Search Results (438)

Background/Objectives: Pregnancy is associated with increased procoagulant conditions, and when combined with obesity, it can elevate the risk of thrombosis. The study aims to assess thrombosis risk markers during pregnancy in relation to obesity. Methods: Somatically healthy women aged 18–42 years with spontaneous pregnancies who did not receive specific antithrombotic treatment were enrolled in the study (n = 97). The participants were divided into groups based on pregestational BMI: the first group consisted of patients who had a BMI ≤ 25 (n = 42), and the second group consisted of patients who were overweight (BMI > 25) and obese (BMI > 30) (n = 55). The control group comprised healthy, non-pregnant, non-obese women (n = 10). Results: Fibrinogen levels, elevated during pregnancy, were higher in the II and III trimesters, with gestational period having a greater influence than BMI. Moderate D-dimer accumulation was observed regardless of obesity, but higher levels were seen in obese women during the III trimester, indicating the dissolution of intravascular fibrin deposits. Soluble fibrin was significantly higher in obese and overweight women during the II trimester and elevated in both groups during the III trimester, correlating with D-dimer accumulation and indicating thrombus formation. A decrease in platelet aggregation ability was observed correlating with D-dimer and soluble fibrin patterns. Conclusions: A significant accumulation of thrombosis risk markers was observed in the III trimester compared to the II, occurring earlier in obese and overweight pregnant women and indicating a higher risk of thrombotic complications in obesity. Full article

Objectives: The objectives are to evaluate the influence of different maternal characteristics on ultrasound image quality and operator satisfaction, and to assess, preliminarily, a rating scale to stratify the difficulty level of ultrasound examination in early gestation. Methods: A multicentric observational study of ultrasound scans was carried out on singleton pregnant women undergoing routine gestational ultrasound at 11–14 weeks and 19–21 weeks of gestation at two Prenatal Care Centers in the Apulia region (Southern Italy). Inclusion criteria included the presence of one or more limiting features, i.e., obesity, retroverted uterus, myomas, previous abdominal surgery, and limited echo-absorption. Each woman was given an overall pre-echographic limiting score from 0 to 9. The outcome measure was the operator’s satisfaction with the examination, scored on a Likert scale. Nested linear regression models (raw, semi- and fully adjusted) were built for each of the two trimesters on the pre-ecographic limiting score (0–9 points) as dependent variables, with the operator’s satisfaction as the regressor. Results: The whole sample included 445 pregnant women. The two-center samples did not show statistically different baseline features. The operator’s satisfaction with the sonographic examination was significantly (and inversely) related to the pre-echographic limiting score, regardless of the mother’s age, the operator performing the ultrasound, the Hospital Center where the ultrasound examination was performed, and the duration of the sonographic examination. Conclusions: A number of maternal conditions need to be monitored for good ultrasound performance; using a specific rating scale to stratify the level of difficulty of the ultrasound examination at early gestation could represent a potentially useful tool, although it requires further validation. Full article

Obesity affects approximately 30% of pregnancies worldwide and is one of the leading metabolic disorders among pregnant women. Maternal obesity is often associated with placental dysfunction and structural alterations, which increase the risk of developing complications. Efflux transporters, including P-glycoprotein (P-gp), may impact placental function and fetal development. Consequently, our research examined the effects of obesity on P-glycoprotein expression in both a rat model and human placental tissue. P-gp expression was measured by RT-PCR and Western blot techniques in human and rat placental tissues. Moreover, we further characterized the high-fat and high-sugar diet (HFHSD)-induced gestational obesity rat model by measuring tissue weights. Significant decreases were observed in fetal, placental, and uterus weights in the obese animals near the end of pregnancy. In obese rats, mRNA and protein expression of placental P-gp showed a reduction on gestation days 15, 20, and 22. A similar P-gp reduction was observed in the term placenta in obese women in mRNA and protein levels. We hypothesize that the reduced expression of P-gp may heighten the susceptibility of both the fetus and placenta to P-gp substrates. This alteration could potentially result in an increased risk of pregnancy complications and obesity-related drug contraindications linked to P-gp transport during pregnancy. Full article

