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FREQUENTLY ASKED QUESTIONS

COVID-19 Pandemic, Pregnancy and Cord Blood Banking

As the novel coronavirus disease (COVID-19) continues to spread rapidly across the world, emerging clinical analyses are providing more insights on the pandemic. Amongst the findings are those related to areas such as pregnancy, umbilical cord blood and perinatal tissues.

To help expectant families make informed choices, we have gathered existing information from recent clinical studies and prepared known answers to address some commonly asked questions about stem cell banking.


According to the American College of Obstetricians and Gynecologists (ACOG) as well as the Centres for Disease Control and Prevention (CDC) of the United States, there is no evidence to suggest that pregnant mothers are more at risk of getting infected with COVID-191,2.

However, pregnant mothers who have viral respiratory infections may be at greater risk of developing severe symptoms2. Given that the symptoms of COVID-19 are similar to many respiratory infections, see a doctor immediately if you are experiencing symptoms such as cough and fever.

If you are pregnant during the COVID-19 pandemic, it is absolutely crucial to observe personal hygiene by washing your hands with soap frequently and also avoid travelling to crowded places. If travelling is essential, always wear a face mask.

Evidence suggests that the transmission of COVID-19 is mainly through close human-to-human contact via air droplets, which contain the virus emitted from an infected person who coughs or sneezes. According to the CDC, mother-to-child transmission of COVID-19 during pregnancy is unlikely1.

In a recent case study on nine pregnant mothers diagnosed with COVID-19 who underwent caesarean delivery, none of the babies delivered were tested positive for COVID-19. In addition, the virus was not detected in cord blood, throat swabs, and amniotic fluid or other maternal samples collected3.

However, preliminary studies from China have suggested the likelihood of COVID-19 virus transmission from mother to baby after the newborn has been delivered. According to a widely referenced and circulated research letter from Wuhan, China, three out of 33 newborns who were born from COVID-19 positive mothers and delivered through caesarean delivery, were diagnosed with COVID-19. Even though the three newborns showed symptoms of fever and pneumonia right after birth, all of them have recovered and were tested negative for COVID-19 in a span of one week4.

Therefore, the probability of COVID-19 transmission to the newborn through close contact cannot be ruled out. In this circumstance, the mother may consider hiring a caregiver or finding someone in the family to take care of the baby until the mother has fully recovered.

As far as we know, your baby’s cord blood will not contain the COVID-19 strain even if the mother is a carrier. Typically, when a mother is sick with a respiratory virus, it is very rare for the virus to be present in the cord blood5,6,7

A retrospective study was conducted in Wuhan, China, on nine pregnant women in their third trimester who all had a history of epidemiological exposure to COVID-19, has also provided further reassurance that the virus is unlikely to be present in cord blood and birth tissues. All nine livebirths in the study were tested negative for COVID-19, with no severe perinatal asphyxia3. Perinatal asphyxia is defined as a lack of blood flow or oxygen to or from the foetus in the period immediately before, during, or after the birth process8. Furthermore, amniotic fluid, cord blood and neonatal throat swab samples of the newborns were also COVID-19 negative at the point of birth3.

A recent analysis was conducted on 38 pregnant women and their newborns in China, to assess the effects of COVID-19 and the transmissibility of the virus from mother to foetus. The results also revealed that the COVID-19 virus did not lead to maternal mortality and found no cases of intrauterine transmission of COVID-19 from mothers to their foetuses. Furthermore, neonatal specimens as well as placentas in some cases were tested negative from the virus9.

As cord blood will be collected by your caregiver immediately after the delivery of your baby, the collection of cord blood, cord lining and cord tissue remains safe even during this pandemic period.

Emerging evidences are now suggesting that the risk ofdirect transmission at the point of delivery is lowand there was no detection of COVID-19 virus strain within the maternal and neonatal samples that can be transmitted to the umbilical cord blood and cord tissue9.

In most if not all cases of COVID-19 human-to-human transmission globally, the virus is spread mainly through close interaction with an infected person where respiratory secretions can enter the eyes, mouth, nose or airways and via the touching of a surface or an object that is contaminated with the respiratory droplets10.

Cordlife is listed as an essential service provide rduring this pandemic. Our laboratory operations remain unaffected and we will adhere to the most stringent protocols to ensure that your baby’s cord blood, cord lining and cord tissue are safely collected, processed and cryopreserved.

At this juncture, there is little or no conclusive evidence to prove that mesenchymal stem cells (MSCs) can help to treat COVID-19. It is important to note that the major risk factor in COVID-19 mortality is the development of acute respiratory distress syndrome(ARDS) in critically ill patients, among other considerations such as age and pre-existing medical conditions11. According to the European Respiratory Journal, MSC treatmentwas administered on ARDS patients contracted with influenza virus respiratory infections (H7N1) and was concluded as a viable treatment that resulted in shortened ICU stay and faster recovery in patients11.

A recent pilot study was conducted in Wuhan, China, in which seven COVID-19 patients received allogeneic mesenchymal stem cells (MSCs) infusions. Among the seven patients, three (two moderate and one severe) patients had recovered and were discharged 10 days after the treatment. The results may suggest that MSCs could play a potential role in treating or significantly improving the conditions of the patients12.

