠糖尿病、妊娠高血压、妊娠方式、分娩方式、单胎/双胎，新生儿性别、生后Apgar评分，胎盘形态、羊水胎粪污染、脐带绕颈等情况进行分组，组间比较脐血有核细胞总数及CD34+细胞计数差异均无统计学意义（P > 0.05）。孕母年龄、新生儿体重与脐血有核细胞总数无相关性（P > 0.05），新生儿体重与CD34+细胞计数无相关性（P > 0.05），孕母年龄与CD34+细胞计数呈正相关（P < 0.05）。结论 脐血中CD34+细胞数量随孕母年龄增大而增多，故脐血库在筛选脐血时，同等条件下可以选择年龄偏大的孕妇。
Objective To study the association of different maternal and infant factors with the number of total nucleated cells and CD34+ hematopoietic stem/progenitor cells in umbilical cord blood, and to provide a reference for reasonable selection of umbilical cord blood in the cord blood bank. Methods A prospective study was performed for the umbilical cord blood samples of 130 neonates who were born in Dalian Women and Children's Medical Center from June 2019 to January 2020, with a male/female ratio of 1:1. Related perinatal information was collected, including maternal age and blood type, presence or absence of gestational diabetes or gestational hypertension, pregnancy method, mode of delivery, singleton pregnancy/twin pregnancy, body weight and sex of neonates, Apgar score after birth, and the conditions of placenta, amniotic fluid, and umbilical cord. Results The neonates were grouped according to maternal blood type, gestational diabetes, gestational hypertension, pregnancy method, mode of delivery, singleton pregnancy/ twin pregnancy, sex of neonates, Apgar score after birth, placental morphology, meconium staining of amniotic fluid, and umbilical cord around the neck. The comparison between groups showed no significant differences in the numbers of total nucleated cells and CD34+ cells in umbilical cord blood (P > 0.05). Maternal age and neonatal body weight were not correlated with the number of total nucleated cells in umbilical cord blood (P > 0.05), and neonatal body weight was not correlated with the number of CD34+ cells (P > 0.05), while maternal age was positively correlated with the number of CD34+ cells (P < 0.05). Conclusions The number of CD34+ cells in umbilical cord blood increases with the increase in maternal age, and therefore, umbilical cord blood in the cord blood bank may be selected based on maternal age.
Umbilical cord blood / Maternal and infant factor / Hematopoietic stem cell / Neonate
[1] Mousavi SH, Abroun S, Zarrabi M, et al. The effect of maternal and infant factors on cord blood yield[J]. Pediatr Blood Cancer, 2017, 64(7):e26381.
[2] 张玉明. 脐血移植新技术进度[J]. 南方医科大学学报, 2013, 33(12):1839-1843.
[3] Dessels C, Alessandrini M, Pepper MS. Factors influencing the umbilical cord blood stem cell industry:an evolving treatment landscape[J]. Stem Cells Transl Med, 2018, 7(9):643-650.
[4] 谢幸. 妇产科学[M]. 9版. 北京:人民卫生出版社, 2018:83-91, 107.
[5] 中华医学会妇产科学分会产科学组, 中华医学会围产医学分会妊娠合并糖尿病协作组. 妊娠合并糖尿病诊治指南(2014)[J]. 中华妇产科杂志, 2014, 49(8):561-569.
[6] 吴琳琳, 周欣, 牛建民. 《妊娠期高血压疾病:国际妊娠期高血压研究学会分类、诊断和管理指南(2018)》解读[J]. 中国实用妇科与产科杂志, 2018, 34(7):758-763.
[7] Gluckman E, Broxmeyer HA, Auerbach AD, et al. Hematopoietic reconstitution in a patient with Fanconi's anemia by means of umbilical-cord blood from an HLA-identical sibling[J]. N Engl J Med, 1989, 321(17):1174-1178.
[8] Gluckman E, Rocha V, Boyer-Chammard A, et al. Outcome of cord-blood transplantation from related and unrelated donors. Eurocord Transplant Group and the European Blood and Marrow Transplantation Group[J]. N Engl J Med, 1997, 337(6):373-381.
[9] Tanaçan A, Yurdakul P, Aktoz F, et al. Factors influencing the success of cord blood collection:a tertiary perinatal medicine center's experience[J]. Turk J Med Sci, 2018, 48(5):961-966.
[10] Fernandes JF, Rocha V, Labopin M, et al. Transplantation in patients with SCID:mismatched related stem cells or unrelated cord blood?[J]. Blood, 2012, 119(12):2949-2955.
[11] Ballen KK, Gluckman E, Broxmeyer HE. Umbilical cord blood transplantation:the first 25 years and beyond[J]. Blood, 2013, 122(4):491-498.
[12] Bielec-Berek B, Jastrz?bska-Stojko ?, Drosdzol-Cop A, et al. Maternal predictors and quality of umbilical cord blood units[J]. Cell Tissue Bank, 2018, 19(1):69-75.
