The role of insulin-like growth factor-I and insulin-like growth factor-binding protein-1 in the control of human fetal growth

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Abstract
Introduction The size of the human infant at birth depends on the duration of gestation and the rate of fetal growth. Growth, and thus delivered weight, are determined by several factors: genetic constitution, nutritional status and pathological conditions (e.g. maternal diabetes, pre-eclampsia or eclampsia, smoking, infections etc.). However, despite extensive investigation, it has been difficult to identify any specific endocrine mechanism which plays an essential role in fetal growth (Chard, 1989). Recent attention has therefore focused on the autocrine and paracrine actions of growth factors, especially the insulin-like growth factors (IGFs) and their binding proteins (IGFBPs). Here, we review evidence for the role of the IGFs and IGFBPs in the control of fetal growth, and present a hypothesis that secretion of these compounds by the maternal decidua may play an important part in the control of the growth process. Structure and function of IGFs and IGFBPs

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