INTRODUCTION:

Blood left in the umbilical cord and placenta after birth is known as umbilical cord blood stem cell. Umbilical cord is the part of placenta that provide nutrients to a fetus, which helps the fetus to survive during intrauterine period. After birth placenta and umbilical cord blood is rich in stem cell.

Umbilical cord blood is taken from the umbilical vein after the birth when cord is cut and clamped. Umbilical cord blood can be stored for up to 25- 75 years. (Abhay Thakur, 2014)

Umbilical cord blood is collected through a non -invasive procedure after the birth of the child, this procedure is safe and it doesn’t harm the mother and the baby. Stem cell are the modern and new technique to treat life threatening diseases. Stem cell have the most effective therapeutic effect on cancerous cells, they are able to kill and destroy the cancerous cells in the human body. In last 10 years umbilical cord blood stem cell has safe to many life of patients, stem cell have been very useful to patient from painful and expensive bone marrow procedure of inborn errors of the metabolism. (Weiss and Deryl. L. TROYER, 2006)

After the child is born, tissue and stem cell are collected from the cord blood and store for possible use in the future. This process is known as stem cell banking. (Cryocell) Umbilical cord blood is collected at birth it is rich source of stem cell that is use for treatment and can also be used in research of stem cell. Umbilical cord blood is stored in both private and public cord bank. (Stem Cell Australia)

Stem cells are currently used for several life threatening diseases. Cord blood stem cell is used to treat blood and immune system related genetic disease like cancer and blood disorder. Cord blood stem cell are only used for family and siblings who have a matching tissue type. 75% sibling have chance of compatibility of matching tissue type and 50% for parents and grandparents. Cord blood stem cell collection is an easy procedure it dosen’t harm the mother, baby and it doesn’t interfere with the birthing process. (Wikipedia)

Stem cells are only obtained from umbilical cord blood and it have high regenerative properties and ability to treat about 80+ diseases. These stem cells developed into blood cells to replace diseased cell. (Life cell) [Surabhi Kumari]

Umbilical cord is a single lifeline that acts as a binding bridge between fetus and placenta, it is not only fetal life support but also holds the ability to support life even after the baby is born. Umbilical cord contains different type of stem cells which serves as building blocks. Stem cells helps to repair and replace the damage cell from the body. It can also be used in future medical treatment. (Dr. S. Kalabarathi, Ms. W.S.Khanpam, 2019).

BACKGROUND OF THE STUDY:

Human body is made up of three basic categories of cells i.e. (a) Germ cells, (b) stomatic cells, (c) stem cells. The stem cells are capable of self- replication into different type of cells, it is found in blood, bone marrow, dental tissue, muscles, skin and organs such as brain and liver. Embryonic stem cell are isolated from the inner cells mass of blastocysts and adult stem cells are found in various tissue. Stem cells and progenitor cell act as a repair system for the body. In developing embryo, stem cells can differentiate into all specialized cells and also maintain the normal turnover of regenerative organs such as blood, skin or intestinal tissue. (D Vignesh, et.al, 2017)

Cord blood has been used as an alternative to bone marrow for therapeutic for over 25 successful years in condition of the blood, immune system and metabolic disorder. Cord blood is now one of the main hemapoietic stem cell sources. Umbilical cord blood banking is an easy and non-invasive procedure of collection and storing umbilical cord blood immediate after child birth. Cord blood can be preserve in public or private banks. (Lisa Peberdy, et.al, 2018)

When the newborn is delivered out the umbilical cord is divided, the cord is attached with the placenta and blood can be collected through the segments of umbilical cord. Stem cells retrieved from the remaining blood in the segment of umbilical cord and placenta, i.e. it is known as “umbilical cord blood (UCB) stem cells.” Umbilical cord blood is of no use to mother and child after cord clamping of the baby but it has been used for treated as medical waste for centuries as a rich sources of stem cells. (Deeksha Pandey, et.al, 2016)

Umbilical cord blood stem cell have unique properties which have many promising uses for future. These cells are naive, on allogenic transplantation, they produced as attenuated donor-derived immune response and thus have a lower incidence of graft-verus –host reaction which compared to other sources of the stem cells (bone marrow of peripheral cells), not like other sources, these can also be transplanted even without an identical HLA (Human Leukocyte Antigen) match. (Deekhsa Pandey, et.al, 2016).

