Abstract Objective: To assess the difference in the trajectories of soluble HLA-G in maternal sera during pregnancy between women delivering small for gestational age (SGA) and appropriate for gestational age (AGA) neonates. Design and Settings: Pilot case-control study nested within a cohort study - Garbh-Ini. Population: North-Indian pregnant females delivering SGA (N=23) or AGA (N=17) neonates. Method: Soluble HLA-G1/G5 was estimated in the maternal sera at different time points in pregnancy using sandwich ELISA. Linear mixed models were built and compared to study the association between sHLA-G levels during pregnancy and SGA births. Main Outcome Measure:Birth of SGA or AGA neonates. Results: No significant difference was observed in the sHLA-G trajectories during pregnancy in mothers delivering SGA as compared to those delivering AGA (p-value = 0.5677). A trend towards higher sHLA-G levels at the first trimester of pregnancy (<14weeks of gestation) was observed in mothers delivering SGA neonates (Median= 41.71, IQR= 21.31 to 71.38) as compared to those delivering AGA neonates (Median=37.58, IQR=19.05 to 73.57). Conclusion: The trajectory of sHLA-G during the course of pregnancy is not different between mothers delivering SGA and those delivering AGA. However, a trend towards higher sHLA-G levels at the first trimester was observed in mothers delivering SGA, which could be explored further in studies with larger sample sizes. Funding: “Department of Biotechnology, Ministry of Science and Technology, Government of India (BT/07/IYBA/2013-12), (grant BT/PR9983/MED/97/194/2013)” and “Grand Challenges India–All Children Thriving Program, Biotechnology Industry Research Assistance Council (grant BIRAC/GCI/0114/03/14-ACT)”. Keywords: India, SGA, pregnancy, sHLA-G