title: Pre-pregnancy maternal plasma cytokine levels and risks of small-for-gestational-age at birth.
abstract: OBJECTIVE
  Small-for-gestational-age (SGA) results from abnormalities of the feto-placental-maternal unit. Cytokine profiles during early pregnancy may predict placental changes that lead to SGA, however it is unknown if these altered profiles precede conception. We examined the role of maternal cytokines prior to conception as risk factors for subsequent delivery of an SGA infant.
  
  
  METHODS
  We included a sample of 80 women and their offspring from a large trial of pre-conceptual multiple micronutrient supplementation. Plasma samples collected before conception were tested with a high sensitivity multiplex assay for IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-13, IFNγ, and TNFα.
  
  
  RESULTS
  Pre-conceptual IL-13 and IFNγ were lower in women who gave birth to an SGA child than among control women (0.81 versus 1.14 pg/ml and 7.81 versus 11.01 pg/ml, respectively). Multivariable logistic regression showed that IL-13 (p = 0.029) and IFNγ (p = 0.015) were both inversely associated with SGA.
  
  
  CONCLUSIONS
  These results suggest maternal immune function prior to conception may indicate an unfavorable immune balance leading to placental abnormalities and high risk of SGA. Preconception assessment of cytokine profiles could potentially contribute to early detection of SGA and to the timely implementation of interventions to prevent it.
authors.affiliation: a Department of Epidemiology , Rollins School of Public Health, Emory University , Atlanta, GA , USA .
authors.forename: Brad D
authors.initials: BD
authors.lastname: Pearce
authors.affiliation: b International Food Policy Research Institute, Poverty, Health and Nutrition Division , Washington, DC , USA , and.|c Thai Nguyen University of Pharmacy and Medicine , Thai Nguyen , Vietnam.
authors.forename: Phuong H
authors.initials: PH
authors.lastname: Nguyen
authors.affiliation: a Department of Epidemiology , Rollins School of Public Health, Emory University , Atlanta, GA , USA .
authors.forename: Ines
authors.initials: I
authors.lastname: Gonzalez-Casanova
authors.affiliation: a Department of Epidemiology , Rollins School of Public Health, Emory University , Atlanta, GA , USA .
authors.forename: Yuchen
authors.initials: Y
authors.lastname: Qian
authors.affiliation: a Department of Epidemiology , Rollins School of Public Health, Emory University , Atlanta, GA , USA .
authors.forename: Saad B
authors.initials: SB
authors.lastname: Omer
authors.affiliation: a Department of Epidemiology , Rollins School of Public Health, Emory University , Atlanta, GA , USA .
authors.forename: Reynaldo
authors.initials: R
authors.lastname: Martorell
authors.affiliation: a Department of Epidemiology , Rollins School of Public Health, Emory University , Atlanta, GA , USA .
authors.forename: Usha
authors.initials: U
authors.lastname: Ramakrishnan
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007236:Infant, Small for Gestational Age / Q000276:immunology; D007371:Interferon-gamma / Q000097:blood*; D007378:Interleukins / Q000097:blood*; D010865:Pilot Projects; D016742:Preconception Care; D011897:Random Allocation; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D012306:Risk; D018709:Statistics, Nonparametric; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D055815:Young Adult
chemical_list: D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma
keywords: Cytokine; Vietnam; pre-pregnancy; small-for-gestational-age