Pala et al. (43), found that while serum fractalkine levels showed no significant differences between controls and intrauterine growth restriction (IUGR) groups, amniotic fluid levels were markedly elevated in IUGR, reflecting localized placental hypoxia Variability in CX3CL1 expression between serum and amniotic fluid, along with small cohorts and inconsistent assays, limits its clinical application, as noted by Szewczyk et al. (47). Here, CX3CL1 is linked to fetal growth restriction.