Abstract:Objective To investigate the risk factors of fetal macrosomia in gestational diabetes mellitus. Methods The clinical data of 275 gestational diabetes patients who admitted to Renji Hospital from October 2017 to July 2018 were collected. According to the delivery outcome, they were divided into two groups:macrosomia group (33 cases) and non- macrosomia group (242 cases). Single factor statistics and Logistic regression equation were used to predict the risk of gestational diabetes mellitus. Results There was no significant difference in age, height, education background, birth history, gestational age, OGTT 2h blood glucose between the macrosomia group and the non-macrosomia group (all P>0.05). The body weight before pregnancy, BMI before pregnancy, weight gain during pregnancy, fasting blood glucose of OGTT, blood glucose of OGTT 1h and HbA1c at 24-28 weeks of pregnancy in the macrosomia group were significantly higher than those in the non-macrosomia group (all P<0.05). The results of univariate statistics and multivariate logistic stepwise regression analysis showed that weight gain before pregnancy, weight gain during pregnancy, HbA1c at 24-28 weeks of gestation and blood glucose at OGTT 1 h were independent influencing factors of macrosomia (all P<0.01). Conclusion Weight before pregnancy, weight gain during pregnancy, glycosylated hemoglobin during 24-28 weeks of pregnancy and OGTT 1h blood glucose are the main influencing factors for the delivery of macrosomia in patients with gestational diabetes mellitus. The above factors should be taken into consideration in clinical decision-making, and corresponding prevention and control measures should be taken to reduce the incidence of macrosomia to reduce adverse pregnancy outcomes.