There are also notable gains in knowledge of the consequences of maternal obesity on risks of complications and adverse outcomes. Obese pregnant women (pre-pregnant BMI 30 kg/m2) have a 4-fold higher risk of developing gestational diabetes mellitus and double the risk of developing preeclampsia compared with normalweight women. During labor and delivery, maternal obesity is associated with maternal death, hemorrhage, caesarean section or infection. There is a clear excess risk of macrosomic babies, birth asphyxia or trauma and newborn mortality. In addition, there may excess risks of subsequent child