Background/Objectives: Pregnancy has been considered a risk factor for severe SARS-CoV-2 infection, as well as for adverse maternal and neonatal outcomes. This study aimed to assess the clinical impact of COVID-19 on pregnant women managed at a Spanish tertiary care hospital across different phases of the pandemic. Methods: A retrospective observational study was conducted at Dr. Balmis General University Hospital (Alicante, Spain) between March 2020 and May 2023. All pregnant women who received hospital care with confirmed SARS-CoV-2 infection were included. Maternal and neonatal outcomes were analyzed and compared with the 6120 total births recorded during the same period. Results: A total of 249 pregnant women with COVID-19 were included, with 30.8%, 25.0%, and 7.9% hospitalized during each respective pandemic phase. The overall incidence of infection was 41 cases per 1000 births. Hospitalized pregnant women showed significantly higher rates of preterm birth, labor induction (70.4% vs. 47.0%; OR: 2.67; 95% CI: 1.12–6.43), and cesarean delivery (46.9% vs. 24.9%, OR: 2.60; 95% CI: 1.27–5.50). Neonatal outcomes included lower Apgar scores, increased admission to the neonatal unit (25.8% vs. 8.2%, p = 0.007), and a higher rate of neonatal complications (23.3% vs. 7.7%, p = 0.015). Maternal obesity and non-Spanish nationality were associated with more severe maternal disease. Vaccination against SARS-CoV-2 significantly reduced the risk of hospitalization due to the infection (OR: 0.30; 95% CI: 0.13–0.69). Conclusions: Pregnant women admitted with COVID-19 had increased risks of adverse obstetric and neonatal outcomes, underscoring the importance of preventive strategies, such as vaccination. Full article

Gestational diabetes mellitus (GDM) occurs in approximately 9–25% of pregnancies and, if left undiagnosed or inadequately controlled, can lead to adverse outcomes for both the mother and the fetus, short and long term. GDM is characterized by glucose intolerance with onset or first recognition during pregnancy and is a multifactorial condition with a pathophysiology that remains incompletely understood. It is strongly associated with a chronic low-grade inflammatory state that contributes to insulin resistance, a hallmark of GDM pathogenesis. Among the fundamental pro-inflammatory cytokines implicated in this process, TNF-α and IL-6 play central roles. TNF-α is a cytokine primarily secreted by activated macrophages, as well as by adipocytes in the context of obesity. Many studies have shown that its levels are elevated in pregnant women with GDM compared to normoglycemic pregnant individuals. IL-6 is another pro-inflammatory cytokine secreted by immune cells, adipose tissue, and the placenta. It is found in higher concentrations in the maternal circulation during pregnancies complicated by GDM. Both TNF-α and IL-6 act synergistically to perpetuate a pro-inflammatory intrauterine environment. Their combined effects exacerbate insulin resistance and may impair pancreatic β-cell compensation during pregnancy, facilitating the onset of GDM in genetically or metabolically susceptible individuals. Recent research has identified various maternal serum biomarkers, such as TNF-α and IL-6, that may hold promise for the early detection of GDM. The aim of our study is to evaluate whether TNF-α and IL-6 can be used as diagnostic tools for the early diagnosis of GDM, allowing for timely intervention and reducing the risk of associated maternal and fetal complications. Full article

Background and Objectives: Gestational diabetes mellitus (GDM) is a complex condition characterized by metabolic disorders of blood glucose that significantly impact the health of both mother and fetus. The objectives of this study were to assess the prevalence and risk factors for maternal and fetal–neonatal complications in women with GDM, comparing them to a control group (pregnant women without GDM) and pregnant women with type 1 diabetes mellitus (T1DM) or type 2 diabetes (T2DM). Materials and Methods: A retrospective observational study was conducted with 1418 pregnant women (279 with GDM, 74 with T1DM, 107 with T2DM, and 958 in the control group). The retrospective data included information on demographics, diagnostic test results, the medical history of pregnant women, treatments administered, identified complications, and other relevant variables for the study’s purpose. Results: Significant differences were found regarding maternal and neo-fetal complications between GDM and the control group in terms of abortion, pregnancy-induced hypertension, and increased fetal weight (macrosomia). Women with T1DM and T2DM showed a higher rate of abortion, premature birth, and an APGAR score of <7 at 5 min compared to those with GDM, and for T1DM, there was a higher rate of fetal mortality than in GDM cases. The primary risk factors for maternal complications included age OR = 1.03 (95% CI: 1.01–1.05, p = 0.002), obesity OR = 2.37 (95% CI: 1.42–3.94, p < 0.001), and chronic hypertension OR = 2.51 (95% CI: 1.26–5.01, p = 0.009). Age and obesity were also significant cofactors for maternal complications. Furthermore, the main significant risk factors for fetal–neonatal complications were obesity OR = 2.481 (95% CI:1.49–4.12, p < 0.001) and chronic hypertension OR = 2.813 (95% CI:1.44–5.49, p = 0.002), both independently and as cofactors. Conclusions: We found that obesity and chronic hypertension are risk factors for both maternal and fetal–neonatal complications. It is essential to prevent and adequately treat these two factors among pregnant women to avoid the onset of GDM. Additionally, screening for GDM is necessary to prevent maternal and fetal complications. Our results highlight the importance of specialized medical care and tailored management protocols in mitigating risks and ensuring positive outcomes for both mother and child during and after childbirth. Full article

