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目的:探讨孕早期体内铁代谢水平是否与妊娠期糖尿病（GDM）和巨大儿有关。方法:纳入2018年11月至2019年8月在北京儿童医院顺义妇儿医院建档产检的378例孕早期孕妇，首次产检时（孕12周内）采集空腹静脉血测定血红蛋白及铁代谢指标如血清铁、铁蛋白、转铁蛋白、总铁结合力、铁饱和度、转铁蛋白饱和度等，随访并收集GDM和巨大儿的发生率。利用Logistic回归分析孕早期体内铁代谢水平与GDM和巨大儿的关系。结果:本研究GDM发生率为16.9%，孕早期贫血发生率为2.4%，铁缺乏发生率为2.5%。Logistic回归分析显示，调整年龄、孕前BMI、糖尿病家族史、产次等变量后，铁饱和度>50% （n OR=0.238，95%n CI：0.068~0.831）、转铁蛋白饱和度>50% （n OR=0.08，95%n CI：0.010~0.677）为GDM的保护因素；铁饱和度25%~50% （n OR=0.361，95%n CI：0.143~0.908）；转铁蛋白饱和度25%~50% （n OR=0.383，95%n CI：0.165~0.891）；铁蛋白>30 ng/ml （n OR=0.418，95%n CI：0.186~0.939）为巨大儿的保护因素。n 结论:孕早期的铁代谢水平可能与GDM和巨大儿的发生相关，有必要在孕早期对孕妇进行铁营养状态评估。“,”Objective:To evaluate the association of maternal nutrition status in the first trimester with gestational diabetes mellitus (GDM) and macrosomia.Methods:378 pregnant women who took prenatal care in Shunyi Women′s and Children′s Hospital of Beijing Children′s Hospital were enrolled in the study. Blood samples were collected at first prenatal visit (50% (n OR=0.238, 95%n CI 0.068-0.831), transferrin saturation>50% (n OR=0.08, 95%n CI 0.010-0.677) were protective factors of GDM; iron saturation 25%-50% (n OR=0.361, 95%n CI 0.143-0.908); transferrin saturation 25%-50% (n OR=0.383, 95%n CI 0.165-0.891); ferritin>30 ng/ml (n OR=0.418, 95%n CI0.186-0.939) were protective factors of macrosomia.n Conclusion:Maternal iron status in the first trimester might be associated with GDM and macrosomia. Thus, maternal iron status assessment in the first trimester is necessary.