Metabolic Roles of Fatty Acid Binding Protein 4 (FABP4) in Fetal and Maternal Health and Maintenance of Pregnancy in Women with Obesity: A Review.

The global obesity epidemic has seen a dramatic rise, with maternal obesity increasing from 20.9% to a projected 23.3% by 2030. In pregnancy, metabolic dysregulation linked to obesity and gestational diabetes mellitus (GDM) elevates risks for both mother and child, contributing to complications such as macrosomia, fetal growth restriction (FGR), preterm labor, and higher cesarean rates. Central to these processes is fatty acid-binding protein 4 (FABP4), a key regulator of lipid metabolism, vascular inflammation, and insulin sensitivity. FABP4, primarily expressed in adipose tissue and macrophages, plays a pivotal role in placental lipid transport and intracellular fatty acid handling, with elevated serum levels correlating with higher body mass index (BMI) and inflammatory states in obese individuals. Emerging evidence highlights FABP4 as a potential biomarker for predicting metabolic complications, including GDM and pregnancy-induced hypertension, offering opportunities for early intervention. This review underscores the critical role of FABP4 in obesity-related pregnancy complications, emphasizing its potential as both a biomarker and therapeutic target. Advancing research into FABP4's mechanisms and therapeutic applications could significantly improve outcomes for pregnant women with obesity, fostering healthier pregnancies and reducing long-term metabolic risks for mother and child. This article reviews the metabolic roles of fatty acid binding protein 4 (FABP4) in fetal and maternal health and maintenance of pregnancy in women with obesity.