Abstract：Objective: To investigate the influencing factors that may lead to postpartum hemorrhage in patients with gestational diabetes mellitus, in order to ensure maternal and infant safety and to provide interventional guidance for promoting good pregnancy outcomes. Methods: The baseline data of 152 patients with gestational diabetes admitted to our hospital between January 2021 and December 2022 were retrospectively analysed. The patients were divided into a haemorrhage group (42 patients with bleeding ≥500 mL 24 h after delivery in natural delivery and ≥1000 mL within 24 h in caesarean section) and a non-haemorrhage group (110 patients) according to the presence or absence of postpartum haemorrhage. The baseline data of the two groups were compared to explore the factors that may have contributed to the patients' postpartum haemorrhage. Results: The 152 patients with gestational diabetes mellitus enrolled had 42 cases of postpartum haemorrhage (27.63% (42/152), with a mean postpartum haemorrhage volume of (920.38±40.56) mL, and they were included in the haemorrhage group, and 110 cases of postpartum haemorrhage did not occur (72.37% (110/152), with a mean postpartum haemorrhage volume of (280.25±20.45) mL, and they were included in the non-hemorrhage group; compared with the non-hemorrhage group, patients in the hemorrhage group had a higher proportion of pregnancy (≥3), combined gynaecological inflammation (yes), excess amniotic fluid (yes), combined pre-eclampsia (yes), low expression of serum FIB and AT-III, and high expression of HbA1c, all with statistically significant differences (P<0.05); the differences in age, pre-pregnancy body mass index, week of delivery, number of deliveries, mean systolic blood pressure, mean diastolic blood pressure, history of uterine surgery, history of induced abortion and history of spontaneous abortion between the two groups were not statistically significant (P>0.05); the results of logistic regression analysis showed that the number of pregnancies (≥3), combined gynaecological inflammation (yes), excess amniotic fluid (yes), combined pre-eclampsia (yes), serum FIB, AT-III and HbA1c expression were all influential factors in the development of postpartum haemorrhage in patients with gestational diabetes (OR > 1, P<0.05). Conclusion: Postpartum haemorrhage in patients with gestational diabetes is associated with the number of pregnancies, combined gynaecological inflammation, excess amniotic fluid, combined pre-eclampsia, serum FIB, AT-III and HbA1c expression. For the high-risk groups with ≥3 pregnancies, combined gynaecological inflammation, excess amniotic fluid, combined pre-eclampsia, low serum FIB, AT-III expression and high HbA1c expression, clinical interventions should be tailored to the specific conditions of the patients, with the aim of reducing the risk of postpartum haemorrhage in patients with gestational diabetes and ensuring maternal and infant safety.
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2023, Vol. 29 
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