A perinatal nomogram enables two-step screening for umbilical cord blood donors from antenatal assessment to bedside confirmation

Abstract The high-quality umbilical cord blood (HQUCB) is closely related to successful cord blood transplantation, and given the substantial resources required for umbilical cord blood (UCB) collection, processing, and storage, optimizing the identification of HQUCB donors for cord blood banking has become a critical priority. This study aimed to develop and validate a perinatal nomogram that enables two-step donor screening: antenatal triage using routine maternal indicators, followed by bedside confirmation with neonatal indicators immediately after delivery. We recruited 423 participants, randomly dividing them into training ( n = 296) and validation ( n = 127) cohorts. Multivariate analysis identified seven independent predictors: younger maternal age, absence of hypertensive disorders complicating pregnancy, higher amniotic fluid index, earlier gestational age, male neonate, higher neonatal weight, and vaginal delivery. These predictors were subsequently allocated into two tiers, with the first four maternal factors for antenatal screening and the remaining three neonatal factors for postnatal confirmation, thus forming a two-step framework within the nomogram. Model performance was comprehensively evaluated using receiver operating characteristic (ROC) analysis and calibration curves. The nomogram demonstrated robust discrimination, with an area under the ROC curve (AUC) of 0.982 in the training cohort and 0.943 in the internal validation cohort. The calibration curve demonstrated good agreement in both cohorts. This perinatal two-step nomogram enables immediate prediction of donor suitability from antenatal assessment to bedside confirmation, thereby supporting optimal resource allocation in cord blood banking using readily accessible clinical data.