Washington, DC -- Physicians should give balanced information to their pregnant patients who are considering cord blood banking, presenting both the advantages and disadvantages of public vs. private cord blood banks, according to The American College of Obstetricians and Gynecologists (ACOG) in a revised Committee Opinion published today in the February issue of Obstetrics & Gynecology. ACOG also advises physicians who recruit patients for for-profit cord blood banking to disclose their financial interests or other potential conflicts of interest to pregnant women and their families.
Blood from a newborn's umbilical cord, once considered a waste product that was routinely discarded along with the placenta, is now considered to contain potentially life-saving stem cells. Private banks were initially developed to store cord blood stem cells from newborns, for a fee, for potential future use by the same child or a family member if he/she developed disease later in life. Today, there are public banks that store, for free, stem cells that can be used by anyone needing them similar to how public blood banks work.
"Patients need to be aware that the chances are remote that the stem cells from their baby's banked cord blood will be used to treat that same child—or another family member—in the future," said Anthony R. Gregg, MD, chair of ACOG's Committee on Genetics. ACOG's Committee Opinion is a joint document produced by the Committee on Obstetric Practice and the Committee on Genetics.
Although ACOG takes no position for or against cord blood banking, it recommends that physicians disclose that there is no reliable estimate of a child's likelihood of actually using his or her own saved cord blood later. Some experts estimate this likelihood at 1 in 2,700, while others argue the rate is even lower. Physicians should also disclose to their patients that it is unknown how long cord blood can successfully be stored.
Pregnant women should be aware that stem cells from cord blood cannot currently be used to treat inborn errors of metabolism or other genetic diseases in the same individual from which they were collected because the cord blood would have the same genetic mutation. "Cord blood collected from a newborn that later develops childhood leukemia cannot be used to treat that leukemia for much the same reason," said Dr. Gregg.
Federal legislation was passed in 2005 that provides funding for continued growth of a national cord blood registry in the US. Several states have laws requiring physicians to inform patients about cord blood banking options. Physicians should consult with their state medical association for more information about their individual state laws.
Committee Opinion #399, "Umbilical Cord Blood Banking," is published in the February 2008 issue of Obstetrics & Gynecology.