Maeghan MacDougall didn’t think twice when University of Iowa Hospitals and Clinics obstetrician Mark Santillan, MD, asked if she would consider donating her cord blood for research following her baby’s delivery. “So much medicine is done on a crisis-to-crisis basis, and no one really has the luxury of asking why this happened,” says MacDougall, the mother of nine children from Robins, Iowa. “You really need the mental breathing space of research to be able to ask why and to discover the answers.” She’s been a UI Hospitals and Clinics patient for her last three pregnancies and said she donated cord blood and other tissue with each one.
“This isn’t about DNA mapping, this is about research,” MacDougall says. “Only university hospitals are in a position to be able to afford their doctors that opportunity to do that kind of research.”
It’s that research—looking to discover why things like premature births and preeclampsia occur with some women and not others, for example—that led Santillan and his wife, Donna Santillan, PhD, UI assistant research professor in obstetrics and gynecology, to introduce the Women’s Health Tissue Repository.
Researchers studying pregnancy-related problems are turning to cord blood and tissue banking to help them find answers, patterns, and new information regarding a wide variety of diseases in pregnancy. Though the use of stem cells in research is widely known, the use of cord blood‚ the blood that comes from the umbilical cord and which contains a type of stem cell‚ is still relatively new.
“The cord blood bank has been around for a long time, and its utility is growing. Researchers in pregnancy, cancer, and immunologic disease have used the banked samples,” says Mark Santillan.
Raising awareness and promoting research is an ongoing activity, Santillan said, as the need for cord blood increases. In comparison to other disciplines, he said research into maternal-fetal conditions and high-risk pregnancies is still in its infancy globally.
“The true molecular causes of many obstetric diseases such as preterm labor, preeclampsia, and gestational diabetes are not well understood,” he said. “We need to be able to understand these causes in order to effectively prevent, treat, and potentially cure some of these diseases.”
Santillan and his wife Donna Santillan coordinate the Women’s Health Tissue Repository, a tissue bank designed to help researchers study a variety of issues affecting women’s health. There are three banks within the repository: a maternal fetal tissue bank; a reproductive endocrinology and infertility tissue bank; and the long-standing oncology tissue bank. A fourth bank, a well women’s tissue bank, is planned for the near future.
Most women receiving obstetric care at UI Hospitals and Clinics are eligible to be a part of the Maternal Fetal Tissue Bank. If a woman consents to be part of this bank, the bank has approval to take “a little extra” blood, urine, or any specimen from a clinically necessary test. At the time of birth, cord blood, maternal blood, and placenta are also collected.
“The stem cell bank had been available, but we decided we needed to collect other samples in order to have the complete picture during pregnancy to allow us to focus on both the health of the mother and the child,” Donna Santillan says. “In comparison to other areas of research, there is really little research on pregnancy and maternal health, even though everyone in the world is affected by pregnancy. “Our goal with the maternal fetal tissue bank is to focus on the health of women and their babies during pregnancy because it is an incredibly under-studied area that is at a very critical time in development,” she says.
Blood samples for the bank are drawn at the same time regular blood samples are taken throughout the pregnancy: at the first visit with an obstetrician, during the screening in the second trimester, and at glucose testing at 28 weeks. Samples are stored with a study number, but they are not identifiable for researchers using the bank. To maintain privacy, researchers are given relevant clinical information pertaining to the sample, but they cannot trace it back to a particular person. Donna Santillan said the bank is strictly for research and not for personal use. In other words, she said, families aren’t able to store tissue to withdraw later in the case of a medical emergency.
“Women who choose to participate are giving a great gift by really helping with research that may not benefit them now, but could help in our understanding for future generations,” she says. The bank is growing over time; in its first year 532 women had consented to donate tissue to the banks.