Nutritional and hormonal milieu in utero affect fetal growth. Both parties involved have an independent chance, for the occurrence of a developmental error at any stage of their constant developing system. Studies suggest that pregnancy outcome is associated with fetal demand for nutrients and the materno-placental capacity to meet that demand. Failure of the materno-placental supply line to satisfy fetal nutrient requirements results in a range of fetal adaptations and developmental changes, and may lead to permanent alterations in the body's structure and metabolism, and thereby to cardiovascular and metabolic disease in adult life. Changes in the in-utero homeostasis may lead to programming of endocrine and metabolic systems so that feedback systems and reactions are permanently changed. At the present stage, short- and long-term hazards of intra-uterine growth retardation (IUGR) have been identified, but preventive strategies are still lacking. It is unlikely that a single factor will reduce a multi-causal outcome like IUGR. Appropriate population-specific interventions should be a priority.