Avaliação das características maternas, neonatais e técnicas de coleta em um banco publico de sangue de cordão umbilical e placentário
Arquivos
Data
2010
Autores
Santos, Sandra Valeria Francisconi 
Orientadores
Barros, Sonia Maria Oliveira de
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: Análises dos transplantes realizados com sangue de cordão umbilical e placentário (SCUP) para transplante demonstram que a probabilidade de enxertia e o tempo de recuperação hematopoética estão intimamente relacionadas ao número total de células nucleadas (TCN) e número total de células progenitoras CD34+ infundidas. Objetivo: Descrever o perfil da população de gestantes doadoras para o Banco de Sangue de Cordão Umbilical e Placentário (BSCUP) Público do Hospital Israelita Albert Einstein; relacionar as características maternas, neonatais e técnicas de coleta do SCUP com o TCN e o total de células progenitoras CD34+ e por conseqüência com o percentual de armazenamento e descarte das unidades de SCUP coletadas. Método: Estudo transversal e retrospectivo incluiu 3473 registros de coleta de SCUP realizadas entre 4/10/2004 e 29/07/2008. Resultados: Houve predomínio de idade materna acima de 30 anos (70,1%), idade gestacional (IG) acima de 38 semanas (84,9%), parto cesárea (79,8%) e gravidez única (98,3%). Houve distribuição homogênea se sexo dos RNs. Houve predominância de RN de raça branca (97,8%), e com peso acima 3000g (73,5%). A técnica de coleta foi intra e extraútero (96,2%). As características associadas ao armazenamento foram: idade materna (p<0,001), idade gestacional (p<0,001), tipos de parto (p<0,001), tipo de gravidez (p=0,001), peso do RN (p<0,001) e técnica de coleta (p<0,001). O volume total de sangue de cordão se associou à idade materna (p<0,001), tipo de parto (p<0,001), peso do RN (p<0,001) e técnica de coleta de sangue de cordão (p<0,001).Não houve associação entre volume e idade gestacional, tipo de gravidez e gênero ou raça do RN. Verificou-se que a idade materna e o peso do RN foram diretamente proporcionais ao número total de células nucleadas (p=0,012 e p<0.001). Além disso, os maiores números de células nucleadas foram encontrados nos grupos com idade gestacional de 38 semanas ou mais (p<0,001), parto cesárea (p<0,001), gravidez única (p<0,001), técnica intra e extra-útero (p<0,001) e RN do sexo feminino (p= 0,001). Maior quantidade de células progenitoras CD34+ foram obtidas nos grupos com idade gestacional <38 semanas (p=0,036), parto cesárea (p=0,006), RN com maiores pesos (p<0,001) e RN do gênero masculino (p=0,028). Não houve associação de células CD34+ com as outras variáveis estudadas. Conclusão: Maiores volumes de sangue de cordão coletado foram observados nas gestantes com maior idade materna, no parto cesárea, peso do RN e técnica de coleta. Quanto maior a idade materna e o peso do recém nascido, maior o número total de células nucleadas. Houve maior possibilidade de armazenamento das unidades para idade materna, idade gestacional, parto cesárea, gravidez única, maior peso do RN e na utilização de técnica coleta intra e extra-útero. As variáveis associadas igualmente ao volume, total de células nucleadas e ao número total de células progenitoras foram parto tipo cesárea e peso do recém-nascido. Idade gestacional mais precoce (<38semanas), parto tipo cesárea, RN do sexo masculino e RN de maior peso se correlacionaram a um maior número de células CD34+.
