Abstract
Human fetal growth is not uniform. Tissue patterns and organ primordia are established during embryogenesis, then from the end of the first trimester and throughout the second the fetus undergoes massive hyperplasia. In the third trimester further organ modelling and functional maturation occur in preparation for extrauterine life. Each aspect ofdevelopment requires orchestrated intercellular signalling at two levels. The release of peptide growth factors and the modulation of an extracellular matrix are paracrine actions that occur within cell populations and between adjacent germ layers. In contrast, endocrine hormones may stimulate growth nonspecifically or promote specific maturational events. The interactions between paracrinology, endocrinology, and environmental constraints to growth during normal and abnormal fetal development have been reviewed in detail recently.1 2 In this commentary emphasis has been placed on new concepts of embryonic and fetal growth control.
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