Introduction: Migraines are a prevalent neurovascular disorder that affects more than a billion people worldwide. Even though both women and men are affected by this neurological disorder, migraines are primarily recognized as a women’s health disruption factor. Pregnancy leads to significant hormonal changes, including a rise in estrogen, progesterone, and endogeny opioid levels, and, therefore, it can affect the course of migraines. Women dealing with migraines often experience migraine symptom reduction during the course of pregnancy, but in the setting of increased maternal body mass index and obesity, this common pattern may be altered. Due to the complexity of the interplay between pregnancy, obesity, and migraines, all mediated by hormonal changes, the aim of our study is to try to unravel the impact of migraines and obesity on maternal health and pregnancy outcomes. Methods: This study included 350 subjects who have suffered at least one migraine attack three months preceding pregnancy, or at any point during the course of pregnancy. Initially, the study subjects were divided into two groups. The first group included women suffering from migraines before pregnancy, but not during the course of pregnancy, and the other group included all subjects who remained symptomatic during the course of pregnancy or had a first migraine attack during their pregnancy. Further comparisons were made based on the patients’ BMI values, and correlations were made between the obese and non-obese study subjects. Results: Higher parity (p = 0.005), obesity (p = 0.005), earlier age of migraine onset (p = 0.004), and gestational diabetes mellitus (p = 0.004) were statistically significant predictors for migraine symptom persistence during pregnancy. Obese pregnant women were more likely to experience migraine intensity and frequency persistence during pregnancy (p < 0.001 and p < 0.001, respectively). They sought magnesium treatment more often (p < 0.001), but this had a modest therapeutic effect compared to non-obese pregnant women (p < 0.001). A diagnosis of hypertensive disorder of pregnancy and gestational diabetes mellitus was also more frequently established in the group of obese pregnant women (p = 0.002 and p < 0.001, respectively). Conclusions: Pregnancy induces substantial physiological changes that can both alleviate and exacerbate migraine symptoms. Obesity is a modifiable risk factor that not only may increase the intensity and frequency of migraine symptoms, but may also compromise pregnancy course and outcome. The co-occurrence of migraines and obesity during pregnancy may amplify health risks for the mother and fetus, including heightened susceptibility to gestational diabetes mellitus. Future research should prioritize focusing on better understanding the causal relationships between pregnancy, migraines, and obesity and providing treatment strategies the home in on weight management and the control of migraine symptoms and associated comorbidities. Full article

Background: Maternal nutrition is one of the main determinants of healthy pregnancy outcomes. The aim of this study is to investigate maternal nutritional risks and their relationship with gestational weight gain (GWG) among Saudi women. Methods: This is a cross-sectional study conducted in the antenatal clinics of a university hospital. The FIGO Nutrition Checklist was used to investigate the nutritional habits of pregnant women attending their regular antenatal visits. The FIGO tool includes a brief food frequency questionnaire (FFQ) and total nutritional risk score (NRS). Data on other variables were collected, including participant demographics and obstetric history. Current weight and height were extracted from nursing notes of the current visit, and the pre-pregnancy weight was self-reported by participants. GWG was reported and participants were classified according to IOM Guidelines. All data were analyzed using SPSS (Version 30, release September 2024) and p < 0.05 was defined as statistically significant. Results: A total of 570 pregnant women participated in the study, of whom 96% had at least one nutritional risk. More than 90% of participants reported sufficient folic acid intake, normal hemoglobin level and adequate meat and poultry intake. Only 23.9% of participants had sufficient fish intake and 24.6% reported proper sun exposure. Additionally, 10% of participants scored poorly on the FFQ, while 30% were classified as high-risk based on NRS scale. Poor nutritional scores were not associated with any clinical or socioeconomical variables. According to IOM guidelines, 26.3% of the participants achieved adequate GWG, while 49.5% had inadequate GWG, and 24.2% exceeded recommended GWG. Inadequate GWG was most common among those with low pre-pregnancy BMI (60%), followed by overweight (43.2%) and obese (37%) women. Neither parity nor nutritional scores significantly influenced GWG. Conclusions: Although poor nutritional quality and high nutritional risk are relatively uncommon among Saudi women, the prevalence rates remain consistent across all sociodemographic groups. This suggests widespread, uniform patterns of suboptimal dietary habits within the community. While GWG was not affected by nutritional status or parity of the participants, nearly half of participants had inadequate GWG, particularly those with a low pre-pregnancy BMI. Full article

