title: Hormonal and nutritional drivers of intrauterine growth.
abstract: OBJECTIVE
  Size at birth is critical in determining life expectancy with both small and large neonates at risk of shortened life spans. This review examines the hormonal and nutritional drivers of intrauterine growth with emphasis on the role of foetal hormones as nutritional signals in utero.
  
  
  RESULTS
  Nutrients drive intrauterine growth by providing substrate for tissue accretion, whereas hormones regulate nutrient distribution between foetal oxidative metabolism and mass accumulation. The main hormonal drivers of intrauterine growth are insulin, insulin-like growth factors and thyroid hormones. Together with leptin and cortisol, these hormones control cellular nutrient uptake and the balance between accretion and differentiation in regulating tissue growth. They also act indirectly via the placenta to alter the materno-foetal supply of nutrients and oxygen. By responding to nutrient and oxygen availability, foetal hormones optimize the survival and growth of the foetus with respect to its genetic potential, particularly during adverse conditions. However, changes in the intrauterine growth of individual tissues may alter their function permanently.
  
  
  CONCLUSIONS
  In both normal and compromised pregnancies, intrauterine growth is determined by multiple hormonal and nutritional drivers which interact to produce a specific pattern of intrauterine development with potential lifelong consequences for health.
authors: Department of Physiology, Development and Neuroscience, Centre for Trophoblast Research, University of Cambridge, Cambridge, UK. ans48@cam.ac.uk
authors: Amanda N
authors: AN
authors: Sferruzzi-Perri
authors: Owen R
authors: OR
authors: Vaughan
authors: Alison J
authors: AJ
authors: Forhead
authors: Abigail L
authors: AL
authors: Fowden
mesh_terms: D001682:Biological Availability; D005260:Female; D047109:Fetal Development; D005333:Fetus / Q000196:embryology / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000378:metabolism; D020738:Leptin / Q000378:metabolism; D039382:Maternal Nutritional Physiological Phenomena; D009752:Nutritional Status; D010100:Oxygen / Q000008:administration & dosage / Q000493:pharmacokinetics; D010920:Placenta / Q000196:embryology / Q000378:metabolism; D010929:Placentation; D011247:Pregnancy; D013002:Somatomedins / Q000378:metabolism; D013963:Thyroid Hormones / Q000378:metabolism*
chemical_list: D007328:Insulin; D020738:Leptin; D013002:Somatomedins; D013963:Thyroid Hormones; D010100:Oxygen