Inflammation throughout pregnancy and fetal growth restriction in rural Nepal

Michael W. Sauder, Sun Eun Lee, Kerry J. Schulze, Parul Christian, Lee S.F. Wu, Subarna K. Khatry, Steven C. LeClerq, Ramesh K. Adhikari, John D. Groopman, Keith P. West

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Maternal systemic inflammation during pregnancy may restrict embryo-fetal growth, but the extent of this effect remains poorly established in undernourished populations. In a cohort of 653 maternal-newborn dyads participating in a multi-armed, micronutrient supplementation trial in southern Nepal, we investigated associations between maternal inflammation, assessed by serum α1-acid glycoprotein and C-reactive protein, in the first and third trimesters of pregnancy, and newborn weight, length and head and chest circumferences. Median (IQR) maternal concentrations in α1-acid glycoprotein and C-reactive protein in the first and third trimesters were 0.65 (0.53-0.76) and 0.40 (0.33-0.50) g/l, and 0.56 (0.25-1.54) and 1.07 (0.43-2.32) mg/l, respectively. α1-acid glycoprotein was inversely associated with birth size: weight, length, head circumference and chest circumference were lower by 116 g (P = 2.3 × 10-6), and 0.45 (P = 3.1 × 10-5), 0.18 (P = 0.0191) and 0.48 (P = 1.7 × 10-7) cm, respectively, per 50% increase in α1-acid glycoprotein averaged across both trimesters. Adjustment for maternal age, parity, gestational age, nutritional and socio-economic status and daily micronutrient supplementation failed to alter any association. Serum C-reactive protein concentration was largely unassociated with newborn size. In rural Nepal, birth size was inversely associated with low-grade, chronic inflammation during pregnancy as indicated by serum α1-acid glycoprotein.

Original languageEnglish (US)
Pages (from-to)e258
JournalEpidemiology and infection
StatePublished - Aug 30 2019


  • Fetal growth restriction
  • laboratory tests
  • low birth weight
  • maternal inflammation
  • orosomucoid

ASJC Scopus subject areas

  • Epidemiology
  • Infectious Diseases


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