The Intrauterine Growth Restriction Phenotype: Fetal Adaptations and Potential Implications for Later Life Insulin Resistance and Diabetes

Thorn, Stephanie; Rozance, Paul; Brown, Laura; Hay, William

doi:10.1055/s-0031-1275516

Cited by 153Birth, Development, and HealthPregnancy and preeclampsia studiesGestational Diabetes Research and Management

The Intrauterine Growth Restriction Phenotype: Fetal Adaptations and Potential Implications for Later Life Insulin Resistance and Diabetes

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Thorn, Stephanie, Rozance, Paul, Brown, Laura, Hay, William·2011·Seminars in Reproductive Medicine

DOI 10.1055/s-0031-1275516PMC PMC3216466

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Abstract

The intrauterine growth restricted (IUGR) fetus develops unique metabolic adaptations in response to exposure to reduced nutrient supply. These adaptations provide survival value for the fetus by enhancing the capacity of the fetus to take up and use nutrients, thereby reducing the need for nutrient supply. Each organ and tissue in the fetus adapts differently, with the brain showing the greatest capacity for maintaining nutrient supply and growth. Such adaptations, if persistent, also have the potential in later life to promote nutrient uptake and storage, which directly lead to complications of obesity, insulin resistance, reduced insulin production, and type 2 diabetes.

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Maternal undernutrition may lead to foetal growth restriction, characterised by reduced pancreatic growth, impaired insulin secretion, and hepatic insulin resistance.
“Maternal undernutrition may lead to foetal growth restriction (FGR), characterised by reduced pancreatic growth, impaired insulin secretion, and hepatic insulin resistance [28,29,30].”
From Medical Nutrition Therapy for Women with Gestational Diabetes: Current Practice and Future Perspectives (2025) · cites this paper as [29]
The fetal muscle-growth section describes maternal nutrient restriction in sheep models of IUGR, and the reduced pancreatic β-cell mass and insulin production section reports smaller pancreatic islets, reduced pancreas weight, and impaired insulin secretion in growth-restricted fetuses. The increased hepatic glucose production section says the IUGR fetal liver *may be developing* insulin resistance and calls for further studies of fetal hepatic insulin sensitivity. The claim presents hepatic insulin resistance as an established characteristic rather than a possibility. (LLM, conf=0.86)
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Leucine metabolism in chronically hypoglycemic hypoinsulinemic growth-restricted fetal sheep
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Induction of Cytosolic Phosphoenolpyruvate Carboxykinase in the Ovine Fetal Liver by Chronic Fetal Hypoglycemia and Hypoinsulinemia
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Authors: Thorn, S., Rozance, P., Brown, L., & Hay, W.
Affiliations: University of Colorado Anschutz (US)
ORCID: Rozance, Paul
Brown, Laura
Hay, William
Venue: Seminars in Reproductive Medicine
Publisher: Georg Thieme Verlag KG
Published: 2011-05
Volume: 29
Issue: 03
Pages: 225-236
ISSN: 1526-4564 (ISSN-L)
1526-8004
DOI: 10.1055/s-0031-1275516
PMC: PMC3216466
OpenAlex: W2059299661
Cited by: 153
References: 122
Citations by year: 2026: 9 · 2025: 11 · 2024: 10 · 2023: 4 · 2022: 12 · 2021: 10 · 2020: 16 · 2019: 17 · 2018: 8 · 2017: 7 · 2016: 13 · 2015: 14 · 2014: 7 · 2013: 9 · 2012: 5
FWCI: 6.52
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Seminars in Reproductive Medicine (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Diabetes and Digestive and Kidney Diseases (K01DK090199)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12HD057022, K08HD060688)
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
Keywords: fetal growth restriction, fetal brain, insulin resistance, type 2 diabetes, obesity, developmental origins of health and disease, fetal programming, insulin production
MeSH terms: Adaptation, Physiological, Adult, Animals, Diabetes Mellitus, Type 2, Female, Fetal Growth Retardation, Humans, Insulin Resistance, Male, Obesity, Pregnancy, Prenatal Exposure Delayed Effects, Fetal Development

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The Intrauterine Growth Restriction Phenotype: Fetal Adaptations and Potential Implications for Later Life Insulin Resistance and Diabetes

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