关键词: 妊娠期糖尿病, 妊娠结局, 影响因素, 母婴安全

Abstract: Objective To explore the status and influencing factors of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus. Methods The pregnant women with gestational diabetes mellitus who established prenatal health records and gave birth in Hebei China Petroleum Central Hospital and Langfang Guang'an Hospital from June 2018 to November 2022 were taken as the subjects of the survey, and were followed up to the end of the delivery. The related data of pregnant women with adverse pregnancy outcomes and pregnant women with normal pregnancy outcomes were compared and analyzed, and multivariate logistic regression model was used to analyze the influencing factors of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus. Results A total of 2 027 pregnant women with gestational diabetes mellitus were included, including 86 cases of polyhydramnios, 94 cases of postpartum hemorrhage, 98 cases of premature rupture of membranes, 108 cases of premature delivery, 101 cases of macrosomia, 86 cases of neonatal hypoglycemia, 92 cases of low birth weight, and 86 cases of neonatal asphyxia. The incidence of adverse pregnancy outcomes was 37.05% （751/2 027）. Multivariate logistic regression analysis showed that the influencing factors of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus included age ≥ 35 years （OR=3.618）, inappropriate weight gain during pregnancy （OR=3.762）, family history of diabetes （OR=2.246）, adverse pregnancy and childbirth history （OR=2.807）, three OGTT blood glucose abnormalities （OR=3.662）, low serum level of glucagon like peptide 1 （GLP-1） （OR=2.408）, high level of monocyte chemoattractant protein-1 （MCP-1） （OR=1.489）, and high serum level of cathepsin S （Cat S） （OR=2.482）.Conclusions The incidence of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus is high. The influencing factors of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus include old age, inappropriate weight gain during pregnancy, family history of diabetes, adverse pregnancy and childbirth history, and three OGTT blood glucose abnormalities,et al. In order to reduce the risk of adverse pregnancy outcomes, targeted intervention and treatment should be carried out for pregnant women with gestational diabetes mellitus.

Key words: Gestational diabetes mellitus, Pregnancy outcome, Influencing factor, Mother and child safety