Gicquel C, Le Bouc Y
Laboratoire d'Explorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris, France.
Horm Res. 2006;65 Suppl 3:28-33. doi: 10.1159/000091503. Epub 2006 Apr 10.
Fetal growth is a complex process depending on the genetics of the fetus, the availability of nutrients and oxygen to the fetus, maternal nutrition and various growth factors and hormones of maternal, fetal and placental origin. Hormones play a central role in regulating fetal growth and development. They act as maturational and nutritional signals in utero and control tissue development and differentiation according to the prevailing environmental conditions in the fetus. The insulin-like growth factor (IGF) system, and IGF-I and IGF-II in particular, plays a critical role in fetal and placental growth throughout gestation. Disruption of the IGF1, IGF2 or IGF1R gene retards fetal growth, whereas disruption of IGF2R or overexpression of IGF2 enhances fetal growth. IGF-I stimulates fetal growth when nutrients are available, thereby ensuring that fetal growth is appropriate for the nutrient supply. The production of IGF-I is particularly sensitive to undernutrition. IGF-II plays a key role in placental growth and nutrient transfer. Several key hormone genes involved in embryonic and fetal growth are imprinted. Disruption of this imprinting causes disorders involving growth defects, such as Beckwith-Wiedemann syndrome, which is associated with fetal overgrowth, or Silver-Russell syndrome, which is associated with intrauterine growth retardation. Optimal fetal growth is essential for perinatal survival and has long-term consequences extending into adulthood. Given the high incidence of intrauterine growth retardation and the high risk of metabolic and cardiovascular complications in later life, further clinical and basic research is needed to develop accurate early diagnosis of aberrant fetal growth and novel therapeutic strategies.
胎儿生长是一个复杂的过程，取决于胎儿的遗传学、胎儿获得营养和氧气的情况、母体营养以及母体、胎儿和胎盘来源的各种生长因子和激素。激素在调节胎儿生长发育中起核心作用。它们在子宫内充当成熟和营养信号，并根据胎儿当前的环境条件控制组织发育和分化。胰岛素样生长因子（IGF）系统，尤其是IGF-I和IGF-II，在整个妊娠期对胎儿和胎盘生长起着关键作用。IGF1、IGF2或IGF1R基因的破坏会阻碍胎儿生长，而IGF2R的破坏或IGF2的过表达会促进胎儿生长。当有营养物质时，IGF-I刺激胎儿生长，从而确保胎儿生长与营养供应相适应。IGF-I的产生对营养不足特别敏感。IGF-II在胎盘生长和营养物质转运中起关键作用。一些参与胚胎和胎儿生长的关键激素基因是印记基因。这种印记的破坏会导致涉及生长缺陷的疾病，如与胎儿过度生长相关的贝克威思-维德曼综合征，或与宫内生长迟缓相关的西尔弗-罗素综合征。最佳的胎儿生长对围产期存活至关重要，并会产生延伸至成年期的长期后果。鉴于宫内生长迟缓的高发病率以及成年后期发生代谢和心血管并发症的高风险，需要进一步开展临床和基础研究，以开发准确的胎儿生长异常早期诊断方法和新的治疗策略。
