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Firstly, maternal obesity, overweight, and gestational weight gain in women aggravate many conditions such as PCOS (polycystic ovary syndrome) which associate with increased incidence of diseases falling under metabolic abnormalities including dyslipidaemia, hypertension, glucose intolerance, and also major reproductive complications including infertility, pregnancy complications, gestational diabetes mellitus (GDM), gestational hypertension, pre‐eclampsia, and delivery of a preterm or growth‐restricted baby (Osibogun et al. 2020).

Prior studies have found that women with increased pathogenesis of PCOS are more likely to have increased subclinical CVD markers and clinical outcomes of insulin resistance. This worsens the reproductive, metabolic, and psychological behaviour of women greatly including anxiety, depression, OCD (obsessive–compulsive disorder), and poor quality of life. PCOS and its strong link with infertility and obesity (~80%) could be managed by lifestyle management of proper nutritional intake and physical activity, which is always the advised first line of treatment. A small percentage (5–10%) of weight loss has led to improved PCOS conditions in women (Chella Krishnan et al. 2018).

Secondly, the pathology of the disruption of metabolic homeostasis between men and women is different due to differences in the normal adipose physiology. The location of the white adipose tissue could be under the skin as subcutaneous adipose tissue (SAT) or in the deep abdominal region as visceral adipose tissue (VAT). It is reported that VAT depots confers more cardiometabolic risk and are higher in adult men in comparison to premenopausal women who possess more SAT depots for the storage of fat (Chella Krishnan et al. 2018). On the other hand, increased risk of cardiometabolic syndrome in middle‐aged women above 50 years of age as compared to men has been attributed to the loss of this cardiometabolic protection in postmenopausal women (Chella Krishnan et al. 2018).

Another major and most common cardiometabolic deregulation diagnosed frequently in pregnant women is GDM which involves a degree of glucose intolerance. GDM affects 5–25% of all pregnant women worldwide and is the largest group of cardiometabolic disorders in pregnant women followed by a higher risk of developing hypertension, hypercholesterolemia, and cancers of nasopharynx, lung kidney, breast, and thyroid glands (Peng et al. 2019; Han et al. 2018) (Figure 2.8). Thus, the dysregulations in cardiometabolic factors are the most common pathway for potential interrelatedness between preterm birth and CVD. It is crucial for women to control overweight through lifestyle changes to prevent the incidence of cardiometabolic disorder and potential multiple comorbidities during pregnancy and beyond (Grieger et al. 2021).

Also, cardiometabolic syndrome in women linked with obesity is due to social problems and socio‐economic cultures in many underdeveloped and developing countries where there are security and safety issues that restrict the free movement, social interactions, and physical activity of children, particularly women leading to increased weight during childhood. All these varied reasons culminate in a nearly 15% higher rate of the risk of cardiometabolic disorders, mental and physical stress facilitated by obesity in women as compared to men.