[13] Omori A, Takahashi K, Hazawa M, et al. Maternal and neonatal factors associated with the high yield of mononuclear lowdensity/CD34+ cells from placental/umbilical cord blood[J]. Tohoku J Exp Med, 2008, 215(1):23-32.
[14] Keersmaekers CL, Mason BA, Keersmaekers J, et al. Factors affecting umbilical cord blood stem cell suitability for transplantation in an in utero collection program[J]. Transfusion, 2014, 54(3):545-549.
[15] Hadarits O, Zóka A, Barna G, et al. Increased proportion of hematopoietic stem and progenitor cell population in cord blood of neonates born to mothers with gestational diabetes mellitus[J]. Stem Cells Dev, 2016, 25(1):13-17.
[16] Kong CM, Subramanian A, Biswas A, et al. Changes in stemness properties, differentiation potential, oxidative stress, senescence and mitochondrial function in Wharton's jelly stem cells of umbilical cords of mothers with gestational diabetes mellitus[J]. Stem Cell Rev Rep, 2019, 15(3):415-426.
[17] Keersmaekers CL, Mason BA, Keersmaekers J, et al. Factors affecting umbilical cord blood stem cell suitability for transplantation in an in utero collection program[J]. Transfusion, 2014, 54(3):545-549.
[18] Wu S, Xie G, Wu J, et al. Influence of maternal, infant, and collection characteristics on high-quality cord blood units in Guangzhou Cord Blood Bank[J]. Transfusion, 2015, 55(9):2158-2167.
[19] Nordin F, Idris MRM, Mahdy ZA, et al. Preeclampsia in pregnancy affecting the stemness and differentiation potency of haematopoietic stem cell of the umbilical cord blood[J]. BMC Pregnancy Childbirth, 2020, 20(1):399.
[20] Ahmed SM, Khalil HB. Comparative assessment of stem cells count, viability and hematological parameters of umbilical cord blood in healthy and preeclampsia deliveries[J]. Afr J Med Sci, 2018, 3(12):1-5.
[21] Al-Qahtani R, Al-Hedythi S, Arab S, et al. Factor predicting total nucleated cell counts in cord blood units[J]. Transfusion, 2016, 56(9):2352-2354.
[22] Chandra T, Afreen S, Kumar A, et al. Correlation of umbilical cord blood volume with CD34+ cells concentration[J]. Int J Blood Transfus Immunohematol, 2011, 1:12-16.
[23] Abdelrazik AM, El Said MN, Abdelaziz HE, et al. The impact of fetal and maternal physiologic factors on umbilical cord blood quality as a source of stem cells in Egyptian population[J]. Transfusion, 2015, 55(12):2882-2889.
[24] Mazzoccoli G, Miscio G, Fontana A, et al. Time related variations in stem cell harvesting of umbilical cord blood[J]. Sci Rep, 2016, 6:21404.
[25] Cobellis L, Castaldi MA, Trabucco E, et al. Cord blood unit bankability can be predicted by prenatal sonographic parameters[J]. Eur J Obstet Gynecol Reprod Biol, 2013, 170(2):391-395.
[26] Akyurekli C, Chan JY, Elmoazzen H, et al. Impact of ethnicity on human umbilical cord blood banking:a systematic review[J]. Transfusion, 2014, 54(8):2122-2127.
[27] Al-Sweedan SA, Musalam L, Obeidat B. Factors predicting the hematopoietic stem cells content of the umbilical cord blood[J]. Transfus Apher Sci, 2013, 48(2):247-252.
[28] Hussein AA, Bawadi RM, Tahtamouni LH, et al. Feasibility of collecting umbilical cord blood in Jordan and the effect of maternal and neonatal factors on hematopoietic stem cell content[J]. Mediterr J Hematol Infect Dis, 2014, 6(1):e2014019.
[29] Nguyen PH, Nguyen VT, Chu TT, et al. Factors affecting human umbilical cord blood quality before cryopreservation:the importance of birth weight and gestational age[J]. Biopreserv Biobank, 2020, 18(1):18-24.
[30] Servais S, Baudoux E, Brichard B, et al. Circadian and circannual variations in cord blood hematopoietic cell composition[J]. Haematologica, 2015, 100(1):e32-e34.
[31] Bijou F, Ivanovic Z, Fizet D, et al. Neonatal sex and weight influence CD34(+) cell concentration in umbilical cord blood but not stromal cell-derived factor 1-3'A polymorphism[J]. Cytotherapy, 2015, 17(1):68-72.
[32] Lim FT, Scherjon SA, van Beckhoven JM, et al. Association of stress during delivery with increased numbers of nucleated cells and hematopoietic progenitor cells in umbilical cord blood[J]. Am J Obstet Gynecol, 2000, 183(5):1144-1152.
