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Background: While the placenta and umbilical cord are usually discarded as medical waste after delivery, cord blood (CB) banks obtain maternal informed consent (IC) for collection, storage and maternal infectious disease testing. The timing of lC varies; it may occur in the prenatal period, during the early stages of labor or postpartum. Prenatal lC is easy to obtain, however, mothers may change their mind after signing the IC. Also, donors may be seen for the first time after labor has begun. Our CB bank obtains a staged IC: intralabor for collection and postpartum for processing, storage, and testing. We performed a donor satisfaction survey to assess mothers' attitudes about being approached for CB donation and lC in the early stages of labor. Methods: Mothers donating CB from October 1999 through January 2001 were surveyed by mail (n=892). Mothers were asked whether they felt: 1. the information about CB donation was complete, clear and accurate, 2. they were able to understand the lC process and respond to questions, and 3. the information provided was timely. Chi-square analysis of the data was performed. Results: Responses were received from 353(40%) donors surveyed. The majority of donors who responded (331,94%) felt the lC information was clear, complete and accurate (see table). Most donors (321,91%) indicated they were able to understand the information presented and to respond to questions. While a majority of the donors (303, 86%) believed the amount of information about cord blood donation was sufficient, some thought it could have been presented earlier (98, 28%). No difference was observed between donors whose CB was discarded (low volume, low total nucleated cells, unacceptable medical history) or successfully banked (p=NS, see table). Conclusion: Intra-labor consent is acceptable to the majority of CB donors. These donors indicate they have met the key elements of IC; understanding the information and the ability to ask and respond to questions. Many donors would prefer information about CB donation earlier in their pregnancy, so better prenatal education of mothers is warranted. [ABSTRACT FROM AUTHOR]

Background: Umbilical cord blood (UCB) transplantation is becoming more widely used, yet ethical and policy issues in obtaining informed consent and health history (HH) information persist. Most UCB banks do not require father's consent or HH. Our UCB bank, established in October 1999, obtains both written paternal consent and HH whenever possible. We performed this study in order to assess the value of paternal health history (PHH) in making cord blood safer for transplantation by excluding units at higher risk of infectious or other disease transmission. Methods: A retrospective review was performed of all CBUs collected over a one-year period, between November 1999 and October 2000. The cases in which PHH was obtained were evaluated to identify those discarded based solely on information provided by the father in the PHH questionnaire. Results: A total of 655 CBUs were collected over the study period and PHH was obtained in 299 of them (46%). Seventy-nine percent of CBUs banked during that period had PHH available (see table). Three CBUs (3 of 299; 1% of all CBUs collected with PHH) were discarded based purely on PHH; written information provided by the father was the only reason for discarding those units since maternal HH and infectious disease testing was negative. The identified high-risk factors in those three cases were: the father gave money or drugs for sex, traveled to an HIV high-risk area, or did not answer the high-risk questions in the PHH questionnaire. Conclusion: Considerable time and effort is expended in the process and follow-up of obtaining PHH. Although it has the potential to broaden the safety profile of CBUs banked for clinical use, our study suggests that it has little overall impact in minimizing infectious disease transmission risk in UCB banking. [ABSTRACT FROM AUTHOR]