The cord blood collection in a non-invasive and easy procedure, without any risk to mother and the baby. Cord blood stem cells have many advantages but also have certain limitations. It requires appropriate blood collection, processing and storage of every single umbilical cord blood stem cells unit. It has remained a limiting factor for transplant the stem cell in an adult recipients. Sometimes in rare cases the patients on umbilical cord blood is not useful as the precursor of the disease may be in the umbilical cord blood stem cells as well. (Deeksha Pandey, et.al, 2016)

The cord blood banking is a term for shortening a child’s cord blood in a medical facility to protect the child and family from future diseases. Over a million units are stored in the private banks and another 500,000 approx registered in the public facilities around the world. The expectant parent should know about the awareness of collecting the stem cell banking they should know that birth is only one time chance to collect and store these valuable stem cells, which can be used for the treatment of over 80 diseases. (Snigdha Bhattacharjee, et.al, 2018)

The umbilical cord blood transplant trial world wide, at an international level. 37 studies has been done in the East Asia region, in Europe 31, in North America 222 and in United States 220 studies has been conducted till now. 2000 cord blood hemopoietic stem cells transplant are performed annually. UCB is very useful and stem cell is the best source for patients even without a donor. (Wikipedia). The private banking is helpful to protects the family from dangerous conditions, while the public donation can help the researchers to find new treatments of diseases or aid the family member with little or no medical options. (Snigdha Bhattacharjee, et.al, 2018)

NEED OF THE STUDY:

In India according to the census 2011 there are approximately 72000 births daily, which results in discarding 72000 umbilical cords a day. The umbilical cord blood stem cells are proved to be the best possible insurance against life threatening diseases and it is literally being disposed off as a medical waste material in labour units across the country day and night. Cord blood is being researched for regenerative medicine where it is seen that stem cells helps in healing and regenerate cells to repair tissues. Stem cells have led to clinical trials using cord blood in experimental therapies to treat brain injury, cerebral palsy and juvenile diabetes. (Amandeep Kaur, et.al, 2017). Physicians and researchers are making significant progress in evaluating the safety and efficacy of cord blood stem cells for therapeutic uses for cancers and blood disorders. Recent researchers have shown that umbilical cord blood stem cells have similar power or ability of health promoting benefits as embryonic stem cells. Advancement in science are being made each day to provide greater safety to the patients. (Florence Daisy, et.al, 2018)

As the researches felt there is lack of knowledge and awareness among the people regarding the cord blood banking and stem cell therapy. It was important to educate the public about the potential uses and advantages of the cord blood stem cells, they planned teaching programmes and it was found effective in improving attitude and knowledge on the practice of mothers regarding ARIs as shown by the post-test score of experimental group. The findings revealed that there was increase in the knowledge level parents and staff after structured education trials. (Snigdha Bhattacharjee, et.al, 2018)

OBJECTIVES:

· To assess the level of knowledge among antenatal mothers regarding umbilical cord blood stem cell banking.

· To find the significant association of knowledge and their demographic variables.

HYPOTHESIS:

H1- There will be significant association of knowledge and their selected demographic variables.

REVIEW OF LITERATURE:

Review of literature is an important step in research process. Review of literature means a comprehensive, complete and analytical scrutiny of publication related to the research project. Before any research can be started, literature reviews of earlier studies and experiences related to intended investigations should be done. The best part of the literature review is the contribution it makes to the new knowledge, insight and gain in knowledge of the researcher.

