Obesity is a major health problem worldwide. The prevalence of obesity is 
increasing in both developed and developing countries. In the UK, for example, 
60% of adults are overweight and 25% are obese. Obesity is associated with many 
pathological complications including respiratory, cardiovascular and endocrine, 
but it also affects fertility and is associated with many reproductive 
complications. This has led us and others to investigate links between women 
with high BMI, pregnancy outcome and uterine function. These studies in turn 
have led investigators to ask how obesity can have such an impact on 
reproduction and, as part of this, to consider the role of the adipokines 
released from adipose tissues. Our focus in this short review is on adipokines 
and myometrial activity, and for completeness we overview their effects on other 
smooth muscles. To date four adipokines (leptin, visfatin, apelin and ghrelin) 
have been investigated and all affect myometrial contractility, but some more 
potently than others. We consider the possible mechanisms involved in how 
adipokines may modify uterine contractility, and discuss the potential impact on 
labor and delivery.