الفهرس 
Preterm Infants and Stem CellsOnly 14 pages are availabe for public view
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Abstract
Umbilical cord blood provides a rich source of stem cells with several advantages. Basically, these cells serve as a sort of repair system for the body and since preterm birth is one of the major clinical problems in neonatology as it is associated with serious neonatal morbidity and mortality therefore it is important to assess the availability of stem cells in their UCB for future transplantation if required.
The aim of this prospective study was to examine the potential effect of prematurity on hematologic indices and umbilical cord CD34+ cells, including circulating nucleated red blood cells, lymphocytes, and platelets in 20 preterm infants at different gestational ages compared to 25 healthy full term infants as controls. We hypothesized that higher neonatal nucleated red blood cell (NRBC), lymphocyte counts and CD34+ stem cells would be found in extremely preterm infants who develops RDS compared to control infants. To confirm this hypothesis we measured TLC, NRBC, CD34+ stem cells, and correlated them to clinical outcome by using prematurity morbidity scores. The study was conducted in Maternity Hospital of Ain Shams University.
The percentage of CD34+ cells in samples was assessed by flow cytometric analysis on a separated mononuclear layer using anti CD34 antibodies. The effect of preterm delivery and mode of delivery on the percentage of these cells were also studied. In addition, all preterm infants have been followed up to assess the relation between degree of morbidity and percentage of these cells using MAIN score and NMI score.
- The study showed statistically significant higher cord blood CD34+ cells % in PT 28-30 wks gestation (Med. = 0.6%, IQ=0.315-0.87) compared to PT 31-36 wks gestation (Med. = 0.17, IQ=0.12-0.36), Z=9 and P=0.002.
- Full term 37-39 weeks has statistically significant lower cord blood CD34+ cells % (Med. = 0.07, IQ=.04-.09) compared to FT 40-42 weeks (Med. = 0.145, IQ=.102-.177), Z=18 and P=0.011.
- The level of cord blood CD34+ cells % decreases from highest at 28th week till 36th week then attains a semi-platu level till 40th and then returns again to rise till 42th week.
- Cord blood absolute CD34+ cell count is highest at 28-30 weeks and decreased by age till lowest at 40-42 weeks of gestational age.
- No Significant difference is found between vaginally and cesarean section delivered regarding cord CD34 cells % in full term neonates.
- No Significant effect of gender regarding cord CD34+ cells % level in different gestational age periods.
- There is a significant negative correlation between APGAR score and cord CD34 + cells %.
- There is a statistically significant positive correlation between cord CD34+ cells % level and cord blood total leucocytic count at 31-36 weeks (r = 0.806, P= 0.003).
- There is a statistically significant positive correlation between cord blood CD34 + cells % level and corrected cord blood White blood cells at 31-36 weeks (r = 0.774, P= 0.005) .
- On the other hand no significant correlation is found between cord CD34+ cells % level and neither with cord Nucleated RBCs level, hemoglobin and nor platelets.
- There is a significant positive correlation between MAIN score and cord CD34 + cells %.
- There is a significant higher cord CD34+ cells % in neonates with NMI scores II& III (Med. =0.4 %, IQ=0.23- 0.84) compared to neonates with NMI scores I (Med. =0.17%, IQ= 0.1– 0.31), Z=15 and P< 0.009. Also, there is a statistically significant higher absolute cord CD34+ cell count in neonates with NMI scores II& III (Med.= 4.16 cell/ul, IQ= 2.3 – 5.4) compared to neonates with NMI scores I (Med.= 1.4 cell/ul, IQ= 0.47 – 2.4), Z= 20 and P< 0.025.