Background/Objectives: Obesity during pregnancy is strongly related to increased insulin resistance, and subsequent development of metabolic syndrome-like disorders, such as glucose intolerance, pre-eclampsia, as well as preterm birth, and cesarean delivery. Nutrition can influence the evolution of glycemic response and may help improve adverse pregnancy outcomes and long-term complications. The main objective of the Nutritional Intervention during Gestation and Offspring Health (NIGOHealth) randomized clinical trial (ClinicalTrials.gov Identifier: NCT02285764) was to investigate the potential effects of a low glycemic index/slow digesting (LGI/SD) carbohydrate product on maternal glycemia (glucose AUC at 27⁺⁰–28⁺⁶ weeks; maternal fasting blood glucose (MFBG) at 34⁺⁰–36⁺⁰ weeks), and neonatal body composition. Methods: Obese pregnant women were randomized: 230 in the intervention group (IG), who consumed two servings of an LGI/SD study product daily from 15 weeks of pregnancy until delivery, and 102 participants in the Standard of Care (SOC) group. Results: When analyzing baseline characteristics, significant differences were found in glucose metabolic parameters with higher values for IG than for the SOC group, compromising the group’s comparability. Despite this, a statistical analysis was conducted (intention-to-treat analysis/evaluable cohort): no differences were detected regarding maternal blood glucose AUC at 27⁺⁰–28⁺⁶ weeks, nor for MFBG at 34⁺⁰–36⁺⁰ weeks. Nonetheless, HbA1c (%) at 34⁺⁰–36⁺⁰ weeks was significantly lower in the IG vs. the SOC group (5.26 ± 0.03, 5.31 ± 0.04, p = 0.007) after adjusting for baseline conditions. Conclusion: This result might suggest a potential effect of the intervention on Evaluable participants. However, it should be taken with caution, due to the limitations of the study. More RCTs should be carried out to explore the effects of LGI/SD products on glycemic response in obese pregnant women. Full article

Background/Objectives: Pre-conception health behaviors may influence the risk of gestational diabetes mellitus (GDM), but evidence on the joint effects of physical activity (PA) and dietary patterns remains limited. This study investigated the associations between pre-conception PA and GDM risk and explored their interaction with adherence to a Mediterranean diet (MD). Methods: This analysis used data from the BORN2020 cohort, which included pregnant women in Greece (2020–2022). Pre-conception PA was assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), expressed as the metabolic equivalent of task (MET)-min/week and categorized into quartiles. Adherence to the MD was assessed via the Trichopoulou score and then grouped into tertiles. Multivariable logistic regression models were computed, accounting for sociodemographic and clinical covariates, including sedentary time and post-lunch nap frequency. Results: In total, 524 women were included and 13.9% (n = 73) were diagnosed with GDM. Women who developed GDM were significantly older (mean age 34.41 vs. 31.98 years, p < 0.0001), were more likely to be >35 years old (46.6% vs. 26.6%, p < 0.001), had higher pre-pregnancy BMI (median 24.6 vs. 22.7 kg/m², p = 0.014), and were more likely to be obese (23.3% vs. 11.8%, p = 0.012). No significant association was observed between total pre-conception PA and GDM risk. Compared to the lowest PA quartile, women in the medium (aOR = 0.80, 95% CI: 0.45–1.40), high (aOR = 1.12, 95% CI: 0.52–2.39), and very high (aOR = 1.10, 95% CI: 0.50–2.38) PA quartiles showed no significant differences in GDM risk. PA, when modeled as a continuous variable, showed no significant trend (aOR = 0.99, 95% CI: 0.99–1.00; p-trend = 0.61). A joint analysis of PA and MD adherence also yielded no significant associations overall. However, in very small BMI-stratified subgroups, a low level of PA combined with very high MD adherence in normal-weight women was associated with increased GDM risk (aOR = 14.06, 95% CI: 1.55–165.54, p = 0.022), while in obese women, very high levels of PA and medium MD adherence showed a potentially protective effect (aOR = 0.006, 95% CI: 8.43 × 10⁻⁶–0.42, p = 0.048). These subgroup findings require cautious interpretation, due to the limited size of the sample set and wide confidence intervals. Conclusions: In this cohort, pre-conception PA, either alone or in combination with MD adherence, was not a reliable predictor of GDM. While our subgroup signals are hypothesis-generating, they do not yet support changes to clinical risk stratification. Future large-scale and interventional studies should investigate combined lifestyle interventions before conception to clarify the potential synergistic effects on GDM prevention. Full article