Introduction: Analyses of transplants performed using umbilical cord and placental blood (UCPb) have showed that the probability of engraftment and the time for hematopoietic recovery are closely related to the total number of nucleated cells (TNC) and the total number of CD34+ progenitor cells infused. Aims: Describe the profile of pregnant women donating to the public Umbilical Cord and Placental Blood Bank at Hospital Israelita Albert Einstein; relate maternal and neonatal characteristics and UCPb collection techniques with the TNC and total amount of CD34+ progenitor cells and consequently the percentage of UCPb units stored or discarded. Methods: This cross-sectional retrospective study included 3,473 registers of UCPb collection from October 4th 2004 to July 29th 2008. Results: Maternal age above 30 years prevailed (70.1%), as well as gestational age (GA) above 38 weeks (84.9%), cesarean section (79.8%) and single pregnancy (98.3%). Neonatal gender was homogeneously distributed. There was a predominance of Caucasian newborn babies (97.8%) with birth weight above 3,000g (73.5%). The most common collection technique was intra- and extra-uterine (96.2%). The characteristics associated with storage were: maternal age (p<0.001), gestational age (p<0.001), type of delivery (p<0.001), type of pregnancy (p=0.001), newborn weight (p<0.001), and collection technique (p<0.001). The total cord blood volume was associated with maternal age (p<0.001), type of delivery (p<0.001), newborn weight (p<0.001) and cord blood collection technique (p<0.001). No correlation was found between volume and gestational ag, type of pregnancy and neonatal gender or race. Maternal age and newborn weight were found to be directly related to the TNC (p=0.012 and p<0.001). Moreover, the highest TNC yields were found in the groups with gestational age >38 weeks (p<0.001), cesarean section (p<0.001), single pregnancy (p<0.001), intra- and extra uterine collection technique (p<0.001) and newborn of female sex (p=0.001). Higher yields of CD34+ progenitor cells were obtained in the groups with gestational age <38 weeks (p=0.036), cesarean section (p=0.006), higher birth weight babies (p<0.001) and male newborn babies (p=0.028). There was no correlation between CD34+ cells with the other variables studied. Conclusion: Higher cord blood volumes were observed with older maternal age and higher gestational age, cesarean section, newborn weight and collection technique. We observed that the older the mother and the higher the newborn weight, the higher the TNC yield. There was a greater probability of storage of UCPb units according to maternal age, gestational age, cesarean section and intra- and extra-uterine collection technique. The variables equally associated with volume total nucleated cell count and total CD34+ progenitor cell number were cesarean section and newborn weight. Lower gestational age (<38 weeks), cesarean section, male newborn sex and higher birth weight correlated significantly with a higher CD34+ cell yield.
Introduction: Analyses of transplants performed using umbilical cord and placental blood (UCPb) have showed that the probability of engraftment and the time for hematopoietic recovery are closely related to the total number of nucleated cells (TNC) and the total number of CD34+ progenitor cells infused. Aims: Describe the profile of pregnant women donating to the public Umbilical Cord and Placental Blood Bank at Hospital Israelita Albert Einstein; relate maternal and neonatal characteristics and UCPb collection techniques with the TNC and total amount of CD34+ progenitor cells and consequently the percentage of UCPb units stored or discarded. Methods: This cross-sectional retrospective study included 3,473 registers of UCPb collection from October 4th 2004 to July 29th 2008. Results: Maternal age above 30 years prevailed (70.1%), as well as gestational age (GA) above 38 weeks (84.9%), cesarean section (79.8%) and single pregnancy (98.3%). Neonatal gender was homogeneously distributed. There was a predominance of Caucasian newborn babies (97.8%) with birth weight above 3,000g (73.5%). The most common collection technique was intra- and extra-uterine (96.2%). The characteristics associated with storage were: maternal age (p<0.001), gestational age (p<0.001), type of delivery (p<0.001), type of pregnancy (p=0.001), newborn weight (p<0.001), and collection technique (p<0.001). The total cord blood volume was associated with maternal age (p<0.001), type of delivery (p<0.001), newborn weight (p<0.001) and cord blood collection technique (p<0.001). No correlation was found between volume and gestational ag, type of pregnancy and neonatal gender or race. Maternal age and newborn weight were found to be directly related to the TNC (p=0.012 and p<0.001). Moreover, the highest TNC yields were found in the groups with gestational age >38 weeks (p<0.001), cesarean section (p<0.001), single pregnancy (p<0.001), intra- and extra uterine collection technique (p<0.001) and newborn of female sex (p=0.001). Higher yields of CD34+ progenitor cells were obtained in the groups with gestational age <38 weeks (p=0.036), cesarean section (p=0.006), higher birth weight babies (p<0.001) and male newborn babies (p=0.028). There was no correlation between CD34+ cells with the other variables studied. Conclusion: Higher cord blood volumes were observed with older maternal age and higher gestational age, cesarean section, newborn weight and collection technique. We observed that the older the mother and the higher the newborn weight, the higher the TNC yield. There was a greater probability of storage of UCPb units according to maternal age, gestational age, cesarean section and intra- and extra-uterine collection technique. The variables equally associated with volume total nucleated cell count and total CD34+ progenitor cell number were cesarean section and newborn weight. Lower gestational age (<38 weeks), cesarean section, male newborn sex and higher birth weight correlated significantly with a higher CD34+ cell yield.
Descrição
Citação
SANTOS, Sandra Valéria Francisconi. Avaliação das características maternas, neonatais e técnicas de coleta em um banco público de sangue de cordão umbilical e placentário. 2010. 118 f. Dissertação (Mestrado em Enfermagem) - Departamento de Enfermagem, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2010.