Abstract :
[en] As for any cell donation, donor safety parameters must be included in the design of cord blood (CB) collection procedures.
Until recently, CB donation has been regarded as a relatively safe procedure, and practices have evolved from the early stages of CB banking to make reasonable provisions to protect mothers and infant donors from harm linked to CB donation: informed consent, exclusion of complicated pregnancies and deliveries, as well as of pre-term births, non-interference with obstetrical practices, use of trained staff for CB collection, standardized aseptic collection practices, donation limited to single births. Besides, professional standards foresee careful record keeping of clinical side effects that may occur in the course of CB collection.
Since 2011 time to cord clamping has become a concern in the light of publications on iron depletion and post natal outcome, including neurological development, and linked to early or late cord clamping at birth. As data show benefits of late clamping in low birth weight infants in terms of anemia and iron stores, it now admitted by professional organizations to delay cord clamping for 1 minute after birth, especially for pre-term births. However, in full term births after uncomplicated pregnancy, that are the target population for CB donation, there is no clear indication to confirm or refute benefits of late clamping.
In some countries, sometimes emotional awareness has increased about optimal timing of cord clamping, leading to some resistance to CB donation and to questioning of the harmless reputation of CB donation.
CB banking professionals however have not changed their recommendations, leaving up to obstetrical teams the decision to collect or not, after risk benefit assessment. However, CB bankers remain with the duty of providing transparent and up to date information to mothers, as well as of setting up accurate policies regarding informed consent.
