ObjectiveTo investigate the risk factors for intrauterine infection in gestational diabetes mellitus (GDM) based on the reaction range model (RRM).MethodsA retrospective analysis of clinical data from 573 GDM patients who underwent prenatal check-ups and deliveries at a hospital from January 2019 to January 2024 was conducted. Based on the RRM theory, univariate factors associated with intrauterine infection in GDM patients were collected through literature review and expert consultation. The incidence of intrauterine infection in GDM patients was recorded. GDM patients were divided into an infected group and a non-infected group based on whether they developed intrauterine infection. Differences in general data between the two groups were compared. Binary multi-variate Logistic regression analysis was performed to identify factors influencing intrauterine infection in GDM patients. The theoretical framework of RRM was used to validate the hypotheses regarding intrauterine infection in GDM patients. Hosmer-Lemeshow test and receiver operating characteristic (ROC) curve were used to verify the efficacy of RRM in predicting GDM complicated intrauterine infection.Results8.90% of the 573 GDM patients developed intrauterine infection. Binary multivariate Logistic regression analysis showed that history of GDM (OR=2.242, 95% CI: 1.419－3.542), coexisting polycystic ovary syndrome (PCOS) (OR=2.542, 95% CI: 1.451－4.454), coexisting sexually transmitted diseases (OR=2.894, 95% CI: 1.435－5.835), polyhydramnios (OR=1.713, 95% CI: 1.126－2.606), and glycosylated hemoglobin (HbA1c) (OR=2.869, 95% CI: 1.743－4.722) were risk factors for intrauterine infection in GDM patients (P<0.05). Based on the theoretical framework of RRM, under the influence of various factors, GDM patients entered the reactive stability stage. If the stress factors persist, stability failure will result in intrauterine infection, which was consistent with RRM and basically consistented with the research hypothesis. Hosmer-Lemeshow test was used to evaluate the goodness of fit of the Logistic regression model constructed under the RRM framework (χ²=0.874, P=0.502). The area under the curve (AUC) for predicting intrauterine infection with GDM was 0.928 (95% CI: 0.887－0.957), sensitivity was 96.15%, and specificity was 87.68%.ConclusionRisk factors for intrauterine infection in GDM include history of GDM, coexisting PCOS, coexisting sexually transmitted diseases, polyhydramnios, and HbA1c based on RRM.