Abstract: Objective: To analyze the expressions of serum microRNA-142-3p (miR-142-3p) and forkhead box protein M1 (FOXM1) in patients with gestational hypertension and explore the predictive value of FOXM1 and miR-142-3p for adverse pregnancy outcomes.Methods: 681 patients with gestational hypertension who received treatment and gave birth in in our hospital from June 2015 to June 2020 were selected as the study group.The above patients were divided into three groups according to the severity of the disease, namely gestational hypertension group (274 cases), mild preeclampsia group (218 cases) and severe preeclampsia group (189 cases); according to pregnancy outcomes, patients were grouped into adverse pregnancy outcome group (298 cases) and normal pregnancy outcome group (383 cases); a total of 700 normal pregnant women who gave birth in our hospital during the same period served as the control group; the differences in the expressions of serum FOXM1 and miR-142-3p between the study group and the control group, among different disease severities, and between adverse pregnancy outcome group and normal pregnancy outcome group were compared and analyzed respectively; logistic regression was applied to analyze the influencing factors of gestational hypertension; Spearman rank correlation was applied to analyze the correlation of serum FOXM1 and miR-142-3p expressions with disease severity and adverse pregnancy outcomes in patients with gestational hypertension; ROC curves were applied to analyze the predictive value of the combination of serum FOXM1 and miR-142-3p for adverse pregnancy outcomes in patients with gestational hypertension.Results: Compared with the control group, the expression of serum FOXM1 in patients with gestational hypertension decreased (P＜ 0.05), and the expression of miR-142-3p increased (P＜ 0.05); 24 h urinary protein, systolic blood pressure, FOXM1 and miR-142-3p were the influencing factors of gestational hypertension (P＜ 0.05); with the aggravation of the disease severity in patients with gestational hypertension, the expression of serum FOXM1 decreased (P＜ 0.05), and the serum miR-142-3p increased (P＜ 0.05); the severity of the disease was negatively correlated with serum FOXM1 (P＜ 0.05) and positively correlated with serum miR-142-3p (P＜ 0.05); the AUC of serum FOXM1, miR-142-3p, and their combination in predicting adverse pregnancy outcomes in patients with gestational hypertension was 0.714, 0.689, and 0.782, respectively.Conclusion: The abnormal expressions of serum FOXM1 and miR-142-3p in patients with gestational hypertension are closely related to the severity of the patients'disease and adverse pregnancy outcomes.