By Alexandra Alvergne, Crispin Jenkinson, Charlotte Faurie
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Extra resources for Evolutionary Thinking in Medicine: From Research to Policy and Practice
1] In the last half of pregnancy, there is an increased tissue resistance to the action of insulin; to compensate for this, the mother increases insulin production. According to the foetal–maternal conflict hypothesis, this is caused by foetal signalling using placental allocrine hormones including human placental lactogen (hPL) and human placental growth hormone among others, to guaranty its adequate glucose supply, whereas the increased production of insulin would be a maternal countermeasure .
Espinoza gestational age) and prematurity confers a higher risk of foetal  or neonatal death  among other adverse perinatal outcomes [68–73]. To the extent that preterm parturition is a survival strategy to exit an inadequate intrauterine environment, the safety of tocolysis (interventions to stop uterine contractions) in the growth-restricted premature foetus should be re-evaluated. 6 Gestational Diabetes David Haig in a very insightful article proposed that gestational diabetes mellitus (GDM), among other pregnancy complications, may also be the result of a foetal– maternal conflict .
Combining foetal and maternal characteristics may be more accurate [32, 90], but predictive power remains relatively low. Promising areas for investigation include identiﬁcation of large foetal head circumference by ultrasound in late pregnancy  and disproportionately large foetal mass relative to head circumference in macrosomic infants [4, 92], and predicting cephalopelvic disproportion risk from the ratio of parental head circumference to height [33, 93]. , cephalopelvic disproportion, shoulder dystocia or malpresentation of the foetus, which prevent its passage through the birth canal  Phenotype The physical characteristics of an individual, population or species.