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Perinatal growth phenotype is largely determined by genes, nutrient supply, placental transport function, environment, and growth hormones. Recently, gene mutation and expression have been reported to play an important role in perinatal growth and development. Perinatal growth epigenetics, a new concept in growth phenotype, has been accepted in fetal programming. This paper outlines the findings of perinatal phenotype in several studies and summarizes fetal growth restriction, birth defects, angiotensinogen gene mutation and pathological phenotypes of placenta, and the occurrence of other pregnancy complications. We review genetic approaches to IUGR, especially those related to growth factor genes, gene mutations and epigenetics with abnormal perinatal characterizations. We also discuss gene study directions, which should be valuable in elucidating mechanisms employed by the fetus and prevent the development of abnormal perinatal outcomes.