Understanding the physiological regulation of fetal growth is important, as normal variations in size at birth relate to differences in neonatal and adult health. Although fetal growth directly reflects net placental transfer, little is known about how normal fetal growth relates to the transfer capabilities of the placental epithelium, the syncytiotrophoblast. The Na(+)-dependent and Na(+)-independent uptakes of methylaminoisobutyric acid (MeAIB) by vesicles prepared from the syncytiotrophoblast microvillous plasma membrane give measurements of system A neutral amino acid transporter activity and diffusive permeability, respectively. In 62 normal pregnancies, we related vesicle MeAIB uptakes to neonatal anthropometry. Smaller babies with a lower abdominal circumference had higher placental system A activity per mg membrane protein (P = 0.004); activity rose from 0.020 to 0.043 nmol/30 sec/mg protein as abdominal circumference fell from 34.6 cm or more to 32.0 cm or less. Within the normal range of fetal and placental size, this may reflect a tendency toward compensatory up-regulation of the placental system A transporter in smaller babies. Babies with a lower abdominal circumference also had higher Na(+)-independent MeAIB uptakes (P = 0.0005); this could reflect important compositional changes in the microvillous plasma membrane, leading in vivo to increased back-diffusion of amino acids out of the syncytiotrophoblast.