Catherine R, Raji D, et.al (2019) a descriptive approach study was conducted to assess the level of knowledge and attitude regarding umbilical cord blood banking among antenatal mothers in OPD at Pondicherry Institute of Medical Sciences, Pondicherry. The total 70 sample were selected using convenient sampling technique. Structured questionnaire were used. The result revealed that the mothers are having (75.7%) inadequate knowledge and (24.3%) adequate knowledge. The attitude of the Participant was (23.5%) positive attitude and (17.0%) negative attitude.

Ellappan Varalakshmi, Rose Shalinimaria (2019) a descriptive research design study as conducted to assess the knowledge regarding cord blood storage among antenatal mothers visiting Saveetha Medical College and Hospital. 30 samples were Selected using non- probability convenient sampling technique. Semi- structured questions were used. The results of the study are 22 mothers (73.3%) had inadequate knowledge, 8 mothers (26.6%) had moderate knowledge and 0 mothers had adequate knowledge.

Amera Bekhatroh Awed Allah Rashed, et. al (2018) a quasi-experimental study wasconducted to evaluate the pregnant women’s knowledge and attitude towardbanking of stem cells from the umbilical cord blood before and after counseling. A quasi-experimental design (pre and post test). The data was collected by interviewing questionnaire, attitude scale. The sample size was 100 pregnant women at the antenatal clinic of maternal and child health center (MCH). The most of the women (88.7%) had poor knowledge level before counseling and after counseling, the majority of women (68.6%) had good knowledge level. 28% of women had positive attitude toward stem cells collection and banking before counseling. After counseling, the positive attitude increased to 81%.

Hanan EL- Sayed Mohamed El- Sayed, et. al, 2018 a quasi-experimental pre, post test design study was conducted on umbilical cord stem cell banking. The aim of this study was to study the application of counseling about umbilical cord stem cell collection and banking among antenatal mothers and its effect on their knowledge and attitude. The study was carried out at the antenatal clinics in Mansoura University Hospital, Egypt. The sample size was 98 pregnant women. A purposive sampling technique was used. The tools were counseling sheet using gather model, likert scale and woman satisfaction scale. The study finding had revealed that there was a highly statistically significant improvement of knowledge about umbilical cord stem cell collection and banking post intervention compared to pre intervention. There was improvement among antenatal mothers concerning their attitude towards the umbilical cord stem cell collection and banking.

Ayushi A. Mistry, et. al (2018) a study was conducted to assess the knowledge of obstetricians and expectant mothers towards umbilical cord blood banking and their awareness regarding umbilical cord blood stem cell banking in Anand and Kheda district, India. 100 mothers and 100 gynecologists were used as a sample. Thequestionnaire were given. 63% of the obstetricians were aware of the procedure and preservation technique. 63% of the mothers were unaware of such a procedure, whereas 65% were not sure about the usefulness of the procedure.

RESEARCH METHODOLOGY:

Research approach:

Research approach is a plan of action that provides way to conduct research systematically, efficiently, appropriately. In this research study, quantitative and descriptive approach was used.

Research design:

In this research study descriptive design is used to assess the level of knowledge regarding umbilical cord blood stem cell banking among antenatal mothers.

Research setting:

The research setting is the place, location, area where the research conduct or takes place where the researcher wants to study. In this study is conducted in selected hospital, Dehradun.

Population:

In this study the research populations are antenatal mothers.

Sample and Sample size:

· In this study, the samples are antenatal mothers.

· In the study, the sample sizes are 90 antenatal mothers.

Sampling techniques:

The sampling techniques used for this study is convenient sampling technique to access the sample easily.

Sample criteria:

Inclusion:

· Antenatal mothers admitted in the hospital.

· Antenatal mothers come for follow up.

Exclusion:

· Antenatal mothers with mental disability.

· Antenatal mothers who cannot understand Hindi or English language.

