VSPM MADHURIBAI DESHMUKH INSTITUTE OF

NURSING EDUCATION AND RESEARCH CENTRE

SUBJECT: NURSING RESEARCH AND STATISTICS

RESEARCH JOURNAL PRESENTATION

ON

‘‘A STUDY TO ASSESS THE LEVEL OF KNOWLEDGE REGARDING

UMBILICAL CORD BLOOD STEM CELL
BANKING AMONG ANTENATAL MOTHERS IN SELECTED
HOSPITAL, DEHRADUN’’

SUBMITTED TO:

MS. PASCALINE DAVID

ASSOCIATE PROFESSOR

MSC NURSING

VSPM MDINE

NAGPUR

SUBMITTED BY:

MS. DEVIKA BANDRE

FIRST YEAR MSC NURSING

VSPM MDINE

NAGPUR

SUBMITTED ON:

22/10/2022
RESEARCH ARTICLE

“A Study to assess the level of knowledge regarding Umbilical cord blood stem cell
banking among antenatal mothers in selected hospital, Dehradun.”

Researchers:

a. Tomar Sonam
Assistant Professor, DIMS, Dehradun, Uttrakhand, India.
b. Khatoon Parveen, Malik Rehnuma, Issachar Aradhna, Rana Payal, Ram Pradeep,
Hansda Andrew
B.Sc. Nursing 4" Year Students, DIMS, Dehradun, Uttrakhand, India.

ABSTRACT:

Introduction:

Blood left in the umbilical cord and placenta after birth is known as umbilical cord blood stem
cell. Umbilical cord blood is taken from the umbilical vein after the birth when cord is cut and
clamped. Umbilical cord blood is stored in both private and public cord banks. Umbilical cord
blood can be stored for up to 25-75 years. It is collected through a non-invasive procedure after
the birth of the child. This procedure is safe and doesn’t harm the mother and her baby.

Objectives /Aims:

To assess the level of knowledge among antenatal mothers regarding umbilical cord blood stem
cell banking and to find the significant association of knowledge and their demographic
variables.

Method:

The research approach for present study is quantitative approach aimed to assess the knowledge
regarding the umbilical cord blood stem cell banking among antenatal mothers. The research
design used for this study is descriptive design. The study was conducted in selected hospital
at Dehradun. The sample size for this study are 90 antenatal mothers. Convenient sampling
technique are used for this study. Self-structured questionnaire method are used for data
collection.
Result:

The present study finding revealed that the majority of the antenatal mothers (64.4%) had poor
knowledge, (35.5%) had average knowledge and remaining (0%) had good knowledge. The
study result revealed that there was statistically significant association between the level of
knowledge with their demographic variables.

CONCLUSION:

The purpose of the present study was to find out the knowledge regarding the umbilical cord
blood stem cell banking among antenatal mothers in selected hospital of Dehradun. Majority
of the antenatal mothers had less knowledge regarding umbilical cord blood stem cell banking
and there is need to improve it with the help of health education programme.

KEYWORDS: Antenatal Mother, Umbilical Cord, Knowledge, Stem cell.

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 doesn’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 hemopoietic stem cell sources. Umbilical cord blood banking 1s 4 easy
und non-invasive procedure of collection and storing umbilical cord blood immediate after
child birth. Cord blood can be preserve in public or private bank, (Lisa Peberdy, et.al, 2018)
When the new born is delivered out the umbilical cord 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 ag 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. (Deeksha 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
recipient. 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 worldwide, 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 of diseases can help the researches 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 m
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 at 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
nonprobability 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 O mothers had adequate knowledge.

Amera Bekhatroh Awed Allah Rashed, et. al (2018) a quasi-experimental study was conducted
to evaluate the pregnant women’s knowledge and attitude toward banking 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 counselling 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 counselling 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) 0 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 ant
100 gynaecologists were used as a sample The questionnaire were given 63%. of the
obstetricians were aware of the procedure and preservation technique. 63% of the mothers were
unaware of such 8 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 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 thus 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.

FREQUENCY AND PERCENTAGE DISTRIBUTION OF
DEMOGRAPHIC VARIABLES AMONG ANTENATAL MOTHERS

N=90

DEMOGRAPHIC FREQUENCY PERCENTAGE

S. N
VARIBALES (F) (%)
1 AGE (In Years)
a. 19-24 38 42.20%
b. 25-30 47 52.20%
c. 31-36 5 5.50%
2 Mother's Educational Status
a. Primary Education 27 30%
b. Secondary Education 51 56.60%
c. Graduation 12 13.30%
d. Post Graduate 0 0%
3 Mother's Occupation
a. Housewife 63 70%
b. Private job 23 25.50%
c. Government Job 4 4.40%
d. Business 0 0%
4 Family Income Per Month
a. <1500 30 33.30%
b. >1500 41 45.50%
c. 5000-6000 10 11.10%
d. Above 10,000 9 10%
5 Residential Area
a. Urban 64 71.10%
b. Rural 26 28.80%
6 Gravida
a. Primigravida 41 45.50%
b. Multigravida 49 54.40%
Variables of the study:

Independent Variable:

In this study independent variable is knowledges.

