The thyroid gland is the largest endocrine organ in the human body, which secretes thyroid hormone to participate in various metabolic activities and regulate growth and development.1 Hypothyroidism, a condition characterized by a decrease in the thyroid hormone levels, plays a significant role in pregnant women by promoting bone tissue development and regulating energy metabolism.2 It is a common endocrine disorder during pregnancy, with a prevalence of subclinical hypothyroidism (SCH) ranging from 2% to 5% according to the Thyroid Disease in Pregnancy: ACOG Practice Bulletin in 2020.3 However, scholars have yet to reach a consensus on the prevalence of subclinical thyroid diseases in pregnant women, with the majority estimating it to be between 5% and 8%.4 During pregnancy, the mother’s iodine demand increases, and the thyroid gland is in a highly metabolic state. If the body is unable to adapt to this state, thyroid function may be impaired, resulting in reduced thyroid hormone synthesis and symptoms, such as dry skin and slow reactions, which may also impact fetal development, leading to malformations, mental retardation, and other adverse outcomes, such as abortion and premature delivery.5,6 Therefore, early screening, diagnosis, and timely intervention of thyroid function during pregnancy are crucial. Identifying the influencing factors of hypothyroidism during pregnancy is also essential for reducing and preventing adverse pregnancy outcomes, benefiting both maternal health and infant health. Accordingly, this study aimed to explore the clinical characteristics of patients with gestational hypothyroidism (GH) and analyze the risk factors associated with adverse pregnancy outcomes, providing a theoretical basis for the management of patients with clinical GH.