Higher cord blood PCSK9 concentrations are significantly associated with maternal overweight/obesity status, after adjustment for GA, birth weight, sex, and intrauterine growth restriction; this finding may warrant larger, prospective, longitudinal studies to examine the utility of PCSK9 as a biomarker of lipoprotein metabolic profile in high-risk neonates and its potential predictive role in later metabolic syndrome. Here, PCSK9 is linked to fetal growth restriction.