Abstract: Objective: To investigate the relationship between the serum levels of C1q/TNF related protein 3(CTRP3) and peroxisome proliferator activated receptor γ(PPARγ) and pregnancy outcome in patients with gestational diabetes mellitus(GDM). Methods: One hundred and sixteen GDM patients were selected as the GDM group,and subdivided into the good pregnancy outcome group(78 cases) and adverse pregnancy outcome group(38 cases) according to the adverse pregnancy outcome.Ninety-three normal pregnant women with normal glucose tolerance test at 24 weeks were collected as the control group.The serum levels of CTRP3 and PPARγ were detected by enzyme linked immunosorbent assay.The Pearson correlation was used to analyze the correlation between the serum levels of CTRP3 and PPARγ,and levels of FPG and HbA1c in GDM patients with adverse pregnancy outcomes.The ROC curve was used to analyze the predictive value of serum levels of CTRP3 and PPARγ for adverse pregnancy outcomes in GDM patients.Logistic regression analysis was used to analyze the influencing factors of adverse pregnancy outcomes in GDM patients. Results: Compared with the control group,the serum levels of CTRP3 and PPARγ in GDM group greatly decreased(P<0.01),the total incidence of adverse pregnancy outcomes greatly increased(P<0.01).Compared with the good pregnancy outcome group,the levels of FPG and HbA1c in the adverse pregnancy outcome group increased greatly,and the levels of serum CTRP3 and PPARγ decreased greatly(P<0.01).The serum levels of CTRP3 and PPARγ in GDM patients with adverse pregnancy outcomes were negatively correlated with FPG and HbA1c(P<0.05).The AUC of serum CTRP3,PPARγ and combination of both for predicting adverse pregnancy outcomes in GDM patients were 0.747,0.844 and 0.901,respectively.The CTRP3 and PPARγ were the protective factors for adverse pregnancy outcome in GDM patients(P<0.01). Conclusions: The serum levels of CTRP3 and PPARγ in GDM patients are related to the adverse pregnancy outcome,and both of them have certain value in predicting the adverse pregnancy outcome of GDM patients.