The Role of Fatty Acid-Binding Protein 4 in Pregnancy Complications and Fetal Health

Fatty acid-binding protein 4 (FABP4) is an adipokine involved in regulating lipid metabolism, glucose homeostasis, and inflammatory processes. Altered circulating FABP4 concentrations have been associated with insulin resistance, adipose tissue dysfunction, and endothelial abnormalities. Growing evidence suggests that FABP4 dysregulation may contribute to impaired maternal metabolic and vascular adaptation during pregnancy, although the underlying mechanisms remain incompletely understood. FABP4 has been implicated in the pathophysiology of several pregnancy-related conditions, including maternal obesity, gestational diabetes mellitus, hypertensive disorders of pregnancy, preeclampsia, and recurrent pregnancy loss. Circulating FABP4 has also emerged as a potential biomarker for the early identification of women at increased risk of pregnancy-related metabolic and vascular complications, potentially improving risk assessment and providing earlier preventive or therapeutic interventions. This review summarizes current evidence on the role of FABP4 during pregnancy and its potential involvement in the pathophysiology of pregnancy-related complications, with particular emphasis on its biological functions, diagnostic and prognostic potential, and emerging therapeutic implications. Further mechanistic and prospective clinical studies are needed to determine whether FABP4 is a clinically useful biomarker and to clarify its potential as a therapeutic target in the management of pregnancy-related complications.