title: Angiogenic and inflammatory biomarkers in midpregnancy and small-for-gestational-age outcomes in Tanzania.
abstract: OBJECTIVE
  We sought to investigate the relationship between a panel of angiogenic and inflammatory biomarkers measured in midpregnancy and small-for-gestational-age (SGA) outcomes in sub-Saharan Africa.
  
  
  METHODS
  Concentrations of 18 angiogenic and inflammatory biomarkers were determined in 432 pregnant women in Dar es Salaam, Tanzania, who participated in a trial examining the effect of multivitamins on pregnancy outcomes. Infants falling below the 10th percentile of birthweight for gestational age relative to the applied growth standards were considered SGA. Multivariate binomial regression models with the log link function were used to determine the relative risk of SGA associated with increasing quartiles of each biomarker. Restricted cubic splines were used to test for nonlinearity of these associations.
  
  
  RESULTS
  A total of 60 participants (13.9%) gave birth to SGA infants. Compared to those in the first quartile, the risk of SGA was reduced among those in the fourth quartiles of vascular endothelial growth factor-A (adjusted risk ratio [RR], 0.38; 95% confidence interval [CI], 0.19-0.74), placental growth factor (adjusted RR, 0.28; 95% CI, 0.12-0.61), soluble fms-like tyrosine kinase-1 (adjusted RR, 0.48; 95% CI, 0.23-1.01), monocyte chemoattractant protein-1 (adjusted RR, 0.48; 95% CI, 0.25-0.92), and leptin (adjusted RR, 0.46; 95% CI, 0.22-0.96).
  
  
  CONCLUSIONS
  Our findings provide evidence of altered angiogenic and inflammatory mediators, at midpregnancy, in women who went on to deliver SGA infants.
authors.affiliation: Department of Global Health and Population, Harvard School of Public Health, Boston, MA. Electronic address: adarling@hsph.harvard.edu.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Darling
authors.affiliation: SAR Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Chloe R
authors.initials: CR
authors.lastname: McDonald
authors.affiliation: SAR Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Conroy
authors.affiliation: SAR Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Kyla T
authors.initials: KT
authors.lastname: Hayford
authors.affiliation: Department of Medicine, University of Washington School of Medicine, Seattle, WA.
authors.forename: W Conrad
authors.initials: WC
authors.lastname: Liles
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA.
authors.forename: Molin
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors.forename: Said
authors.initials: S
authors.lastname: Aboud
authors.affiliation: Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors.forename: Willy S
authors.initials: WS
authors.lastname: Urassa
authors.affiliation: SAR Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Kain
authors.affiliation: Department of Global Health and Population, Harvard School of Public Health, Boston, MA; Department of Epidemiology, Harvard School of Public Health, Boston, MA; Department of Nutrition, Harvard School of Public Health, Boston, MA.
authors.forename: Wafaie W
authors.initials: WW
authors.lastname: Fawzi
mesh_terms: D000293:Adolescent; D000328:Adult; D042682:Angiopoietins / Q000097:blood; D015703:Antigens, CD / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D002097:C-Reactive Protein / Q000378:metabolism; D003165:Complement System Proteins / Q000378:metabolism; D016207:Cytokines / Q000097:blood; D000071063:Endoglin; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007249:Inflammation / Q000097:blood*; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D020738:Leptin / Q000097:blood; D015999:Multivariate Analysis; D018919:Neovascularization, Physiologic / Q000502:physiology*; D000072483:Placenta Growth Factor; D011247:Pregnancy; D011257:Pregnancy Proteins / Q000097:blood; D011261:Pregnancy Trimester, First / Q000097:blood; D011262:Pregnancy Trimester, Second / Q000097:blood; D011956:Receptors, Cell Surface / Q000097:blood; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000097:blood; D012044:Regression Analysis; D013636:Tanzania; D042461:Vascular Endothelial Growth Factor A / Q000097:blood; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood; D055815:Young Adult
chemical_list: D042682:Angiopoietins; D015703:Antigens, CD; D015415:Biomarkers; D016207:Cytokines; C064206:ENG protein, human; D000071063:Endoglin; D020738:Leptin; C000608036:PGF protein, human; D011257:Pregnancy Proteins; D011956:Receptors, Cell Surface; D047889:Receptors, Tumor Necrosis Factor, Type II; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D018799:Intercellular Adhesion Molecule-1; D000072483:Placenta Growth Factor; D003165:Complement System Proteins; D002097:C-Reactive Protein; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1
keywords: angiogenesis; inflammation; small for gestational age