Currently, the World Health Organization (WHO) and multiple agencies led by the CDC in the United States are studying the use of expanded MSCs as a possible treatment for COVID-1913.The limited but emerging evidence regarding MSCs in managing COVID-19 suggests an urgent mandate for more clinical trials to determine the direct impact these regenerative cells have on patient recovery, which may point in favour of uncovering the potential applications of MSCs to treat COVID-19.

Stem cells are at the forefront of one of the most fascinating and revolutionary areas of medicine today. Doctors recognise that stem cells have the potential to regenerate healthy new cells and tissue to help treat numerous diseases.

As clinical trials progress and researches continue to develop, umbilical cord stem cells may prove to be useful for conditions that have no cure today. In the last 19 years, Cordlife Group has released cord blood and cord tissue samples for blood reconstitutionand other cellular regenerative therapies. We believe having a readily available supply of cord blood and stem cells from the umbilical cord preserved at birth helps enable our clients to gain access to standard therapies as well as groundbreaking clinical trials and experimental treatment for themselves and their loved ones.


LINKS TO RESOURCES


REFERENCES

  1. CDC/Coronavirus Disease 2019 (COVID-19). Centers forDisease Control and Prevention website. https://www.cdc.gov/coronavirus/2019-ncov/need-extra precautions/pregnancy-breastfeeding.html. Accessed April 27, 2020.
  2. ACOG/Coronavirus Disease 2019 (COVID-19) Practice Advisory. The American College of Obstetricians and Gynecologists website. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/03/novel-coronavirus-2019. Accessed April 27, 2020.
  3. ChenH, GuoJJ, WangC, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19infection in nine pregnant women: a retrospective review of medical records. THE LANCET. 2020; 395(10226): 809 –815.
  4. ZengLK, XiaSW, YuanWH, et al. Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates Born to Mothers With COVID-19 in Wuhan, China. JAMA Pediatrics. 2020; https://jamanetwork.com/journals/jamapediatrics/fullarticle/2763787. Accessed April 27, 2020. doi:10.1001/jamapediatrics.2020.0878.
  5. Irving WL, James DK, Stephenson T, et al. Influenza virus infection in the second and third trimesters of pregnancy: a clinical and seroepidemiological study [Abstract]. BJOG. 2000; 107(10): 1282-9. https://www.ncbi.nlm.nih.gov/pubmed/11028582. Accessed April 27, 2020. PMID: 11028582.
  6. Robertson CA, Lowther SA, Birch T, et al. SARS and Pregnancy: A Case Report. Emerg Infect Dis. 2004;10(2):345–348. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3322896/. Accessed April 27, 2020. PMID: 11028582.
  7. Zou S. Potential Impact of Pandemic Influenza on Blood Safety and Availability. Transfus Med Rev. 2006;20(3):181–189. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7134961/. Accessed April 27, 2020. PMID: 16787826.
  8. Gillam-Krakauer M, Gowen Jr CW. Birth Asphyxia. [Updated 2019 Nov 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020. https://www.ncbi.nlm.nih.gov/books/NBK430782/. Accessed April 27, 2020.
  9. Schwartz DA. An Analysis of 38 Pregnant Women with COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2:Maternal Coronavirus Infections and Pregnancy Outcomes [Abstract]. Arch Pathol Lab Med. 2020; https://www.ncbi.nlm.nih.gov/pubmed/32180426. Accessed April 27, 2020. PMID: 32180426.
  10. Royal College of Obstetricians and Gynaecologists:Coronavirus (COVID-19) Infection in Pregnancy-Information for healthcare professionals. Ver 7; 2020: 1-53. Info
  11. Khoury M, Cuenca J, Cruz FF, et al. Current Status of Cell-Based Therapies for Respiratory Virus Infections: Applicability to COVID-19. Eur Respir J. 2020; in press (https://doi.org/10.1183/13993003.00858-2020). Accessed April 27, 2020.
  12. LengZK, ZhuRJ, HouW, et al. Transplantation of ACE2-Mesenchymal Stem Cells Improves the Outcome of Patients with COVID-19 Pneumonia. Aging and disease. 2020; 11(2): 216-228. http://www.aginganddisease.org/EN/10.14336/AD.2020.0228. Accessed April 27, 2020. DOI: 10.14336/AD.2020.0228.
  13. Atluri S, ManchikantiL, Hirsch JA. Expanded Umbilical Cord Mesenchymal Stem Cells (UC-MSCs) as a Therapeutic Strategy in Managing Critically Ill COVID-19 Patients: The Case for Compassionate Use [Abstract]. Pain Physician. 2020; 23(2):E71-E83. https://www.ncbi.nlm.nih.gov/pubmed/32214286. Accessed April 27, 2020. PMID: 32214286.

DCR No. 4071, June 2020, Version A

[Announcement]

Cordlife’s consultation booths located at Mount Elizabeth Novena Hospital, Parkway East Hospital and Thomson Diagnostic Ultrasound Centre will reopen with Safe Management Measures in place as we transition into Phase 1 of Post-Circuit Breaker.

Opening Hours:
Mon – Fri: 10am to 4pm
Sat: 9:30 am to 1 pm

Our sales consultants will still remain available through web consultations should you have any questions about our services/and or are interested to store your baby’s umbilical cord stem cells with us.

To find out more about cord blood banking, you may choose to download our information pack or make an appointment with our friendly consultants.

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