Abstract： Objective To investigate the change of adipocyte fatty acid-binding protein(FABP4) in maternal serum and umbilical cord blood and FABP4 mRNA placental expression in patients with preeclampsia(PE). Methods A total of 60 women with PE and 60 normal pregnant women as control participated in this study. All are admitted to Fujian Maternity and Children Health Hospital for delivery from December 2008 to October 2009. Patients with PE were divided into early-onset group (n = 30, presented at ≤34 weeks of gestation) and late-onset group(n = 30, presented at > 34 weeks of gestation), with 30 normal pregnant women as early control group(≤34 weeks of gestation) and 30 as late control group(>34 weeks of gestation). Enzyme-linked immunosorbent assay (ELISA) was used to detect FABP4,fasting serum glucose,fasting insulin(FINS) in maternal serum and FABP4 in umbilical cord blood. Real-time fluorescent quantitative revere transcription PCR was used to detect placental FABP4 mRNA expression. Furthermore,clinical and biochemical parameters were recorded, such as body mass index(BMI), systolic pressure(SP),diastolic pressure (DP), mean arterial pressure (MAP), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), creatinine (Cr), uric acid (UA) , glomerular filtration rate (GFR), 24 hours urine protein in pregnant women and neonatal weight. Results (1) Maternal serum FABP4 was (176 ± 9) ng/L in early-onset PE group and (170 ± 9) ng/L in late-onset PE group, significantly elevated as compared to (81 ± 13) ng/L in early control group and (94 ± 15) ng/L in late control group. (2) Mean maternal FINS, homeostasis model of assessment for insulin resistence index (HOMA-IR) were significantly elevated in the early-onset PE group and late-onset PE group as compared to control groups, respectively. (3) Mean placental FABP4 mRNA expression were significantly elevated in the early-onset PE group and late-onset PE group as compared to late control group. However, no significant difference was found in placental FABP4 mRNA expression between early-onset and late-onset PE groups.(4) Mean umbilical cord blood FABP4 concentrations were significantly decreased in the early-onset PE group and late-onset PE group as compared to late control group. Furthermore, umbilical cord blood FABP4 concentration correlated negatively with maternal serum FABP4 level and placental FABP4 mRNA expression, but positively with neonatal weight. (5) Mean maternal serum FABP4 concentrations correlated positively with placental FABP4 mRNA expression,TG, FINS, HOMA-IR, Cr, UA; and negatively with HDL, GFR. Conclusions Increased FABP4 expression in maternal serum and placenta may be involved in the pathogenesis of preeclampsia. Increased FABP4 mRNA expression in placenta may contribute to high serum FABP4 level in women with PE.