Background: An univocal definition for a lack of glucose peak during the oral glucose tolerance test in pregnancy (flat curve) has never been agreed upon. Thus, the aim of this study was to provide a definition for the flat 75 g oral glucose tolerance test (OGTT) and to assess its clinical significance. Methods: A retrospective cohort study, where 8.810 pregnant singleton women were evaluated at the time of a 75 g OGTT between 24⁰ and 28⁶ weeks for the universal screening of gestational diabetes (GDM). The 75 g OGTT was considered flat when the difference between peak and fasting glucose concentrations was ≤30 mg/dL. A total of 953 (10.8%) women were diagnosed as having GDM, while 7.857 (89.2%) had normal glucose tolerance (NGT); 2791 women with normal glucose tolerance (35.5%) had a FLAT curve and 5066 (64.5%) had a concentration difference > 30 mg/dL (NGT). In all groups, we evaluated maternal characteristics and perinatal outcome. Results: Women with a FLAT curve were younger, taller, thinner, and their pre-pregnancy body mass index was lower than the other groups (all p < 0.001). The rate of obesity was also lower (p < 0.01). The vaginal delivery rate was higher than in NGT (80.4% vs. 77.8%; p < 0.01) and women with GDM (73.0%; p < 0.001) and that of primary cesarean lower than in NGT (11.9% vs. 14.8%; p < 0.001) and women with GDM (18.2%; p < 0.001). Between women with a FLAT and NGT OGTT curve, there was no significant difference for birthweight < 10th percentile (6.9% vs. 6.2%; p = 0.2), though the proportion of birthweight > 90th was lower (8% vs. 10%; p < 0.01). Conclusions: A 75 g flat OGTT as defined does not represent an abnormal maternal phenotype nor portend an adverse perinatal outcome. Full article

Background/Objectives: Maternal free fatty acids (FFAs) play a critical role in maternal metabolism, fetal growth, and pregnancy outcomes. However, their relationship with maternal metabolic status in early pregnancy and the subsequent development of gestational diabetes mellitus (GDM) remains unclear. Aim: Assess the trajectory of FFA concentrations during pregnancy, considering first-trimester metabolic status (obesity, insulin resistance—IR) and the development of GDM, and evaluate whether first-trimester FFA is a relevant risk factor for GDM. Methods: A case–control study nested within the OBESO cohort (Mexico City, pregnant women and their children), classified women according to first-trimester metabolic status (pregestational body mass index—pBMI, insulin resistance homeostasis model assessment—HOMA-IR > 1.6), as well as the presence of GDM: Group 1 (normal weight without IR, n = 60), Group 2 (obesity without IR, no GDM, n = 20), Group 3 (obesity with IR, no GDM, n = 20), and Group 4 (obesity with IR, with GDM, n = 9). FFA concentrations were measured each trimester. Statistical analyses included repeated measures ANOVA and logistic regression models. Results: FFA concentrations were the highest in Group 4 across all trimesters (p < 0.05). FFAs decreased throughout pregnancy in all groups (p = 0.023), with the most significant decline from the first to the third trimester (p < 0.001). The greatest reduction occurred in Group 4 (p < 0.001), followed by Group 3. Multivariate logistic regression showed no association between first-trimester FFAs and the development of GDM. Higher gestational weight gain was associated with a higher GDM risk (OR: 1.22, 95%CI: 1.01–1.48), when the FFAs difference was accounted for. Conclusions: FFA levels are higher in women with GDM compared with women with obesity or a normal weight. However, FFAs progressively decline from the first to the third trimester, with the most pronounced decrease in women with obesity, IR, and GDM. Full article

