Abstract:【Objective】To explore the correlation between the levels of leptin and insulin-like growth factor binding protein 3 (IGFBP-3) in umbilical cord blood and the delivery of macrosomia in pregnant women with gestational diabetes mellitus (GDM). 【Methods】 A total of 312 pregnant women with GDM who delivered in our hospital from April 2020 to June 2023 were selected. The pregnant women were divided into Group A (macrosomia, neonatal birth weight ≥4 kg) and Group B (non-macrosomia, neonatal birth weight normal or lower than normal weight) according to the birth weight of the newborns. The levels of leptin and IGFBP-3 in umbilical cord blood before delivery were compared between the two groups. We analyzed the influencing factors of macrosomia delivery in pregnant women with GDM to explore the correlation of macrosomia delivery in pregnant women with GDM with umbilical cord blood levels of leptin and IGFBP-3. The predictive value of umbilical cord blood leptin and IGFBP-3 levels for macrosomia delivery in pregnant women with GDM was evaluated. 【Results】The levels of IGFBP-3, umbilical cord blood leptin and fasting blood glucose in group A were all higher than those in group B (P<0.05). The results of binary Logistic regression analysis showed that higher levels of fasting blood glucose, umbilical cord blood leptin, and IGFBP-3 were risk factors for pregnant women with GDM to deliver macrosomia (P<0.05). The results of the receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of the combined prediction of umbilical cord blood leptin, IGFBP-3, and fasting blood glucose for the delivery of macrosomia in pregnant women with GDM was higher than that of the single index detection (P<0.05). The results of the correlation analysis showed that umbilical cord blood leptin and IGFBP-3 were positively correlated with the delivery of macrosomia in pregnant women with GDM(P<0.05).【Conclusion】The combined detection of fasting blood glucose, umbilical cord blood leptin, and IGFBP-3 has a high predictive value for the delivery of macrosomia in pregnant women with GDM.