Abstract: Objective To explore the effect ofabnormal glucose metabolism on pregnancy outcomes in elderly GDM women.Methods 851 pregnant women over 35 years old with GDM who had their antenatal care in our hospital from January 2017 to December 2017 participated in this research. With acknowledgement of general information on age,weight gain during pregnancy,family history,past medical history,history of gestation,and results of OGTT based on questionnaire and medical history reviewing.Participants were divided into 3 groups based on the results of OGTT,GDMa with only fasting plasma glucose abnormal,GDMb with 1 hOGTT and/or 2 h-OGTT abnormal,and GDMc with fasting plasma glucose and 1 h-OGTT and/or 2 h-OGTT abnormal. To analyze the effect of the number of abnormal result of OGTT on pregnancy outcomes,participants were divided into 3 groups. GDM1 with only 1 result abnormal,GDM2 with 2 results abnormal,and GDM3 with all of the 3 results abnormal. Collected the information of premature deliver,LGA,and macrosomia after delivery. And analysis the effect of abnormal glucose metabolism on pregnant outcomes.Results There were no difference among GDMa,b,c on age,weight gain during pregnant and birth weight of new born(P>0.05). There were no difference among GDM1,2,3 on the three indexes too(P>0.05). The rate of LGA were higher in GDMa and GDMc than in GDMb(P<0.001). The rate of LGA was higher in GDM3 than in GDM1 and GDM2(P<0.001).Conclusion The result of OGTT had effect on the rate of LGA in elderly GDM women. LGA rate in abnormal fasting plasma glucose group(GDMa) was higher. So was in GDM3 with three abnormal results. Medical advice should be given based on the result of OGTT to reduce adverse pregnantr outcomes,and promote health in both mothers and infants.