To investigate the correlation between the complement C1q/tumor necrosis factor-related protein 3(CTRP3), fibroblast growth factor 19(FGF-19) of pregnant women with gestational diabetes mellitus(GDM) and their adverse pregnancy outcomes, and to study the predictive values of the serum CTRP3 and FGF19 levels of the women for their adverse pregnancy outcomes. Methods: A total of 114 pregnant women with GDM from January 2020 to December 2023 were included in study group retrospectively. According to whether the adverse pregnancy outcomes occurred, these women were divided into group A(38 women with adverse pregnancy outcomes) and group B(76 women with normal pregnancy outcomes). Another 100 healthy pregnant women during the same period were selected in control group. All the women in these groups had completed the detections of the serum CTRP3 and FGF19 levels during the third trimester of pregnancy. The correlation between the serum CTRP3 and FGF19 levels of the women with GDM and their adverse pregnancy outcomes was analyzed. Receiver operating characteristic(ROC) curve was used to evaluate the serum CTRP3 and FGF19 levels of the women with GDM for predicting their adverse pregnancy outcomes. Results: The levels of serum CTRP3(0.54±0.16μg/L) and FGF19(55.48±15.61 pg/ml) of the women in the study group were significantly lower than those(0.66±0.19μg/L and 64.89±17.23 pg/ml) of the women in the control group. The CTRP3 and FGF19 levels of the women in group A were significantly lower than those of the women in group B(all P<0.05). Logistic regression analysis showed that the decreased serum CTRP3 and FGF19 levels of the women with GDM were the risk factors of their adverse pregnancy outcomes(P<0.05). ROC curve analysis showed that the area under curve of the serum levels of CTRP3 and FGF19 of the women with GDM for predicting their adverse pregnancy outcomes were 0.710, 0.724, and the area under the curve of the combined levels of CTRP3 and FGF19 of the women with GDM for predicting their adverse pregnancy outcomes was 0.789. Conclusion: The levels of the serum CTRP3 and FGF19 of the women with GDM decrease, which are the risk factors of the adverse pregnancy outcomes of the women. Both of the serum CTRP3 and FGF19 levels of the women with GDM have predictive values for their adverse pregnancy outcomes, and the combined serum CTRP3 and FGF19 levels of the women can improve the predictive efficiency.