The early increase in sEng level, which does not appear to change with gravidity (Fig. 2A), is likely required for normal placentation while malaria-induced increases in sEng in later gestation (Fig. 2C) may restrict TGF-β–mediated placental vessel growth and lead to functional placental insufficiency and impaired fetal growth. The gene discussed is TGFB1; the disease is placental insufficiency.