Despite the well-established association between GDM and future risk of T2DM (5,8), less is known about even more
common pregnancy complications and future risk of T2DM. For example, preterm birth and low birth weight
complicate more than 10% of US pregnancies (9,10). Macrosomia occurs in 1% to 10% of all pregnancies. Preterm birth
and low birth weight share common underlying risk factors with T2DM, including elevated pre-pregnancy and
pregnancy lipid concentrations (11,12) and inflammatory markers (13,14). These shared biological factors suggest that
preterm birth and low term birth weight may be early markers of subclinical risk of future development of T2DM. In
addition, giving birth to a macrosomic infant (10 pounds or more) could suggest an increased risk of future maternal
T2DM in the absence of GDM or could result from undiagnosed GDM. For example, T2DM could result from excess
glucose exposure and consequent high fetal growth from impaired glucose tolerance that falls short of GDM diagnostic
criteria (15). If such associations are found, women experiencing these complications could potentially benefit from
early intervention to reduce future T2DM risk.