Department of Physiology, Development and Neuroscience, Centre for Trophoblast Research, University of Cambridge, Cambridge, UK.
Curr Opin Clin Nutr Metab Care. 2013 May;16(3):298-309. doi: 10.1097/MCO.0b013e32835e3643.
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.
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.
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.
出生时的大小对于预期寿命至关重要，无论是体型较小还是较大的新生儿，其预期寿命都可能缩短。本综述检查了胎儿生长的激素和营养驱动因素，重点关注胎儿激素作为胎儿宫内营养信号的作用。
营养物质通过为组织积累提供底物来驱动宫内生长，而激素则调节胎儿氧化代谢和质量积累之间的营养物质分布。宫内生长的主要激素驱动因素是胰岛素、胰岛素样生长因子和甲状腺激素。这些激素与瘦素和皮质醇一起，控制细胞的营养物质摄取以及在调节组织生长过程中积累和分化之间的平衡。它们还通过胎盘间接作用，改变母体-胎儿的营养物质和氧气供应。通过对营养物质和氧气可用性的反应，胎儿激素根据胎儿的遗传潜力优化了胎儿的生存和生长，特别是在不利条件下。然而，个体组织的宫内生长变化可能会永久性地改变它们的功能。
在正常和有问题的妊娠中，宫内生长取决于多种激素和营养驱动因素，这些因素相互作用，产生特定的宫内发育模式，对健康具有潜在的终身影响。
