Seghieri G, Di Cianni G, Seghieri M, et al. - In this population cohort study, researchers assessed the risk of gestational diabetes (GDM) and of neonatal/maternal complications (macrosomia, large for gestational age (LGA), cesarean sections, preterm deliveries, neonatal distress and fetal malformations) among women coming from High Migration Pressure Countries (HMPC), compared with native (Italian) mothers. GDM risks and associated neonatal/maternal complications were assessed in a cohort of 581,073 Italian compared with 105,111 HMPC women aged 15-45 years, living in Tuscany, Italy during 2012-2017, delivering 122,652 singleton live births (18,596 from HMPC mothers). GDM was correlated with increased risk of preterm delivery and cesarean sections, whereas migrants, independent of GDM, were burdened with a higher risk of all the complications considered. HMPC women were at higher risk for GDM and all considered adverse events compared with Italian mothers. The addiction in the predictive model to the interaction term GDM x HMPC ethnicity, however, reversed the increasing probability of all adverse outcomes associated with HMPC.