Association between peripheral markers in women with malaria in pregnancy and small newborns: A cross-sectional study

Alterations in angiogenic proteins play a role in newborn growth potential, and they have been widely studied, but not further explored in malaria research. We aimed to identify maternal peripheral proteins that are associated with newborn growth parameters in the context of malaria in pregnancy. We analysed data and biological samples collected from 386 pregnant women with and without malaria selected from previous cohort study in the Amazon region, Brazil, between 2013 and 2015. ELISAs were used to quantify Ang-1, Ang-2, Tie2, VEGF, sFlt1, VEGFR2, PlGF, sENG, and leptin in peripheral plasma at time of delivery. We generated receiver operating characteristic curves and multivariable logistic regression models to assess the associations of maternal peripheral protein levels with the anthropometric profiles of newborns. Tie2, sFlt1, sENG and leptin were associated to growth parameters in newborns of mothers who had malaria during pregnancy. sFlt1 levels were associated with newborn weight and length, and sENG was associated with newborn length in Plasmodium vivax-infected women. Tie2, sFlt1 and leptin levels were associated with newborn length in Plasmodium falciparum-infected women. Identifying maternal peripheral proteins associated with newborn outcomes might help in understanding biological dynamics of malaria in pregnancy in areas of low transmission, improving future health interventions, and encourage further studies with angiogenic proteins.