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Regulation of fetal growth by the somatotrophic axis
Peter D Gluckman1, Catherine S Pinal
1The Liggins Institute, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. pd.gluckman@auckland.ac.nz
Insights
Suboptimal fetal growth increases risks for fetal, neonatal, and later-life diseases. This review explores how fetal growth reflects genetic, maternal, and early developmental factors.
Area of Science:
- Reproductive biology
- Developmental biology
- Perinatal medicine
Background:
- Suboptimal fetal growth is linked to increased fetal mortality and neonatal complications.
- Altered birth size, indicative of abnormal fetal environment, predicts childhood and adult disease risk.
- Fetal growth is a complex outcome of fetal genetics and the maternal-placental environment.
Purpose of the Study:
- To review the role of endocrine and metabolic factors in fetal growth.
- To examine the influence of the maternal-placental environment on fetal development.
- To discuss the impact of periconceptual and embryonic events on fetal growth.
Main Methods:
- Literature review focusing on endocrine and metabolic factors.
- Analysis of the interplay between fetal genome and maternal environment.
- Examination of evidence linking early life events to fetal growth outcomes.
Main Results:
- Endocrine and metabolic factors play a crucial role in mediating fetal growth.
- Maternal-placental function significantly determines the in utero environment.
- Periconceptual and embryonic periods critically influence fetal growth trajectories.
Conclusions:
- Fetal growth is a sensitive indicator of early life health.
- Understanding fetal growth determinants is key to preventing long-term disease.
- Interdisciplinary approaches are needed to fully elucidate fetal growth regulation.
Abstract:
Suboptimal fetal growth is associated with higher fetal mortality and with higher neonatal morbidity and mortality. It increases the likelihood of premature birth that in turn further compounds perinatal health risks. Moreover, an abnormal fetal environment, as reflected in an altered birth size phenotype, increases the propensity for disease in childhood and adulthood. Fetal growth represents the culmination of interaction between the fetal genome and the in utero environment determined by maternal-placental function. The role of endocrine and metabolic factors in mediating this interaction will be reviewed. There is also evidence that fetal growth, as measured in late gestation, is dependent not only on the maternal environment but on events that occurred during the periconceptual period. Thus, fetal growth not only reflects the immediate fetal environment but events surrounding conception and embryonic life.