Dependent Variable:

In this study dependent variable es antenatal mothers.

Statistical Analysts:

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

-Association of the knowledge will be done Karl Pearson formula.

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

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.

FREQUENCY AND PERCENTAGE DISTRIBUTION OF KNOWLEDGE

SCORE OF ANTENATAL MOTHERS.

SCORE GRADE FREQUENCY PERCENTAGE

21-30 GOOD 0 0%
11-20 AVERAGE 32 35.50%
01-10 POOR 58 64.40%
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.
 ASSOCIATION BETWEEN KNOWLEDGE AND THEIR
DEMOGRAPHIC VARIABLES.

DEMOGRAPHIC <AT CHI P

DF
VARIBALES BELOW ABOVE SQUARE VALUE
1 AGE (In Years)
a. 19-24 19 19
b. 25-30 27 20 2.67 2 0.84
c. 31-36 1 4
2 Mother's Educational Status
a. Primary Education 13 14
b. Secondary Education 27 24 0.16 2 0.91
c. Graduation 6 6
3 Mother's Occupation
a. Housewife 27 36
b. Private job 18 5 9.59 2 0.008
c. Government Job 1 3
4 Family Income Per Month
a. <1500 11 19
b. >1500 28 13 8.46 2 0.03
c. 5000-6000 5 5
d. Above 10,000 3 6
5 Residential Area
a. Urban 28 36 4.8 1 0.02
b. Rural 18 8
6 Gravida
a. Primigravida 17 24 2.8 1 0.09
b. Multigravida 29 20
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.
REFERENCES:

1. Thakur Abhay. (2014) Umbilical cord stem cell, https:'llwww.Slideshare.net /mobile /abhay
thakur 98/umbilical -cordstem-cell.

2. Weiss L. Mark, Troyer L. Deryl. et.al. (2006). Stem cells in the umbilical cord. PMCID.
2(2). 155-162.

3. Cord blood banking. https:// wwow.cryo-cell.com.

4. Umbilical cord stem cells. https.// stem cellsaustralia.edu.au.

5. Umbilical cord stem cell. https://en.m. wikipedia. org/wiki/cordblood-bank.

6. Kumari Surbhi. (2020). Sources and uses of stem cells. https://www.lifecell.in/

biobank/about —stem-cells.
SUMMARY

In this research article we have seen the following points: -

1. Research article
2. Abstract
- Introduction
- Objectives/Aims
- Method
- Result
- Conclusion
3. Introduction of the study
4. Background of the study
5. Need of study
6. Objectives
7. Hypothesis
8. Review of Literature
9. Research Methodology
- Research Approach
- Research Design
- Research Setting
10. Population
11. Sample and sample size
12. Sampling technique
13. Sample criteria
- Inclusion
- Exclusion
14. Frequency and percentage distribution of demographic variables among antenatal
mothers
15. Variables of study
- Independent
- Dependent
16. Statistical analysts
17. Frequency and percentage distribution of knowledge score of antenatal mothers
18. Conclusion
19. Association between knowledge and their demographic variables.
20. Recommendations
21. Limitation of this study
22. Reference of this study
CONCLUSION

The above research study “A Study to assess the level of knowledge regarding Umbilical
cord blood stem cell banking among antenatal mothers in selected hospital, Dehradun.”
Which was performed by the researcher- Tomar Sonam Assistant Professor, DIMS, Dehradun,
Uttrakhand, India and Khatoon Parveen, Malik Rehnuma, Issachar Aradhna, Rana Payal, Ram
Pradeep, Hansda Andrew; B.Sc. Nursing 4" Year Students, DIMS, Dehradun, Uttrakhand,
India, shows that the majority of the participants (64.4%) were having poor knowledge,
(35.5%) were having average knowledge and remaining (0%) were good knowledge.
According to this study, the antenatal mothers were having less knowledge regarding umbilical
cord blood stem cell banking and there is need to improve it with the help of health education
programme.
REFERENCE

International Journal of Advance in Nursing Management, Volume 10, Issue 3, July-

September 2022, Page no. 237-242.