Review: Public perspectives on the utilization of human placentas in scientific research and medicine

Yoshizawa, Rebecca Scott

doi:10.1016/j.placenta.2012.10.014

Cited by 29 publications

(33 citation statements)

References 67 publications

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“…This dependency is reflected in the way that various societal groups consider the placenta as a twin or guardian angel, and venerate it as a sacred object [1,2]. Hence, the placenta is often accorded ritual burial, for in some beliefs the soul must be reunited with its placenta before being able to pass through to the afterlife.…”

Section: Introductionmentioning

confidence: 99%

The placenta: a multifaceted, transient organ

Burton

Fowden

2015

Phil. Trans. R. Soc. B

568

380

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The placenta is arguably the most important organ of the body, but paradoxically the most poorly understood. During its transient existence, it performs actions that are later taken on by diverse separate organs, including the lungs, liver, gut, kidneys and endocrine glands. Its principal function is to supply the fetus, and in particular, the fetal brain, with oxygen and nutrients. The placenta is structurally adapted to achieve this, possessing a large surface area for exchange and a thin interhaemal membrane separating the maternal and fetal circulations. In addition, it adopts other strategies that are key to facilitating transfer, including remodelling of the maternal uterine arteries that supply the placenta to ensure optimal perfusion. Furthermore, placental hormones have profound effects on maternal metabolism, initially building up her energy reserves and then releasing these to support fetal growth in later pregnancy and lactation post-natally. Bipedalism has posed unique haemodynamic challenges to the placental circulation, as pressure applied to the vena cava by the pregnant uterus may compromise venous return to the heart. These challenges, along with the immune interactions involved in maternal arterial remodelling, may explain complications of pregnancy that are almost unique to the human, including pre-eclampsia. Such complications may represent a trade-off against the provision for a large fetal brain.

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Section: Introductionmentioning

confidence: 99%

The placenta: a multifaceted, transient organ

Burton

Fowden

2015

Phil. Trans. R. Soc. B

568

380

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“…[180][181][182][183] Tissue that would otherwise have been discarded, including placentas and umbilical cords, can be obtained for research purposes because their collection poses little risk to the patients. [185][186][187] The placenta has been used in child-health research to investigate preeclampsia, 188 maternal obesity, 63 endocrine disruptors, 189 attention-deficit/hyperactivity disorder, 64 Smith-Lemli-Opitz syndrome, 190 and vertical virus transmissions. 65,66 Blood drawn from umbilical cord veins has been used for regenerative medicine 72 and stem cell research.…”

Section: Sources and Types Of Solid Tissues Collectedmentioning

confidence: 99%

Translational Research in Pediatrics IV: Solid Tissue Collection and Processing

2016

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Solid tissues are critical for child-health research. Specimens are commonly obtained at the time of biopsy/surgery or postmortem. Research tissues can also be obtained at the time of organ retrieval for donation or from tissue that would otherwise have been discarded. Navigating the ethics of solid tissue collection from children is challenging, and optimal handling practices are imperative to maximize tissue quality. Fresh biopsy/surgical specimens can be affected by a variety of factors, including age, gender, BMI, relative humidity, freeze/thaw steps, and tissue fixation solutions. Postmortem tissues are also vulnerable to agonal factors, body storage temperature, and postmortem intervals. Nonoptimal tissue handling practices result in nucleotide degradation, decreased protein stability, artificial posttranslational protein modifications, and altered lipid concentrations. Tissue pH and tryptophan levels are 2 methods to judge the quality of solid tissue collected for research purposes; however, the RNA integrity number, together with analyses of housekeeping genes, is the new standard. A comprehensive clinical data set accompanying all tissue samples is imperative. In this review, we examined: the ethical standards relating to solid tissue procurement from children; potential sources of solid tissues; optimal practices for solid tissue processing, handling, and storage; and reliable markers of solid tissue quality.

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“…Why is this so? 559889J REXXX10.1177/1556264614559889Journal of Empirical Research on Human Research EthicsYoshizawa et al The perceived absence of major ethical concerns on the part of scientists and clinicians is a significant factor in the selection of placentas for research studies and therapeutic applications (Yoshizawa, 2013). Numerous scientific articles state that placentas are fine to collect and use in research because they will otherwise be "thrown out" (see Barachini et al, 2009;Barbati, Mameli, Sidoni, & Di Renzo, 2012;Chang et al, 2007;Ilancheran, Moodley, & Manuelpillai, 2009;Muralidhar & Panda, 1999, 2000Scalinci et al, 2011;Wang et al, 2008;Wolff et al, 1996;Yen et al, 2005;Yu et al, 2009;Zhang et al, 2006).…”

Section: Data Sharing Perspectivesmentioning

confidence: 99%

“…If it's going to be thrown out, no, no consent is necessary for that. (Yoshizawa, 2014, p. 187) In other words, many scientists and clinicians regard placentas as otherwise unwanted hospital wastes (see Halkoaho, Pietilä, & Vähäkangas, 2011), the collection of which therefore does not require in-depth ethical scrutiny (see Yoshizawa, 2013).…”

Section: Data Sharing Perspectivesmentioning

confidence: 99%

“…Little is known about public perspectives on scientific and therapeutic applications of delivered placentas, particularly from rigorous empirical investigation (Yoshizawa, 2013). Two small sample qualitative studies of 18 women who had given birth and 6 of their male partners in Denmark (Lind, Mose, & Knudsen, 2007), and 25 women who had given birth and 4 of their male partners in Finland (Halkoaho et al, 2010), suggest participants support the donation of placentas and their use in science and medicine.…”

Section: Data Sharing Perspectivesmentioning

confidence: 99%

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Postpartum Women’s Perspectives on the Donation of Placentas for Scientific Research in Campinas, Brazil

Yoshizawa

Osis

Nascimento

et al. 2014

Journal of Empirical Research on Human Research Ethics

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Little is known about public perspectives of scientific and therapeutic uses of placentas. Gaps in knowledge potentiate ethical and clinical problems regarding collection and applications. As such, this study sought to assess the perspectives of placenta donation of a sample of women. Postpartum women's perspectives on placental donation were assessed at the State University of Campinas in the Centro de Atençäo Integral a Saúde da Mulher (CAISM) maternity hospital using a cross-sectional survey (n = 384) and semi-structured interviews (n = 12). Surveys were analyzed quantitatively and interviews were analyzed qualitatively using grounded coding; results were compared. The average age of respondents was 27. Fifty-six percent had more than one child, 45% were Caucasian, 38% were mixed-race, 74% identified with a Christian faith, 52% had high school education or higher, 13% regarded the placenta as spiritually important, 72% felt that knowing what happens to the placenta after birth was somewhat or very important, 78% supported the use of the placenta in research and medicine, 59% reported that consent to collect the placenta was very or somewhat important, 78% preferred their doctor to invite donation, and only 7% preferred the researcher to invite donation. Interviews suggested women appreciate being part of research and that receiving information about studies was important to them. Informed by these results, we argue that women support scientific and therapeutic uses of placentas, want to be included in decision making, and desire information about the placenta. Placentas should not be viewed as "throwaway" organs that are poised for collection without the involvement and permission of women. Women want to be meaningfully included in research processes.

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Review: Public perspectives on the utilization of human placentas in scientific research and medicine

Cited by 29 publications

References 67 publications

The placenta: a multifaceted, transient organ

The placenta: a multifaceted, transient organ

Translational Research in Pediatrics IV: Solid Tissue Collection and Processing

Postpartum Women’s Perspectives on the Donation of Placentas for Scientific Research in Campinas, Brazil

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