**Core Concept**
Pregnant women with obesity are at increased risk of various complications due to insulin resistance, inflammation, and other metabolic changes associated with obesity. This can affect both the mother's and fetus's health, leading to a range of potential issues.

**Why the Correct Answer is Right**
Pregnant women with obesity are not at higher risk of infections compared to those with a normal body mass index (BMI). While obesity can impair immune function to some extent, the relationship between obesity and infections during pregnancy is not as clear-cut as it is with other complications. In fact, some studies suggest that obesity may even be protective against certain types of infections, possibly due to increased levels of certain cytokines.

**Why Each Wrong Option is Incorrect**
**Option A:** Fetal macrosomia is indeed a risk associated with obesity in pregnancy. Insulin resistance and increased glucose levels can lead to fetal macrosomia, which is a condition where the baby is significantly larger than average.

**Option B:** Fetal distress is also a potential complication of obesity in pregnancy. The increased metabolic demands and potential for placental insufficiency can lead to fetal distress, which can be life-threatening if not recognized and managed promptly.

**Option C:** Gestational hypertension is another condition that is more common in pregnant women with obesity. The increased blood pressure can put both the mother and fetus at risk, and may lead to other complications such as preeclampsia.

**Clinical Pearl / High-Yield Fact**
It's essential to recognize that obesity in pregnancy is a complex issue, and not all women with obesity will experience complications. However, being aware of the potential risks and taking steps to manage them can help improve outcomes for both mother and baby.

**Correct Answer:**
✓ Correct Answer: D. Infections