The Duchess of Cambridge's acute morning sickness will prevent her attending the opening ceremony and start of the Invictus Games.
Kate, who is expecting her second child following the birth of Prince George, was also forced to cancel an engagement in Oxford earlier this week.
Kensington Palace said in a short statement: "The Duchess of Cambridge will not attend the opening ceremony of the Invictus Games this evening or the athletics event tomorrow.
"The Duchess's attendance on the forthcoming visit to Malta will be kept under review and a decision taken closer to the time."
Kate is suffering from another bout of the illness hyperemesis gravidarum, which she experienced during the early stages of her first pregnancy.
Prince Harry at a pre-games drivng challenge in WarwickshireHer current pregnancy has not passed the 12-week stage and there is speculation her second child could be due in April next year.
Hyperemesis gravidarum, which affects 3.5 per 1,000 pregnancies, causes severe vomiting and can lead to dehydration, weight loss and a build-up of toxins in the blood or urine, called ketosis.
It is thought Kate became unwell sometime last week.
When her husband Prince William visited Oxford University on Monday without her to open the new China Centre, he said she had experienced a "tricky few days".
The royal couple have meanwhile been offered some advice from former England football captain David Beckham - get more sleep before the next baby arrives.
Kate at a WW1 memorial ceremony in Belgium on August 4The father of four, who was a guest at their wedding, told ITV's Lorraine show: "Get some sleep because jumping from one child to two is a big step even though I thought jumping from two to three was bigger."
The Invictus Games, for injured servicemen and women, have been organised by Kate's brother-in-law Prince Harry.
She had been due to attend the opening ceremony at the Queen Elizabeth Olympic Park in east London later, along with Harry and William.
Prince Charles and the Duchess of Cornwall will also be present at the event, which will feature an exclusive performance of the official anthem penned by Coldplay's Chris Martin and a flypast by the Red Arrows.
More than 400 competitors - both serving military personnel and veterans - from 13 nations will go head to head in nine adaptive sports over four days, starting on Thursday.
The Duchess is due to make her first official solo overseas visit from September 20-21, touring Malta to mark the 50th anniversary of its independence.
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