The higher leptin levels in an obese pregnancy may contribute to some of the well-known maternal adverse health outcomes: leptin is known to contribute to obesity- related hypertension (70) and leptin concentrations are higher in women with preeclampsia compared with normotensive controls (71, 72) and thus may mediate some of the relationship between higher maternal BMI and preeclampsia risk. This evidence concerns the gene LEP and hypertensive disorder.