Abstract: Objective To investigate the influencing factors of ghrelin concentration in cord blood and assess the role of ghrelin in fetal growth. Methods Plasma ghrelin concentrations were measured in cord blood of 100 neonates. The relationship between ghrelin and gestational age, gender, delivery mode, birth weight, body length, head circumference and placental weight were analyzed. Results The concentration of plasma ghrelin in cord blood of all 100 neonates was 606.2 (488. 4-914. 4) pg/ml [median (P25-P65]. There was no statistical difference between male and female infants or between neonates underwent cesarean section and vaginal delivery(P>0. 05). Cord blood ghrelin levels were different in different gestational age and birth weight neonates (P < 0.05). Its concentrations were higher in term small for gestational age neonates [1211.7(668. 8-1690. 5) pg/ml] than in term average for gestational age newborns [750. 4(534. 2-1030. 0) pg/ml] and large for gestational age newborns [520. 6(439. 9-773.4) pg/ml] (P<0. 05). Gestational age and birth weight were significant determinants of ghrelin concentrations(β=0. 808,P=0. 000;β=-0. 469, P=0. 020). Conclusions Cord ghrelin concentrations increases with advancing gestational age, but are down-regulated by fetal weight. Ghrelin may play a physiological role in fetal adaptation to intrauterine nutritional environment.