Background/Objectives: Gestational weight gain (GWG) is a critical determinant of pregnancy outcomes; however, studies on factors contributing to suboptimal GWG in developing countries, including Malaysia, remain limited. Methods: This study employed an explanatory sequential mixed-methods design, with the quantitative phase conducted between January and March 2020, followed by the qualitative phase from July 2020 to March 2021 in Selangor. The qualitative phase aimed to explain the factors influencing suboptimal (inadequate and excessive) GWG identified in the quantitative phase. Inclusion criteria included Malaysian women aged 18 and above who had suboptimal GWG (either inadequate or excessive) from the quantitative phase. Exclusion criteria included women who refused participation. Of the 475 participants from the quantitative phase, 20 with suboptimal GWG were purposively selected for in-depth telephone interviews using a semi-structured interview protocol. Data were analysed using thematic analysis. Results: Three key themes emerged: (1) the impact of pre-pregnancy overweight and obesity, shaped by unhealthy lifestyles, social influences, and limited access to nutritious food and physical activity; (2) the management of diabetes during pregnancy, contributing to inadequate GWG due to psychological responses, restrictive behaviours, and barriers to dietary guidance; and (3) financial constraints in middle- and low-income households, leading to income vulnerability, financial crises, and food insecurity. Conclusions: This finding highlights the urgent need for targeted interventions to optimize GWG, emphasizing pre-pregnancy health optimization, enhanced diabetes management, and strategies to mitigate financial constraints and food insecurity among pregnant women. Full article

Objective: Dinoprostone vaginal inserts are widely used as one of the primary pharmacological methods for labor induction. In this study, we aimed to investigate whether BMI affects the duration of the different phases of labor in pregnant women undergoing vaginal delivery induced with slow-release dinoprostone. Methods: A prospective study was conducted on pregnant women at a tertiary maternity hospital between August 2021 and February 2023. Patients were categorized into three groups according to BMI: normal-weight, overweight, and obese. The duration of total labor and each phase of induced labor was recorded. Multivariate analysis was used to determine the association between maternal obesity and the duration of each phase of the labor process. Results: The final analysis included 205 women who received slow-release dinoprostone for labor induction. The mean maternal age was significantly lower in the normal-weight group (p < 0.01). The obese group showed a higher need for oxytocin augmentation and had a higher median infant birth weight compared to the normal and overweight groups. After adjusting for confounders, multivariate linear regression analysis showed that the duration of the latent phase of labor did not differ between the groups. However, the duration of the active phase of labor and total induced labor were significantly longer in the obese group. Conclusions: An increased BMI in pregnant women is associated with a longer active phase and overall labor duration during dinoprostone-induced delivery. Full article

Background: Preeclampsia is a leading cause of maternal and fetal morbidity and mortality, with obesity recognised as a significant risk factor. However, the direct contribution of obesity to the pathophysiology underpinning preeclampsia remains unclear. Objectives: This study aimed to develop and characterise a diet-induced obese mouse model with superimposed preeclampsia to better understand the impact of obesity on disease pathogenesis. Methods: Female mice were fed either standard rodent chow or a high-fat diet from weaning. At 8 weeks of age, mice were mated. Pregnant mice were treated with L-N^G-Nitro arginine methyl ester (L-NAME; to block nitric oxide production) from gestational day (D)7.5 to D17.5 to induce a preeclampsia-like phenotype. Blood pressure was measured on D14.5 and D17.5, followed by the collection of maternal and fetal tissues for histological, biochemical, and molecular analyses. Results: Obese dams exhibited significantly increased body, fat pad, and liver weights compared to lean controls. While L-NAME induced hypertension in the control mice, contrary to expectations, the L-NAME-induced hypertension was partially attenuated in obese dams, with significantly lower systolic and diastolic blood pressures at D14.5 and reduced systolic pressure at D17.5. Fetal weights were comparable between groups, however, placentas were significantly heavier with obesity. Endothelial function, inflammatory markers, and renal gene expression patterns suggested distinct physiological adaptations in obese preeclamptic-like mice. Conclusions: These findings challenge the prevailing assumption that obesity drives hypertension, endothelial dysfunction, and inflammatory markers. The differential vascular and physiological responses observed in the obese dams highlight the complexity of obesity–preeclampsia interactions and underscore the need for refined preclinical models to disentangle mechanistic contributions. This work has implications for personalised management strategies and targeted therapeutic interventions in obese pregnancies at risk of preeclampsia. Full article