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Abstract To explore the changes of intestinal flora, vitamin D level, and glucose and lipid metabolism of pregnant women with gestational diabetes mellitus (GDM), and to analyze their values for predicting adverse pregnancy outcomes of these women. Methods: A total of 95 pregnant women with GDM who underwent routine pregnancy examinations from January 2018 to January 2021 were selected as in research group, and 80 healthy pregnant women were selected in control group during the same period. The change of the intestinal flora, the levels of serum 25(OH)D, the blood glucose indicators, such as fasting blood glucose (FBG), 2h postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS), and insulin resistance index by homeostasis model assessment of insulin resistance (HOMA-IR), and the blood lipid indexes, such as triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), of the women in the two groups were detected. The pregnancy outcomes of the women in the two groups were analyzed. Results: The proportions of intestinal enterobacteria and yeast of the women in the research group were significantly higher than those of the women in the control group, while the proportions of intestinal bifidobacteria, lactobacillus, and bacteroides of the women in the research group were significantly lower than those of the women in the control group. The levels of FBG, 2hPG, HbA1c, FINS, TG, and LDL-C, and the HOMA-IR value of the women in the research group were significantly higher than those of the women in the control group. The levels of 25-(OH) D of the women in the research group was significantly lower than that of the women in the control group. The proportions of adverse pregnancy outcomes, such as pregnancy-induced hypertension, postpartum hemorrhage, premature delivery, and puerperal infection of the women in the research group were significantly higher than those of the women in the control group (all P<0.05). The analysis of receiver operator characteristics curve showed that the intestinal microbiota, the vitamin D, and glucose and lipid metabolism levels of the women with GDM had impact on their pregnancy outcomes. The FBG and 25-(OH) D levels, and the HOMA-IR value of the women with GDM had certain predictive values for their adverse pregnancy outcomes, and the Youden index of which were 0.562, 0.517, and 0.573, respectively, the sensitivity of which were 0.842, 0.737, and 0.895, respectively, and the specificity of which were 0.720, 0.780, and 0.678, respectively. Conclusion: Compared with those of the healthy pregnant women, the proportions of beneficial bacteria in the intestines of the pregnant women with GDM reduce significantly, their vitamin D level decreases, and their glucose and lipid metabolism are imbalanced, which leads to the increase of adverse pregnancy outcomes. It is suggested that the levels of vitamin D, and glucose and lipid of the pregnant women with GDM should be detected early, and the changes of intestinal flora of these women should be paid attention to in order to reduce the incidence of their adverse pregnancy outcomes.
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