Objective — to assess the role of gene polymorphisms of energy exchange to change the parameters of lipid metabolism and gas homeostasis of blood in pregnancies complicated by FGR. Material and methods. The study included 70 patients with spontaneous singleton pregnancy. All patients were divided into two groups: main group — 50 pregnant women in the gestation of 20—33 weeks with an established diagnosis of fetal growth retardation (FGR) II—III degree and a control group — 20 apparently healthy pregnant women. Results. A decrease in the content of low density lipoproteins (LDL), cholesterol and triglycerides in the mother’s blood in the main group of pregnant women with FGR was revealed. In the control group of uncomplicated pregnancies, a significant increase in the level of high-density lipoprotein (HDL) was found. When studying the blood gases of pregnant women in the main group, a significant decrease in the partial oxygen tension was revealed, as well as an increase in the level of lactate compared to the control group. A significant increase in the frequency of occurrence in the main group of genotypes containing the variant allele -87_T of the polymorphic DNA locus PPARD: -87C> T As well as the S482 A allele of the PPARGC 1A gene (p<0.05) was noted during the genetic study. Conclusion. Significant increase in the incidence of the genotype with the variant allele -87_T, the S482 A allele in the genes of energy metabolism PPARD: -87C> T, PPARGC 1A (p<0.05) results in the inability to maintain an adequate level of energy metabolism during pregnancy. Genetically determined reduction in LDL cholesterol, triglycerides in maternal blood lead to similar changes in the fetus, promoting its growth delay. Identified, in the study of the acid-base state and gas homeostasis of arterialized capillary blood of pregnant women, signs of tissue hypoxia in the main group lead to disruption of normal mechanisms of fetoplacental gas exchange, exacerbating the delay in fetal growth.