Figure 4.

In primigravidas, activation of fetal macrophages was associated with decreased birth weight. (a) Increased numbers of fetal CD68+ HBCs (left) and CD68+ maternal macrophages (right) were found in PM (gray) as compared to uninfected controls (white). Upon stratification by gravidity, there were increased HBCs and maternal macrophages irrespective of gravidity. Data is shown as median, interquartile range, and adjacent values. P-values were calculated with the Wilcoxon rank sum test. (b) Phenotypic characterization of HBCs (left) and maternal macrophages (right) showed a decrease in HBC M2 percentage in primigravidas with PM, but not multigravidas, as compared to uninfected controls. Overall maternal macrophages showed an increase in M2 polarization with PM. (c) Linear regression analysis showed that the HBC M2 percentage was highly predictive of birth weight in primigravidas, but not multigravidas or all gravidities. Abbreviations: PG, primigravidas; MG, multigravidas; HPF, high-powered field; HBC, Hofbauer cell; PM, placental malaria.