Andraweera PH, et al. - This study draws on data from the SCreening fOr Pregnancy Endpoints (SCOPE) study to examine the impact of birth weight on the risk of pregnancy complications [ie, preeclampsia (PE), gestational hypertension (GH), small for gestational age (SGA) pregnancy, spontaneous preterm birth, and gestational diabetes mellitus (GDM)] and to evaluate the influence of early pregnancy BMI on the this relationship. Study participants included 5,336 nulliparous women. According to findings, women born with birth weight < 2,500 g and who subsequently developed overweight or were diagnosed with obesity had an increased risk of GH, PE, and GDM vs women who were born with birth weight ≥ 2,500 g and remained lean. They suggested that those who were born small may have received "programming" in response to unfavorable intrauterine conditions. The physiological demands of pregnancy might act as a “second hit,” leading to pregnancy complications in such women.