Objective:To investigate the factors affecting the delivery of macrosomic infants in pregnant women with gestational diabetes mellitus, and utilize data to construct a nomogram model and validate it.Methods:A total of 1 493 pregnant women with gestational diabetes mellitus who received treatment at Shaanxi Provincial People's Hospital from January 2023 to January 2024 were included in this study. A retrospective study was conducted to analyze the proportion of pregnant women with gestational diabetes mellitus who delivered macrosomic infants. The influential factors in pregnant women with gestational diabetes who delivered macrosomic infants were analyzed using both univariate and multivariate analyses. A predictive model for macrosomia in pregnant women with gestational diabetes mellitus was established, and its predictive efficiency was evaluated.Results:Among the 1 493 pregnant women with gestational diabetes mellitus included in this survey, 51 delivered macrosomic infants, accounting for 3.42%. Univariate analysis revealed that weight gain during pregnancy [(14.11 ± 3.25) kg vs. (10.62 ± 2.72) kg, t = 8.94], pre-pregnancy body mass index [(24.31 ± 2.51) kg/m2 vs. (23.25 ± 2.13) kg/m2, t = 8.94], gestational week [(39.14 ± 0.42) weeks vs. (38.92 ± 0.51) weeks, t = 3.04], fasting blood glucose [(5.15 ± 0.41) mmol/L vs. (4.75 ± 0.35) mmol/L, t = 7.97], blood glucose level during the oral glucose tolerance test at 0 hours [(5.71 ± 0.42) mmol/L vs. (5.49 ± 0.41) mmol/L, t = 3.76], and insulin resistance index [(0.54 ± 0.13) vs. (0.41 ± 0.10), t = 9.02] had a significant impact on the delivery of macrosomic infants (all P < 0.05). Multivariate logistic analysis indicated that weight gain during pregnancy, fasting blood glucose, and insulin resistance index were independent risk factors for delivering macrosomic infants in pregnant women with gestational diabetes mellitus ( OR = 1.685, 27.113, 25.816, all P < 0.05). The multivariate logistic regression model demonstrated good goodness of fit (Hosmer-Lemeshow χ2 = 10.34, P > 0.05). Based on the factors identified through multivariate analysis, a nomogram risk model was constructed, yielding a C-index of 0.742. The independent risk factors from the logistic regression model and their prediction probabilities were utilized to generate the receiver operating characteristic curve for predicting the likelihood of delivering macrosomic infants among pregnant women with gestational diabetes mellitus. The areas under the curve were 0.815, 0.779, 0.795, and 0.938, respectively. Conclusion:The predictive model established based on weight gain during pregnancy, fasting blood glucose levels, and the insulin resistance index demonstrates significant predictive value for the delivery of macrosomic infants in pregnant women with gestational diabetes mellitus.

Objective To investigate degrees of fibrosis of adenomyosis(AM)myometrium and explore its relationship with dysmenorrhea. Methods Thirty AM patients who had hysterectomy from July, 2015 to December, 2016 in Beijing Obstetrics and Gynecology Hospital were selected as AM group; 28 cases of hysterectomy due to cervical lesions(none AM)were selected as control group. The area ratio of collagen fiber in the two groups was analysed by modified Masson stain, and the expression of collagen type Ⅰprotein in the two groups was analysed by immunohistochemical method. Results (1)The degree of fibrosis:the area ratio of collagen fiber and the expression of collagen type Ⅰof AM group [(34.5±5.1)％, 0.23±0.06] were significantly higher than those of control group [(26.7±10.1)％,0.18±0.08; all P<0.05].(2)The relationship between the degree of fibrosis and dysmenorrhea: the area ratio of collagen fiber and the expression of collagen type Ⅰ in severe dysmenorrhea, moderate dysmenorrhea, and none-mild dysmenorrhea were(35.3± 4.3)％,0.25±0.05;(35.7±3.2)％, 0.26±0.06;(25.0±2.9)％,0.15±0.03, there were significantly different among them(all P<0.01). And the area ratio of collagen fiber, the expression of collagen type Ⅰ were positively correlated with the degree of dysmenorrhea(r=0.50, 0.50; all P<0.05). Conclusions The area ratio of collagen fiber and the expression of collagen type Ⅰin AM are higher than in control group, and positively correlated with the severity of dysmenorrhea. These results suggest the degrees of fibrosis might be correlated with dysmenorrhea.