The results of pre- vious reports from the HAPO Study have shown significant independent associa- tions of higher maternal glucose concen- trations (4,6) and maternal obesity (5) with adverse pregnancy outcomes. This study adds to the previous reports by ex- amining the impact of GDM and obesity aloneaswellastheircombinedimpacton adversepregnancyoutcomes.Thecombi- nationofthesefactorsshowsagreaterrisk of adverse pregnancy outcomes than ei- ther GDM or obesity alone.