Maternal Health Questionnaire and Eligibility to Donate and Bank Cord Blood

The maternal and family health questionnaires that mothers usually complete before the collection of their baby's cord blood are designed to safeguard the health of the cord blood recipient. These questionnaires are an important component of the health evaluation, along with the testing of the maternal blood sample for infectious disease markers. Maternal blood tests may indicate past exposure, prior illness, or even current illness. The questionnaires cover some of the same conditions, but also many other areas for which testing is impractical or unavailable.

The questionnaire may ask about a past history of hepatitis and HIV, and there may be questions which address potential recent exposure to these conditions. Examples of the latter might include queries about recent tattoos and piercings, contact with individuals with hepatitis, and use of needles. Recent transfusion or a transplant may also be a risk factor for these diseases. Travel history may indicate exposure to malaria, if the trip included regions in which malaria has been identified. In addition, mothers may be questioned about travel to Europe to minimize the risk of variant Creutzfeldt-Jacob Disease (vCJD), more commonly known as "Mad Cow Disease".

Vaccinations may be a cause for deferral, although Rh immune globulin, commonly known by the brand name, RhoGAM ®, is usually acceptable. Use of many of the medications that are acceptable during pregnancy will not preclude acceptance of the donor and use of the cord blood. An exception is typically bovine insulin because of the risk of vCJD. In fact, if a mother has ever taken bovine insulin, or insulin derived from a cow, that is typically a contraindication for donating. However, insulin from other sources used to treat gestational or pre-existing diabetes mellitus is generally acceptable.

The family health questionnaire may be incorporated into the maternal health history or it may be a separate document. It is designed to capture information on not only the birth mother's history, but also that of the birth father and other close relatives. Typically, these questions are generally about inherited conditions which may be passed to the baby and render the cord blood unsuitable for transplantation.

While the forms from different organizations and facilities may appear dissimilar, most cover the same topics. In the United States, the government defines requirements for determining the eligibility of cord blood donors. The questionnaires typically cover the topics in the guidances issued by the United States Food and Drug Administration (FDA) and perhaps those required by other accrediting organizations, such as AABB (formerly known as the American Association of Blood Banks) and FACT (Foundation for the Accreditation of Cellular Therapy), depending on the cord blood bank.

For those parents contemplating private banking, it is important to ask if the questionnaires and testing will enable use of the cord blood for close family members, in addition to the baby, should the stem cells be needed for transplantation. In addition, if there is a chance that the stem cells might be used for transplantation in a country other than the one in which the blood was collected, it may be important to ascertain if alternate questions should be addressed. The use of a cord blood unit for transplant is at the discretion of the transplant physician.

Please remember that these are general guidelines. Check with the cord blood banks that you are considering, either for donation or private banking, if you have specific questions to determine your eligibility according to their requirements.

Gail Moskowitz M.D. is a board certified pathologist specializing in the medical leadership of blood and cord blood banks. She holds academic appointments as Lecturer in Pathology at Harvard Medical School and as Assistant Clinical Professor of Pathology at the Mount Sinai School of Medicine. Dr. Moskowitz has held several posts directing blood banks, and has served as the medical director of cord blood banks, both private and public. She provides healthcare consultant services in the fields of blood banking, cellular therapeutics, laboratory medicine, pharmaceutical, medical-legal and regulatory affairs, and medical informatics. Dr. Moskowitz is active in the AABB and has served as an assessor and on several of their committees.