Ethical Biobanking in Extremely Preterm Infants: Lessons From the EPITOP Study

Area of Science:

• Neonatal Research
• Biobanking
• Biomarker Discovery

Background:

• Extremely preterm infants (<28 weeks gestational age) require specialized care.
• Biomarker research in this population is crucial for understanding and preventing morbidities.
• Ethical and practical challenges exist in collecting samples from this vulnerable group.

Purpose of the Study:

• To develop an ethical and practical biobanking strategy for residual blood samples from extremely preterm infants.
• To minimize clinical risks associated with sample collection.
• To address ethical considerations in neonatal biobanking.

Main Methods:

• Collaboration with Sahlgrenska University Hospital and Biobank Väst.
• Collection of residual blood samples from NICU-admitted infants (March 2020-March 2024).
• Ethical salvage and biobanking post-parental consent, adhering to Sweden's Biobank Act.

Main Results:

• 122 consents obtained from 215 eligible infants (mean GA 25.4 weeks).
• 4238 residual samples collected, primarily from blood gas analyses (92.5%).
• Higher morbidities and lower GA correlated with increased sample numbers; plasma and whole blood aliquots stored.

Conclusions:

• The EPITOP study demonstrates the feasibility of ethically biobanking salvaged residual blood samples from extremely preterm infants.
• This approach minimizes clinical risks while facilitating biomarker discovery.
• The study provides a scalable model for neonatal research biobanking.