Knowledge, Attitudes, and Practices of Pregnant Women and Hospital Staff Regarding Umbilical Cord Blood Banking: Systematic Review and Meta-Analysis.

Abstract

The aim of this study is to assess the knowledge, attitudes, and practices of pregnant women and hospital staff regarding umbilical cord blood (UCB) donation and storage to understand its limitations in clinical practice. MEDLINE, Scopus, LILACS, EMBASE, Scielo.br, and PROSPERO were searched from inception to 30 November 2023 with no geographic or language restrictions. The study eligibility criteria included cross-sectional studies that interviewed pregnant women and/or hospital staff about their knowledge, attitudes, and practices regarding private or public storage. A random-effects restricted maximum-likelihood model with Freeman-Tukey Double arcsine transformation meta-analysis was carried out to calculate the pooled estimates. MOOSE guidelines were followed. STATA 14.1 was used for statistical analysis. The Newcastle-Ottawa Scale and ROBINS-I tool were used for quality and risk of bias assessments. In total, 19 studies providing data for 19,904 pregnant women and 1245 hospital staff members were included. Pooled pregnant women awareness was 61% ((95% CI 0.60 to 0.62), I2 = 0%, τ2 = 0.00, Q = 11.0 (p = 0.950)), and 61% for hospital staff (95% CI 0.58 to 0.64), I2 = 0%, τ2 = 0.00, Q = 4.00 (p = 0.310)). In total, 57% ((95% CI 0.56 to 0.58), I2 = 0, τ2 = 0.00, Q = 4.00 (p = 0.320)) of pregnant women had a positive attitude about UCB, while 34% ((95% CI 0.32 to 0.36), I2 = 0%, τ2 = 0.00, Q = 4.00 (p = 0.310)) were in favor of donating UCB for research and 65% ((95% CI 0.63 to 0.66), I2 = 0%, τ2 = 0.00, Q = 4.0 (p = 0.350)) were planning UCB storage. A significant (p < 0.001) preference for public relative to private banking (51% ([95% CI 0.49 to 0.54], I2 = 0%, τ2 = 0.00, Q = 4.0 (p = 0.310)) vs. 12% ([95% CI 0.10 to 0.13], I2 = 0%, τ2 = 0.00, Q = 4.0 (p = 0.300))) was noted for pregnant women. The same was retrievable for professionals (84% ([95% CI 0.79 to 0.88], I2 = 0%, τ2 = 0.00, Q = 2.0 (p = 0.110)) vs. 6% ([95% CI 0.03 to 0.09], I2 = 0%, τ2 = 0.00, Q = 1.0 (p = 0.070); p < 0.001)). Despite these efforts, lack of knowledge and positive attitudes about UCB banking remain, emphasizing the need for increasing educational programs on the subject.