Variables of the study:

Independent Variable:

In this study independent variable is knowledge.

Dependent Variable:

In this study dependent variable is antenatal mothers.

Statistical Analysis:

· Demographic data of the respondent will be done by descriptive analysis (frequency and percentage distribution).

· Association of the knowledge will be done by using Karl Pearson formula.

The data analysis was done by descriptive statistics (frequency and percentage distribution of sample characteristics of antenatal mothers)

Frequency and percentage distribution of demographic variables among antenatal mothers. N=90

Demographic variables

Frequency (F)

Percentage (%)

1. Age (In Years)

a. 19-24

b. 25-30

c. 31-36

2. Mother’s Educational Status

a. Primary Education

b. Secondary Education

c. Graduation

d. Post graduate

3. Mother’s Occupation

a. Housewife

b. Private Job

c. Government Job

d. Business

4. Family Income Per Month

a. <1500

b. >1500

c. 5000-6000

d. Above 10,000

5. Residential Area

a. Urban

b. Rural

6. Gravida

a. Primigravida

b. Multigravida

(42.2%)

(52.2%)

(5.5%)

(30%)

(56.6%)

(13.3%)

(0%)

(70%)

(25.5%)

(4.4%)

(0%)

(33.3%)

(45.5)

(11.1%)

(10%)

(71.1%)

(28.8%)

(45.5%)

(54.4%)

Frequency and percentage distribution of knowledge score of antenatal mothers.

Score

Grade

Frequency

Percentage

21-30

11-20

1-10

Good

Average

Poor

35.5%

64.4%

Association between knowledge and their demographic variables.

Demographic Variables

<at

Chi Square

P value

Below

Above

1.Age (In Years)

a. 19-24

b. 25-30

c. 31-36

2. Mother Educational Status

a. Primary Education

b. Secondary Education

c. Graduation

3.Mothers Occupation:

a. House wife

b. Privat Job

c. Govt. Job

4. Family Income Per Month:

a. <1500

b. >1500

c. 5000-6000

d. Above 10,000

5.Residential Area:

a. Urban

b. Rural

6 Gravida:

a. Primi Gravida

b. Multi Gravida

2.67

0.16

9.59

8.46

4.80

2.80

0.84

0.91

0.008

0.03

0.02

0.09

Significant association was evaluated when the calculated value is greater than the tabulated value at p>0.05 so we accept the research hypothesis. The association between the knowledge score with selected demographic variables like age, education of mother, mother’s occupation, family income, residential area and gravida. The Chi square with Fisher’s exact test used to find the association. The result finding shown that two demographic variable shows the significant association between knowledge and the mother’s occupation and family income per month.

CONCLUSION:

On the basis of study result, following conclusions were drawn. The purpose of the present study was to find out the knowledge regarding the umbilical cord blood stem cell banking among antenatal mothers. The findings revealed that the majority of the participants (64.4%) were poor knowledge, (35.5%) were average knowledge and remaining (0%) were good knowledge. According to this study, the antenatal mothers were less knowledge regarding umbilical cord blood stem cell banking and there is need to improve it with the help of health education programme.

RECOMMENDATION:

On the basis of the study finding, the following recommendations were made.

· A further study can be conduct with large sample and for better generalization.

· The study can be conduct to assess the attitude of the antenatal mothers regarding umbilical cord blood stem cell banking.

· A study can be conducted on the other group of the population like health professionals.

· The study can be conducted using information through booklet, pamplet, video assisted teaching and health education programme.

LIMITATIONS OF THIS STUDY:

· The study was limited to antenatal mothers.

· The study was limited to antenatal mothers who admitted in the hospital and comes for follow up.

· It was limited to antenatal mothers who cannot understand Hindi or English language.

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Received on 25.04.2022 Modified on 15.05.2022

Int. J. of Advances in Nur. Management. 2022; 10(3):237-242.

DOI: 10.52711/2454-2652.2022.00055