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Here, elevated levels of fatty acid binding protein 4 (FABP4) in the myometrium of obese pregnant women at term, high\u2010fat diet (HFD)\u2010induced obese mice, and palmitic acid\u2010treated uterine smooth muscle cells (USMCs), are demonstrated. FABP4 plays a critical role in transporting fatty acids from the extracellular to the intracellular compartment. Mechanistically, obesity promotes excessive fatty acid uptake, leading to aberrant lipid accumulation and reduced ATP production in USMCs. These abnormalities stem from weakened coupling of mitochondria\u2010associated membranes, which are essential for calcium, lipids, and metabolites exchange. Furthermore, adenoviral injection to elevate FABP4 levels in normal\u2010diet mice mimicks the effects observed in HFD mice. Collectively, these findings highlight FABP4 as a key driver of myometrial dysfunction in obesity and a potential therapeutic target for improving labor outcomes in obese pregnancies.<\/jats:p>","DOI":"10.1002\/advs.202501077","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T18:32:19Z","timestamp":1744050739000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["FABP4 as a Mediator of Lipid Metabolism and Pregnant Uterine Dysfunction in Obesity"],"prefix":"10.1002","volume":"12","author":[{"given":"Xuan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology The First Affiliated Hospital of Anhui Medical University  218 Jixi Rd Hefei Anhui Province 230022 China"},{"name":"NHC Key Laboratory of the Study of Abnormal Gametes and the Reproductive Tract Anhui Medical University  Hefei Anhui Province 230022 China"},{"name":"Anhui Province Key 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