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Imprinted genes, a subset of epigenetically regulated genes that are sensitive to the prenatal environment, are chiefly involved in growth and neurobehavior. We tested the hypothesis that alterations in placental imprinted gene expression mediate fetal alcohol growth restriction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Placental expression of 109 genes previously shown to be imprinted and expressed in the placenta was assessed using the NanoString\u2122 nCounter Analysis System in flash\u2010frozen samples from 34 heavy drinkers and 31 control women in Cape Town, South Africa, from whom prospective pregnancy alcohol consumption data had been obtained. Length\/height, weight, and head circumference were measured at 6.5 and 12\u00a0months and at an <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content> diagnostic clinic (at ages 1.1 to 4.6\u00a0years) that we organized. Imprinted gene expression between exposed and control placentas was compared using the limma R package. The relation of alcohol exposure to World Health Organization length\u2010for\u2010age <jats:italic>z<\/jats:italic>\u2010scores was examined before and after inclusion of expression for each alcohol\u2010related imprinted gene, using hierarchical mixed regression models with repeated measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Heavy drinkers averaged 8 standard drinks on 2 to 3\u00a0days\/wk (vs. 0 for controls). Prenatal alcohol exposure was associated with smaller length\/height and weight during the postnatal period. Heavy exposure was related to alterations in expression of 11 of 93 expressed imprinted genes, including increased expression of 5 genes found to be negatively associated with growth and decreased expression of 3 genes positively associated with growth. Alcohol\u2010related alterations in expression of 5 genes statistically mediated the effect of prenatal alcohol exposure on length.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings identify alcohol\u2010related alterations in placental imprinted gene expression as potential biomarkers of adverse effect in <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content> and suggest that these alterations may play a mechanistic role in fetal alcohol growth restriction. Future studies are needed to determine whether alterations in imprinted gene expression also mediate <jats:styled-content style=\"fixed-case\">FASD<\/jats:styled-content> neurobehavioral deficits and whether such alterations are amenable to intervention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.13808","type":"journal-article","created":{"date-parts":[[2018,6,5]],"date-time":"2018-06-05T12:59:12Z","timestamp":1528203552000},"page":"1431-1443","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Alcohol\u2010Related Alterations in Placental Imprinted Gene Expression in Humans Mediate Effects of Prenatal Alcohol Exposure on Postnatal Growth"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1554-6914","authenticated-orcid":false,"given":"R. Colin","family":"Carter","sequence":"first","affiliation":[{"name":"Division of Pediatric Emergency Medicine and Institute for Human Nutrition Columbia University Medical Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Environmental Medicine and Public Health Icahn School of Medicine at Mount Sinai New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Environmental Medicine and Public Health Icahn School of Medicine at Mount Sinai New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Deyssenroth","sequence":"additional","affiliation":[{"name":"Department of Environmental Medicine and Public Health Icahn School of Medicine at Mount Sinai New York New 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M.","family":"Meintjes","sequence":"additional","affiliation":[{"name":"National Health Laboratory Service Groote Schuur Hospital Cape Town South Africa"},{"name":"the Departments of Human Biology and of Psychiatry and Mental Health University of Cape Town Faculty of Health Sciences Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph L.","family":"Jacobson","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Neurosciences Wayne State University School of Medicine Detroit Michigan"},{"name":"National Health Laboratory Service Groote Schuur Hospital Cape Town South Africa"},{"name":"the Departments of Human Biology and of Psychiatry and Mental Health University of Cape Town Faculty of Health Sciences Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9768-2671","authenticated-orcid":false,"given":"Sandra 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