Newsletter - March 2014
Premature babies may benefit from their own stem cells
Each year in the US, nearly 500,000 babies are born premature. That's 1 of every 8 infants born in the United States. A premature birth is when a baby is born before 37 completed weeks of pregnancy. A full-term pregnancy is 40 weeks. In almost all countries with reliable data, preterm birth rates are increasing.
Globally, prematurity is the leading cause of newborn deaths (babies in the first four weeks of life) and the second leading cause of infant mortality (within the first year of life), after congenital abnormalities. Prematurity is also the second leading cause of death after pneumonia in children under the age of five. In the United States, African Americans and Native Americans have the highest neonatal death rate associated with prematurity.
Prematurity costs an average of $3,000 per day in the Neonatal Intensive Care Unit (NICU), with an overall annual cost of $26 billion dollars per year in the United States.
Important growth and development occur throughout pregnancy - especially in the final months and weeks. Because they are born too early, preemies weigh much less than full-term babies. They may have health problems because their organs did not have enough time to develop. Preemies need special medical care in a NICU. They stay there until their organ systems can work on their own.
These newborns have higher rates of disabilities such as blindness, developmental delays, and cerebral palsy. The more premature the baby, the higher the risk for the development of these disabilities.
Current research is examining whether a newborn's stem cells, from perinatal sources such as umbilical cord blood and cord tissue, can be used to improve common medical complications associated with prematurity. The organ systems that have received the most study to date are the lungs and the brain of premature infants.
The stem cells in cord blood and cord tissue can be collected easily at the time of birth. They are a resource that is available to every child born that would otherwise be discarded. The potential to use the child's own stem cells to produce better clinical outcomes in premature infants is an exciting and promising concept that will be better understood as more studies are conducted and completed.
Charity Profile: Smart Cells & Borne
Borne's goal is to make childbirth safer and promote lifelong health for mothers and babies. Borne was set up in response to a need for greater research into the risks of premature birth. In the UK, more than 1 in 10 babies are born too soon. Worldwide, 15 million babies are born prematurely every year, and this is responsible for 70% of disability and death in newborn babies.
Borne aims to change this:
|Through research into treatment combinations that could prevent premature birth.|
|Through training that develops the expertise and skills of doctors and midwives across London & the UK.|
|Through a global legacy created by supporting health workers in Asia and Africa.|
One of Borne's obstetric research objectives is the protection of the unborn child from cerebral palsy, which occurs in up to 0.5% of babies and is the leading cause of motor deficiency in young children.
A pioneering clinical trial is treating children who have cerebral palsy with stem cells from their own cord blood. Borne's founding donor Smart Cells is a family cord blood bank that has sent two children from their client families to participate in this trial. Collection at birth of the stem cells in umbilical cord blood and tissue is an opportunity to safeguard against future illnesses with the infusion of healthy stem cells that can help the body to repair itself.
Professor Mark Johnson, Consultant in Obstetrics at Chelsea and Westminster Hospital and Co-Founder of Borne, had this to say: "I have had the privilege of looking after thousands of mothers and delivering happy, healthy babies. I am acutely aware that the safe arrival of every child is a miracle. Worldwide, every year 15 million babies are born too soon. Of these babies, one million will die and those that survive have a high risk of developing a lifelong disability. Being born too soon is the most important cause of death and disability in newborn babies."
"As an obstetrician, my aim is to make pregnancy as safe as possible for mothers and babies, but as an individual, I can only help one mother at a time. Working as part of Borne, I can help give hundreds of thousands of babies a better chance in life."
"Our first goal it to prevent preterm delivery and we are currently trialing a treatment which will prolong pregnancy, keeping the baby in the safest place and avoiding the life threatening complications of preterm birth."
"Our second goal is to ensure lifelong health for babies. We are coming to realise that much of our health is determined in the womb in the first few months of existence. We aim to define interventions during pregnancy that will give children the best possible start in life, minimising the adverse effects of prematurity, growth restriction, and maternal diabetes for example. Our interventions will reduce the risk of developing heart disease, diabetes, and other chronic conditions, making a real difference to the health of future generations."
Stem cells from premie cord blood
Babies born prematurely often have serious medical complications that impact their lungs, brain, kidneys and intestinal systems. Stem cells in the umbilical cord blood and tissue, collected after the baby is born, may offer new treatment options for these premature babies. In an effort to understand the potential for the babies' newborn stem cells to be used in such treatments, ViaCord established a pilot program in partnership with Miracle Babies charity and Sharp Mary Birch Hospital in San Diego.
The pilot study collected cord blood and cord tissue from premature babies delivered at less than 34 weeks of pregnancy. The umbilical cord blood and tissue was processed and cryopreserved just like samples from full term babies, in an effort to characterize the stem cell number and density in premie cord blood.
Fifty-one infants ranging in birth age from 27-34 weeks gestation participated in the study. Their cord blood and/or cord tissue collections were sent to the ViaCord processing laboratory for evaluation, processing and storage. The total number of stem cells (CD34+) were counted in each cord blood collection. Cord tissue was processed using ViaCord's proprietary system to release cord tissue stem cells, which were then counted using surface markers (CD45-/CD90/CD105) to identify the Mesenchymal Stem Cell (MSC) population.
The average collection volume and stem cell number in cord blood from the premature babies were both approximately 40% lower than the average of those collected from all births in ViaCord's inventory. Remarkably, the number of stem cells per unit of body weight, for these small babies averaging 3.7 pounds at birth, represents a relative stem cell dose 5-10 times greater than that required to rescue adult patients in cord blood transplants. For the cord tissue collections, the average weight of the cord tissue collected from the premature infants was similar to the average of those collected from all births in ViaCord's inventory; however the preterm cords contained nearly twice as many MSCs.
This data is derived from a small pilot study and must be confirmed with a larger group to validate these findings. The first important lesson learned is that it is indeed feasible to perform cord blood and cord tissue collections on these very small babies in the clinical setting surrounding a preterm birth. Secondly we learned that there are a sufficient quantity of cells from the cord blood and cord tissue of premature babies to support potential therapeutic applications in a clinical trial of acquired diseases associated with prematurity.
- K. Falcon-Girard1, A. Fuhrmann1, R. Briddell1, M. Walters2, K. Foster1 and M. Kraus1. 2013 ISCT Meeting Poster, Auckland, NZ. Characterization of Umbilical Cord Blood (UCB) and Umbilical Cord Tissue (UCT) Stem Cells from Premature Infants
- 1 - ViaCord LLC, a PerkinElmer Company, USA and
- 2 - Childrens Hospital and Research Center Oakland, USA.