Objective  To investigate the predictive value of fetal ultrasonic parameters Z-score and umbilical artery hemodynamics indexes for pregnancy outcome of gestational diabetes mellitus(GDM).

Methods  According to the results of 75 g oral glucose tolerance test, 120 pregnant women with GDM in the observation group and 106 normal pregnant women in the control group were selected.Color Doppler ultrasonography was performed on all of them to measure and calculate the Z-score of fetal ultrasound parameters, including Z-score of biparietal diameter, Z-score of head circumference, Z-score of abdominal circumference, Z-score of femoral length, Z-score of head-abdominal circumference ratio, and umbilical artery hemodynamics indexes including systolic peak velocity/end diastolic velocity (S/D), resistance index (RI), pulsation index (PI), were analyzed and evaluated for their relationship with pregnancy outcome.

Results  The total incidence of adverse pregnancy outcomes in GDM pregnant women in the observation group was higher than that in the control group(P < 0.05).The Z-score of abdominal circumference, the Z-score of head-abdominal circumference ratio, S/D, RI and PI in the observation group were higher than those in the control group(P < 0.01).The Z-score of abdominal circumference, the Z-score of head-abdominal circumference ratio, S/D, RI and PI in poor pregnancy outcome group were higher than those in good pregnancy outcome group(P < 0.01).Logistic regression analysis showed that high Z-score of abdominal circumference, high Z-score of head-abdominal circumference ratio, high S/D, RI and PI were independent risk factors for adverse pregnancy outcomes (P < 0.05 to P < 0.01).ROC curve analysis showed that the Z-score of abdominal circumference, the Z-score of head-abdominal circumference ratio, S/D, RI and PI had high predictive value for pregnancy outcome, and the combined index had the highest predictive value for pregnancy outcome.

Conclusions  The Z-score of abdominal circumference, the Z-score of head-abdominal circumference ratio in fetal ultrasound parameters Z-core and umbilical artery hemodynamics indexes S/D, RI and PI are related to adverse pregnancy outcome of GDM, and are effective indexes to predict adverse pregnancy outcome.