Potential Impact: Currently, nothing is known regarding the role of lipid metabolism in cardiac abnormalities in IBDW. This translational proposal will address an important knowledge gap regarding the potential role of abnormal lipid metabolism in the development of cardiac abnormalities in IBDW. These associations are a critical step towards understanding the mechanisms of cardiac morphologic and functional alterations in IBDW, in order to identify clinical prognostic markers for cardiac abnormalities in IBDW, develop targeted interventions for these cardiac deficits, and to decrease the future risk of cardiovascular disease and heart failure in IBDW. The potential impact of these findings could extend not only to women and children with pre-gestational diabetes, but to other children born to women with clinical complications including gestational diabetes, obesity, intrauterine growth retardation, and HIV.