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Abstract To analyze the risk factors of the postpartum hemorrhage(PPH) occurrence of women with gestational diabetes mellitus(GDM), and to provide the countermeasure and suggestion. Methods: A cluster sampling method was applied to select the clinical date of 2984 women with GDM admitted to three hospitals from January 2021 to February 2023. These women were divided into study group(women with PPH) and control group(women without PPH) based on their 24-hour postpartum bleeding volume. The clinical data of the women in the two groups were collected. Logistic regression analysis model was used to screen the risk factors leading to PPH of the women with GDM. Results: Among 2984 women with GDM patients, there were 539(18.1%) cases with PPH. The proportions of the age ≥35 years old, pre-pregnancy body mass index(BMI) ≥24kg/m2, history of curettage, history of cesarean section, gravidity ≥2 times, multiparity, complicated with gynecological inflammation, fasting blood glucose(FBG) ≥7mmol/L, premature rupture of membranes, placental abruption, placenta previa, placenta residue, polyhydramnios, prolonged labor and HbA1c ≥6.5% of the women in the study group were significantly higher than those of the women in the control group. Multivariate logistic regression analysis showed that the age ≥35 years old, the BMI≥24kg/m2 before pregnancy, the history of curettage, the history of cesarean section, the multiparity, the complicated with gynecological inflammation, the placental abruption, the residual placenta, the polyhydramnios and the HbA1c≥6.5% of the women were the risk factors for their PPH occurrence(all P<0.05). Conclusion: The women with GDM and age ≥35 years old, prepregnancy BMI ≥24kg/m2, history of curettage, history of cesarean section, multiparity, complicated with gynecological inflammation, placental abruption, or polyhydramnios should be paid attention to, and their residual placenta should be removed timely and completely. It is also remind that the pregnant women should be control their fetal weight by controlling their diet, so as to reduce the incidence of PPH.
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