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The risk of complications during pregnancy, such as gestational diabetes mellitus (GDM) and preeclampsia (PE), among PCOS patients is higher than that in the general population. Kisspeptin (KP) is a peptide hormone widely expressed in the hypothalamus, limbic system, gonads, pancreas, and liver; it is highly expressed in the placenta and is considered to play an important role in pregnancy. Therefore, the aim of this review is to summarize the complex relationships among KP levels and pregnancy complications in PCOS and to provide a comprehensive understanding of the role of KP throughout pregnancy in PCOS patients. In our summary of the existing research, we provide information regarding the direct impact of high prepregnancy KP levels in PCOS patients on early embryo implantation and placental development, leading to abnormal KP levels during pregnancy and ultimately increasing the risk of complications such as gestational GDM and PE.<\/jats:p>","DOI":"10.1111\/obr.70008","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T05:00:36Z","timestamp":1754629236000},"page":"1-21","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Exploring the Role of Kisspeptin in Polycystic Ovary Syndrome and Its Associated Pregnancy Complications"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6590-0661","authenticated-orcid":false,"given":"Shaohua","family":"Zhang","sequence":"first","affiliation":[{"name":"Shanghai Key Lab of Reproduction and Development, Shanghai Key Lab of Female Reproductive Endocrine Related Diseases Obstetrics &amp; Gynecology Hospital of Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinmeng","family":"Sun","sequence":"additional","affiliation":[{"name":"Shanghai Key Lab of Reproduction and Development, Shanghai Key Lab of Female Reproductive Endocrine Related Diseases Obstetrics &amp; Gynecology Hospital of Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyun","family":"Guan","sequence":"additional","affiliation":[{"name":"Shanghai Key Lab of Reproduction and Development, Shanghai Key Lab of Female Reproductive Endocrine Related Diseases Obstetrics &amp; Gynecology Hospital of Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongmin","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai Key Lab of Reproduction and Development, Shanghai Key Lab of Female Reproductive Endocrine Related Diseases Obstetrics &amp; Gynecology Hospital of Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Reproductive Endocrinology Obstetrics and Gynaecology Hospital of Fudan University and Shanghai Key Laboratory of Female Reproductive Endocrine Related Disease  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hexia","family":"Xia","sequence":"additional","affiliation":[{"name":"Shanghai Key Lab of Reproduction and Development, Shanghai Key Lab of Female Reproductive Endocrine Related Diseases Obstetrics &amp; Gynecology Hospital of Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1514916"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.12.013"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2017.1290074"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jch.12957"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/35079135"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100897.2011.01073.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23126611"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab617"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.942664"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnac001"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh098"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad463"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dep399"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deac091"},{"key":"e_1_2_8_16_1","first-page":"217","article-title":"Phenotype and Genotype in Polycystic Ovary Syndrome","volume":"53","author":"Legro R. 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