胰岛素抵抗(insulin resistance，IR)作为胰岛素敏感性降低和(或)反应性下降的状态，在妊娠期女性中大多呈现为一种生理变化。当妊娠期生理性IR进一步加重并在此基础上引发与之密切相关的妊娠合并症，称为妊娠期病理性IR。随着我国生育政策的调整和女性婚育年龄的推后，高龄孕妇日趋增多，使得与病理性IR紧密相关的妊娠并发症的发生率逐渐升高。本文着重介绍妊娠合并IR的分类及其相关疾病、评估和围产期母儿管理，以期在妊娠合并病理性IR时为临床医生早发现、早干预提供思路，从而减少与之相关不良妊娠结局的发生。

Insulin resistance (IR), as a state of decreased insulin sensitivity and/or responsiveness, is mostly a physiological change in pregnant women. When IR during pregnancy is further aggravated and causes related pregnancy complications, it is called pathological IR during pregnancy. With the adjustment of fertility policy and the postponement of women′s age of marriage and childbearing in China, the number of elderly pregnant women is increasing, which also increases the incidence of pregnancy complications closely related to pathological insulin resistance. This article focuses on the classification of pregnancy complicated with IR and its related diseases, the evaluation of pregnancy complicated with IR and perinatal maternal and child management, to provide ideas for clinicians to detect and intervene early when pregnancy complicated with pathological IR, to reduce the occurrence of related adverse pregnancy outcomes.