Fatty acids (FAs) are one the most essential substances in intrauterine human growth. They are involved in a number of energetic and metabolic processes, including the growth of cell membranes, the retina and the nervous system. Fatty acid deficiency and disruptions in the maternal-placental fetal metabolism of FAs lead to malnutrition of the fetus, hypotrophy and preterm birth. What is more, metabolic diseases and cardiovascular conditions may appear later in life. Meeting a fetus' need for FAs is dependent on maternal diet and on the efficiency of the placenta in transporting FAs to fetal circulation. "Essential fatty acids" are among the most important FAs during the intrauterine growth period. These are α-linolenic acid, which is a precursor of the n-3 series, linoleic acid, which is a precursor of the n-6 series and their derivatives, represented by docosahexaenoic acid and arachidonic acid. The latest studies have shown that medium-chain fatty acids also play a significant role in maternal-fetal metabolism. These FAs have significant effect on the transformation of the precursors into DHA, which may contribute to a relatively stable supply of DHA - even in pregnant women whose diet is low in FAs. The review discusses the problem of fatty acid metabolism at the intersection between a pregnant woman and her child with reference to physiological pregnancy, giving birth to a healthy child, intrauterine growth restriction, preterm birth and giving birth to a small for gestational age child.