探讨非贫血孕妇早孕期红细胞相关参数与妊娠期糖尿病(GDM)发生的相关性，为临床早期预测GDM提供依据。

选择2016年10月至2017年2月，于四川大学华西第二医院门诊建卡、定期产前检查、住院分娩，并且符合本研究纳入标准的3 617例非贫血孕妇为研究对象。采用回顾性分析方法，采集所有受试者的一般临床资料，早孕期(孕龄为10～14孕周)血红蛋白(Hb)水平、红细胞计数(RBC)、血细胞比容(HCT)等红细胞相关参数。根据四分位数法，将本研究受试者的Hb水平、RBC、HCT划分为4个范围：A(<P₂₅)、B(≥P₂₅～P₅₀)、C(≥P₅₀～P₇₅)、D(≥P₇₅)，分别对Hb水平、RBC、HCT处于不同范围受试者的GDM发生率进行比较。对非贫血孕妇GDM发生的影响因素进行多因素非条件logistic回归分析。

①Hb水平、RBC、HCT处于不同范围受试者的GDM发生率分别整体比较，差异均有统计学意义(χ²＝15.499，P＝0.001；χ²＝20.342，P<0.001；χ²＝26.566，P<0.001)；而两两比较的结果显示，Hb水平处于D范围受试者的GDM发生率，高于处于A、B范围受试者的GDM发生率；RBC处于C、D范围受试者的GDM发生率，均高于处于A范围受试者的GDM发生率；RBC处于D范围受试者的GDM发生率，高于处于B范围受试者的GDM发生率；HCT处于B、C、D范围受试者的GDM发生率，均高于处于A范围受试者的GDM发生率，并且上述差异均有统计学意义(χ²＝13.540，P<0.001；χ²＝8.199，P＝0.004；χ²＝7.841，P＝0.005；χ²＝10.437，P＝0.001；χ²＝13.903，P<0.001；χ²＝17.953，P<0.001；χ²＝23.490，P<0.001)。②对非贫血孕妇GDM发生的影响因素进行多因素非条件logistic回归分析的结果显示，早孕期Hb水平和HCT，为非贫血孕妇GDM发生的独立影响因素(OR＝2.297、2.097，95%CI：1.121～7.265、1.019～5.874；P＝0.033、0.019)。

非贫血孕妇早孕期不同红细胞相关参数水平与GDM发生密切相关，其中早孕期Hb水平和RBC是非贫血孕妇GDM发生的独立影响因素。由于本研究为回顾性研究，临床能否根据非贫血孕妇早孕期红细胞相关参数水平，对GDM高危人群进行监控，仍需多中心、大样本、随机对照的前瞻性研究进一步证实。

To explore the correlation between first trimester red blood cell parameters and gestational diabetes mellitus (GDM) in non-anemic pregnant women, and to provide references for early clinical prediction of GDM.

A total of 3 617 cases of non-anemic pregnant women from October 2016 to February 2017 in West China Second University Hospital, Sichuan Universtiy who met the inclusion criteria in this study were selected as research subjects. The retrospective analysis was conducted in general clinical data, and first trimester (10-14 gestational weeks) hemoglobin (Hb) levels, red blood cell count (RBC) and hematocrit (HCT) of all subjects. According to the quartile method, Hb levels, RBC and HCT of all subjects were divided into four ranges: A (<P₂₅), B (≥P₂₅-P₅₀), C (≥P₅₀-P₇₅), D (≥P₇₅), respectively. Incidence of GDM in subjects with different ranges of Hb levels, RBC, HCT were compared, respectively. Multivariate unconditional logistic regression analysis was performed on the influencing factors of GDM in non-anemic pregnant women.

①There were statistical differences in GDM incidences in subjects with different ranges of Hb levels, RBC and HCT (χ²=15.499, P=0.001; χ²=20.342, P<0.001; χ²=26.566, P<0.001). Multiple comparison results showed that the incidence of GDM in subjects with D range of Hb levels was higher than those in subjects with A and B ranges of Hb levels; the incidences of GDM in subjects with C and D ranges of RBC were higher than that in subjects with A range of RBC, the incidence of GDM in subjects with D range of RBC was higher than that in subjects with B range of RBC; the incidences of GDM in subjects with B, C and D ranges of HCT were higher than that in subjects with A range of HCT, and all the differences were statistically significant (χ²=13.540, P<0.001; χ²=8.199, P=0.004; χ²=7.841, P=0.005; χ²=10.437, P=0.001; χ²=13.903, P<0.001; χ²=17.953, P<0.001; χ²=23.490, P<0.001). ②Multivariate unconditional logistic regression analysis of GDM influencing factors in non-anemic pregnant women results showed that first trimester Hb level and HCT were independent influencing factors of GDM in non-anemic pregnant women (OR=2.297, 2.097; 95%CI: 1.121-7.265, 1.019-5.874; P=0.033, 0.019).

In non-anemic pregnant women, the first trimester levels of red blood cell related parameters are closely related to the occurrence of GDM, in which the first trimester Hb levels and RBC are independent influencing factors of GDM. Because this study is a retrospective study, whether clinicians can monitor the high-risk groups of GDM according to the levels of first trimester red blood cell parameters of non-anemic pregnant women or not, it still needs multi-center, large scale, prospective and randomized trial to further confirmed.