Autologous cord blood cell infusion in preterm neonates safely reduces respiratory support duration and potentially preterm complications

Abstract

Abstract Preterm birth and its complications are the leading cause of neonatal death. The main underlying pathological mechanisms for preterm complications are disruption of the normal maturation processes within the target tissues, interrupted by premature birth. Cord blood, as a new and convenient source of stem cells, may provide new, promising options for preventing preterm complications. This prospective, nonrandomized placebo controlled study aimed at investigating the effect of autologous cord blood mononuclear cells (ACBMNC) for preventing preterm associated complications. Preterm infants less than 35 weeks gestational age were assigned to receive ACBMNC (5 × 107 cells/kg) intravenous or normal saline within 8 hours after birth. Preterm complication rates were compared between two groups to demonstrate the effect of ACBMNC infusion in reducing preterm complications. Fifteen preterm infants received ACBMNC infusion, and 16 infants were assigned to the control group. There were no significant differences when comparing mortality and preterm complication rates before discharge. However, ACBMNC infusion demonstrated significant decreases in duration of mechanical ventilation (3.2 days vs 6.41 days, P = .028) and oxygen therapy (5.33 days vs 11.31 days, P = .047). ACBMNC infusion was effective in reducing respiratory support duration in very preterm infants. Due to the limited number of patients enrolled, powered randomized controlled trials are needed to better define its efficacy. Significance statement The results from this prospective nonrandomized study found that autologous cord blood cells infusion substantially reduced the duration of mechanical ventilation and oxygen supplement. Fewer preterm complications were observed in the cord blood cell infusion group, although there was no significant difference. Preterm birth complications are the first major direct cause of neonatal death, and no curative therapies are available to alleviate the symptoms of preterm complications. Stem cells as a treatment provides regrowth to their underdeveloped organs and therefore could improve the outcomes of preterm infants by adding more stem/progenitor cells. This may be helpful to prevent preterm complications.