Placental adaptations to perturbations that occur during pregnancy strongly influence maternal and offspring health and disease. While it is clear that the placenta successfully adapts to in utero challenges in some individuals, in others, these adaptations are insufficient. A range of factors including fetal sex and maternal age impact how successful the placenta is at adapting to environmental influences. Largely attributed to poor placental function, Gestational diabetes mellitus (GDM) is rapidly becoming the most common complication of pregnancy. GDM is characterised by dysregulated placental hormone secretion which alters maternal glucose homeostasis. There are a large number of risk factors for developing GDM including maternal stress which can disrupt the balance of hormones secreted by the placenta that are involved with mediating insulin resistance in pregnancy. Stress during pregnancy is similarly known to increase maternal risk of a range of other pregnancy disorders and can cause fetal growth restriction, impaired development of key organs and cardiovascular and metabolic disorders in offspring. This highlights that key placental adaptations mediate both maternal disorders of pregnancy and programmed disease risk. This presentation will discuss the impact of maternal perturbations on placental processes that increase maternal risk of developing GDM and offspring risk of programming chronic disease.