The consistent down-regulation of the heme oxygenase 1 gene (Hmox1) along with the upregulation of multiple serpin peptidase inhibitors (Serpin1f and Serpinb5 among others) is in agreement with previous reports on the role of these hypoxia-related genes on placental development, IUGR and preeclampsia in humans and animal models38,39. Here, SERPINB5 is linked to fetal growth restriction.