Increased circulating ghrelin levels in foetuses with intrauterine growth restriction (IUGR) [32], increased maternal plasma ghrelin levels observed in pregnancy-induced hypertension (PIH) leading to IUGR [15] and higher umbilical cord ghrelin plasma concentrations in small-for-gestational-age (SGA) neonates [33] all suggest ghrelin acts as a "hunger signal", with a role in foetal and neonatal energy balance. This evidence concerns the gene GHRL and fetal growth restriction.