Ask Your Midwife Elizabeth Stein, Certified Nurse Midwife Ask your Midife Articles
Umbilical Cord Blood Collection - Fetal Stem Cells

Elizabeth Stein, CNM, MSN, MPH

Stem cells are the future, just not quite the present. But what exactly are stem cells? They are "beginner" cells (progenitor) with the potential to develop into any of the 200 cell types in our body. There are three types of stem cells: embryonic, fetal and adult. Although similar, there are some important differences.

First are stem cells from embryos. Controversy arises because some people have grave concerns that embryos are destroyed to obtain the stem cells, killing potential human life. Most embryos are left over from in vitro procedures (abandoned) or from voluntary abortions. Embryonic stem cells have unlimited potential to develop into any cell type (pluripotent).

Adult stem cells have limited potential to grow into just a few of the 200 cell types in the body. In addition, in order to use adult stem cells (obtained from the bone marrow) the donor cells must be perfectly matched to all six (HLA) antigens of the recipient or they will be rejected, known as graft vs. host disease (GvHD). GvHD usually results in severe worsening of the person's condition or death. This limits the donor to a relative or someone on the "bone marrow" donor list who is a perfect match.

This leaves fetal stem cells, which are obtained from umbilical cord blood after delivery of a baby. There are approximately 4 million deliveries a year, giving us a river of blood and stem cells. If the umbilical cord blood is not collected, the placenta, umbilical cord and blood inside them are discarded as medical waste.

Umbilical cord blood contains fetal stem cells which are young stem cells with a great deal of potential to develop into many of the 200 different cell types. One delivery provides 1-4 ounces of cord blood with enough stem cells to treat an adult. Soon new expansion techniques will be able to make many more cells from the original few ounces - enough for several treatments or to treat more than one person. In addition, they only need to match four or five (HLA) antigens out of six, making it possible to treat unrelated people.

Currently, fetal stem cells from umbilical-cord blood are most useful for treating siblings with blood cancers (leukemias, lymphomas) and genetic inherited anemias (sickle cell, thalassemia, Fanconi's anemia and severe aplastic anemia). At this point, fetal stem cells have been transplanted to treat more than 70 different diseases in children and adults. Fetal stem cells in storage for more than 10 years have been transplanted successfully, so there is no rush to use them.

But in our lifetime, research with stem cells will provide treatments and cures for our most troubling long-term illnesses, such as stroke and spinal cord injury (nerve cells), diabetes, heart disease (heart cells), Alzheimer's and Parkinson's (brain cells), breast cancer and maybe even make oocytes (eggs).

Collecting your baby's umbilical cord blood at the time of delivery may be very useful in the future...your family's "biological insurance policy", expensive but worth every penny.

If you are pregnant and wish to discuss umbilical cord blood collection at delivery, please call Elizabeth Stein, CNM, at 212-685-3232 for an appointment.

<< Back to Articles