To evaluate the value of S/D ratio of umbilical arteries (UA) and Z-scores of multiple ultrasound parameters in the diagnosis of fetal growth restriction (FGR) in pregnant women with gestational diabetes mellitus (GDM).

Three thousand four hundred and nine GDM women with singleton pregnancy who underwent routine prenatal examination and delivery at Jinhua Maternal and Child Health Care Hospital from June 2016 to October 2021 were selected as research subjects. Pregnant women with both GDM and FGR were used included in an observation group (35 cases), and the other pregnant women served as a control group (3374 cases). Fetal biometric parameters including UA S/D ratio, growth parameters, and Z-scores of HC, AC, and HC/AC ratio of the two groups at 28 and 32 weeks of gestation were compared, and subsequently receiver operating characteristic (ROC) curves were produced and area under the curve (AUC) values were calculated.

BPD, HC, AC, and FL in the observation group at 28 and 32 weeks of gestation were significantly decreased compared to those of the control group, and HC/AC ratio was significantly increased compared to that of the control group (P＜0.05). The UA S/D ratio and Z-scores of HC/AC ratio in the observation group at 28 and 32 weeks of gestation were significantly increased compared to those of the control group, and the Z-score of AC was significantly decreased compared to that in the control group (P＜0.05). The AUC values of S/D ratio, Z-score of AC, and Z-score of HC/AC ratio in the diagnosis of FGR at 28 and 32 weeks of gestation were 0.820, 0.984, and 0.948, and 0.855, 0.941, and 0.981, respectively.

The UA S/D ratio and Z-scores of multiple ultrasound biometric parameters can accurately and reliably evaluate the fetal growth and development, which can provide important information for the clinical diagnosis of FGR in pregnant women with GDM.