Umbilical Cord Blood for Newborn DNA Identification. Dr. Suzanne J. Crouch

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1 Umbilical Cord Blood for Newborn DNA Identification Dr. Suzanne J. Crouch

2 Background Methods of newborn identification include foot prints, fingerprints, newborn photos, and identification bracelets.

3 Background However, DNA is the gold standard for identifying a child beyond a reasonable doubt (Roberts & Caruana, 2003).

4 Background The National Center for Missing & Exploited Children (NCMEC) reported a total of 240 cases of newborn abductions in the United States between 1983 and It is imperative that we have a valid newborn identification method.

5 Background NCMEC (2006) recommends a combination of security measures including newborn photos, identification bracelets, newborn foot prints and DNA testing. Baby Jane Baby Jane

6 Purpose of the Study The purpose of the study was to compare umbilical cord blood with newborn heel stick blood to determine if umbilical cord blood is a valid source of newborn DNA.

7 Purpose of the study Currently hospitals that collect newborn DNA utilize a heel stick blood specimen. Parents are often reluctant to consent to a heel stick as the procedure is painful to the infant. In addition, there are potential risks associated with the procedure of an infant heel stick, i.e., nerve damage and necrotizing osteochrondritis ( Meehan, 1998).

8 Setting The setting for this study was the labor and delivery unit in a large private, not for profit community hospital.

9 Participants Two hundred and sixty eight participants (134 newborns and 134 mothers) participated in the comparison study.

10 Educational Process The research team trained over 150 healthcare personnel (L&D nurses, NICU nurses, Certified Nurse Midwives, and Physicians) on the procedure of umbilical cord blood collection and the application on FTA Genecards. Primary investigator was on call for all deliveries.

11 Procedure Blood samples were collected from each newborn utilizing the umbilical cord and a heel stick. A blood sample was collected from each mother utilizing a finger stick. The blood samples were placed on FTA Genecards.

12 Procedure FTA Genecards are impregnated with a patented chemical formula that renders pathogens inactive and supplies a stable environment for the storage of DNA samples.

13 Procedure After samples were obtained they were allowed to dry undisturbed.

14 Procedure After drying, each Genecard was placed in a labeled foil packet and sealed.

15 Procedure A Genecard was given to the parents for safe keeping. All other Genecards were shipped to: Dr. Art Eisenberg at the University of North Texas Health Science Center for DNA analysis.

16 Analysis DNA samples were analyzed using a multiplex short tandem repeat (STR) system. Genetic profiles for each of the samples were computer generated.

17 Results The genetic profile of the cord blood sample is identical to the genetic profile of the newborn heel stick sample from each of the 134 sets. No maternal contamination was detected in any of the cord blood samples.

18 Discussion With advances in technology and increasing knowledge of DNA analysis, footprints and fingerprinting are being replaced by the science of DNA testing.

19 Implications for Nursing Practice The traumatic procedure of the newborn heel stick can be eliminated with utilization of umbilical cord blood to provide a DNA sample. By reducing the number of heel sticks the newborn experiences, risks to both the newborn and nursing professional collecting the specimen can be minimized.

20 Implications for Nursing Practice As DNA technology advances, nursing professionals can help ensure even the tiniest patients benefit from ongoing nursing research.

21 Contact Information Suzanne Crouch, Ed.D., MSN, ARNP, RN-BC Professor of Nursing Palm Beach Atlantic University